The First Question

Over the years I have had the privilege to know many, many people fighting cancer.  Young and old, male and female.  We tend to think cancer ennobles someone—makes them more than they were, somehow heroic simply by virtue of their suffering.  That is not the reality, though.  Cancer patients are just like you and me.  They may be full of hope or be mad as hell at their situation.    They are ordinary people facing extraordinary circumstances, and doing so the very best they can.

A few things link patients, though.  Part of it starts at melanoma diagnosis.  When a person first learns they have cancer, they typically get around to asking three critical questions.  The first and most significant is very simply this:  “Am I going to die?”

Of course, no doctor can predict this.  Every person, every patient is different.  And those differences aren’t readily apparent.  For some reason, some people with advanced melanoma simply don’t die from their cancer.  Several different approaches designed to stimulate the immune system result in around 5% of people living far beyond what anyone expected.  For a very few, the cancer simply goes away. 

Some people move from surgery to surgery, from melanoma treatment to treatment and stay alive for years.  They are determined to outlast this cancer, and are willing to go through anything imaginable to keep the monster away.

On the other end of the spectrum, most people whose melanoma is caught early are cured through simple surgery.  But some small percent of Stage I melanoma patients have recurrences—often with advanced melanoma.  I heard just recently of a person who had a simple, small melanoma removed and was told they had nothing to worry about.  A year and a half later they had multiple metastases in the brain and liver.

“Am I going to die?”  All we know are statistics.  Statistics tell us what has happened to a large group of people over the past several years.  They tell us nothing at all about what will happen to a particular patient diagnosed today. 

Part of our job at the Melanoma Research Foundation is to help people tell their stories.  Stories of tragic loss, and of miraculous recovery.  Stories of staring death in the face with courage and nobility, and stories of being reduced to an emotional wreck by fear and uncertainty.  Through the sharing of individual journeys, patients can find comfort, strength and, above all, melnoma community.

“Am I going to die?”  Truth be told, no-one knows the answer to that question.  The answer we can offer, though, is this:  “Whether you live or die, you won’t be alone.”  And that is not a bad thing.