The Nexus of Reality and the Theoretical

In a few days I begin a regimen of IMRT (Intensity-modulated Radiation Therapy). I’ll go every weekday for the next nine weeks or so. I no longer have a prostate but I have prostate cancer. All they can say for certain is that the cancer cells are in my body, somewhere. As no tumor could be found in any of the scans it’s classified as micro-metastatic disease.

The radiation will be aimed at where they think the cancer cells are. Geographically speaking this would be the area where the prostate was before it was removed. Targeting this area is a judgment call based on experience, very limited research, and probabilities.

I was getting accustomed to the precision of the surgical process with all its measurements and precise outcomes. Pathology reports, like legal documents, use specific language and exact wording. Scans and tests define their results in terms of ultra sensitive measurements of millimeters and nano liters. In this latest chapter I’m learning to deal with nuanced adjectives rather than cold, clear numbers. When certainty leaves the room guessing occupies the space.

The options I’ve been given to choose from are few and none of them are really good. One of the options was to do nothing, put off making a decision. That would give me even fewer choices three months, six months, a year down the line. So to my way of thinking not making a decision is really making a decision, and not a good one.

Facing a treatment that is the result of theoretical constructs and extremely educated guesswork requires trust and a measure of faith. Trust and faith in your medical team as well as trust and faith in your own abilities to navigate the options. I’ve been wondering (usually real late at night) if I’m making the right decision. I simply don’t know, I wonder if it’s even possible to know. What I do know is that it is my decision and I own it.