Today is my anniversary of the last day of post surgical treatment for breast cancer and the first of 1,825 doses of drug therapy.   Since I popped that first pill, this morning ritual has become a moment of looking forward to the last pill, to be taken at the end of five years of Tamoxifen.  That day will also be the day I plan to cast off the job title of patient and strap on “survivor.”  It is 365 days from today.

Will I feel any different on that day?  Will I feel relief?  Will I feel any sense of recovery?  Will I be free of the fear of cancer’s return?

Yes I will feel different on that day.  I will have fulfilled my commitment to myself, to my husband, my children and my friends that I would dutifully fight the disease.  I will stop thinking of myself as a patient, as I do now, saddled with this question mark, straddling in my own sort of purgatory like these years have been my penance.  I shouldn’t feel that way, it is not like I sinned and cancer is my punishment, but I do. That uncertainty about the cancer is always with me.  At five years, I hope I will feel entitled to put that sense of uncertainty away.  It is like waiting for that phone call to come:  “Did I get the job?”  “Am I pregnant?“  “Was I admitted?”  I hope that day will give me an answer.

The biggest surprise about the post surgical period has been the challenges posed by the drug therapy.  I never thought it would present so many difficulties.  The rapid descent into menopause I anticipated, along with a little weight gain, a little hair loss.   After several years on the drug, however, I began to experience joint pain.  First it was minor and then it started to intensify and move around, from ankles to knees to shoulders, to the elbows until it finally attacked my hip and spine and made me give up active sports.  Then I developed symptoms of endometrial cancer – the first biopsy was indeterminate so a D&C was required to finally show no evidence of disease. The drug that so aptly depresses estrogen in the breast stimulates estrogen in the reproductive system and caused the symptoms.  Do I even need to mention how utterly frightening that was? 

There is a woman I know whose cancer occurred at the same time as mine; our cases were strikingly similar.  She opted to forego the Tamoxifen and has done quite well.  Good for her.  For me, I simply couldn’t have lived with that gamble.

So the countdown has started and I think that I am giving it more than its fair share of emphasis.  The psychology of patient is a difficult one to live with:  I have cancer, I am undergoing treatment, I will…survive?  The psychology of survivor is one to live with, it is one to embrace:   I am alive, I have made it, I will live.

Tomorrow, it is just 364 days until “survivor.”