Uncertainty of Cancer

Bob Riter is the retired Executive Director of the Cancer Resource Center. His articles about living with cancer appeared regularly in the Ithaca Journal and on OncoLink. He can be reached at

A collection of Bob’s columns, When Your Life is Touched by Cancer: Practical Advice and Insights for Patients, Professionals, and Those Who Care, is available in bookstores nationwide and through online retailers such as Amazon and Barnes & Noble. All royalties from the sale of the book come to the Cancer Resource Center.

Before you get diagnosed with cancer, you assume that it will be an unpleasant experience, but one that is pretty straightforward. One might think, “I have this type of cancer, so I will get that type of treatment.” Like getting a hernia fixed, only more serious. But cancer is filled with uncertainty and hardly anyone is prepared for it.

Patients often ask: Why did I get cancer? Will I be cured? Which side effects will I experience? Which treatment is best? Oncologists often respond to these questions by saying, “I don’t know.” They aren’t hiding anything – they really don’t know. No one does.

Uncertainty can occur because there’s so much variation in how individuals respond to treatment. You can give two people the exact same chemotherapy drugs and one will sail through without any problems and the other will feel awful every single day. One person will be cured by a particular treatment and another individual with the same diagnosis will have a recurrence within a few months. Sometimes uncertainty exists because there’s no data that specifically answers the question. For example, I’m a guy with breast cancer. There isn’t much research on treating male breast cancer, so it’s generally assumed that what works for post-menopausal women will work for me too. Entirely reasonable, but not altogether reassuring.

Even common cancers are fraught with uncertainty. Men with prostate cancer may be given the options of surgery, radiation, or watchful waiting. Sometimes the best option for a particular patient is clear. Other times, it’s a complete toss-up. Uncertainty continues after treatment is completed. The big question for most people is whether the cancer will return.

As someone who has had cancer, let me say that this uncertainty really sucks. But a change in perspective can be positive as well. I was walking my dog on a cloudy Ithaca day when she came across a ray of sunlight hitting the sidewalk. She immediately sat down, closed her eyes and relished the pure joy of sitting in the sun. That image of her living purely in the moment stays with me. And my cancer, as cancers go, was pretty good. That is, my risk of a recurrence is low, especially now that several years have passed. But I no longer feel invincible. Of course, you don’t have to have cancer to face uncertainty. It’s part of the human experience.

Several people have said to me, “Too bad you got cancer, but life is uncertain for everyone. I could be hit by a bus tomorrow.” (I’m never sure how to respond to this comment. “God willing” seems a bit awkward). Cancer and uncertainty do go hand-in-hand. It’s good in some ways and bad in others. Like many other realities, it just is and we go forward the best we can.

From the Ithaca Journal.

Click here for all of Bob’s columns


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