Can too much hope be hurtful?

My last scan was in September, and results were stable. While “stable is good” (as it means the cancer is not progressing), this one left a bad taste in my mouth. I had shrinkage at the previous check-up, and was hoping it could continue, maybe until a complete response?

Indeed, results from last scan showed that after about 6 months of stability, cancer was reducing. I started to think that immunotherapy would eventually do its job aggressively and get rid of my cancer cells. Maybe completely. I was hoping I could be among the small percentage of patients who go through a complete and durable response for metastatic kidney cancer. That I could enjoy a cancer-free life again, without pain (mostly controlled, don’t worry!) , fatigue, diarrhoea and the stress of living with a time-bomb strapped to me. So what I generally celebrate (a stable scan), became a disappointment for a while.

But with metastatic cancer, the hope of reading the magical three-letter NED (“No Evidence of Disease”) on my scan results is very small (even though it’s there, with some new and upcoming treatments). So, I decided to remain hopeful, but not put too much faith on it to avoid – another – disappointment. As Adam Stern wrote in a recent essay:

The difference between hope and delusion is just an outcome that has been inspected for truth in the light of day. I can’t shake the feeling that my fleeting bouts of optimism are actually psychological threats to be guarded against. Am I delusional to think I might be cured by a medicine that hasn’t been invented yet? No one would tell me if I were, but I worry it will hurt more in the end this way

So for now, I’ll focus on reaching stability – living with “cancer as a chronic disease” – for as long as I can, enjoying one day after the other.

Next scan in a week. The last one showed one-millimetre growth in some lung nodules, but slight reduction in some lymph nodes (this is considered as stable, even though it’s not a “no-change-stability” as I had in the past). With the next results, we should see what the pattern is.