Survivor, surviving, or treading water. Which am I? Am I a cancer survivor or still a cancer patient? They are completely different orientations with different mindsets. The treatments and therapies designed to kill my cancer are over, but it’s Schrödinger’s Box — we don’t know if all of my cancer is dead or alive until we look inside my “box.” My doctors won’t look until my PSA does something wonky. It’s a calculated unknown. Dormant cancer cells can be nudged awake by matters like metabolic changes, and what was “dead” is now “alive.”
Some people think of themselves as survivors every day they’re alive. This is a prudent way to live. If we are never going to know for sure that all of our cancer is gone, why not focus on living as well as we can, instead of twisting ourselves into worry pretzels over everything that might go wrong?
I could assume that because no more treatments are scheduled that my cancer is gone. Does this automatically make me a survivor? Am I technically cured or simply theoretically cured? And if I am a survivor, why hasn’t my oncologist moved me over to the Survivorship Clinic?
I know what “cured” and “survivor” mean in real life, but what do they mean in a medical setting? Do doctors even use these terms? After all of the reading I’ve done about other people’s cancers, my feeling is that once you have cancer, there’s always the chance that it will come back, which makes “cure” a relative term.
Whenever I’m tempted to declare that I’m cured, to say that I’m a survivor, I feel the itch to attach a footnote that says, “for now.” My aggressive cancer has a high risk of metastasizing, which means that if any cancer cells remain, they can easily move into my bones or lymph nodes and, before I realize they are percolating, my Stage 3 becomes Stage 4. Having cancer, and getting bad news after bad news as the diagnostic steps went on and the side effects of the treatments accumulated, made me feel a bit like Job, wondering what was going to go wrong next.
One of the uncertainties is not knowing what criteria my doctors use to determine when someone is cured, and this may differ for each kind of cancer. When I was diagnosed, I had the notion that if I had two years of good PSA results after my treatments ended, then I could consider myself cured. But my oncologist talked about a period of five years after. Then I saw a survivorship chart posted on the MD Anderson Cancer website that said for men with aggressive prostate cancer, and whose Decipher and Gleason scores were high like mine, that the countdown doesn’t begin until two years after treatments end and there have been no PSA blips, so I might have to wait another year before my countdown of five years of waiting begins. So seven years total, which is a long time to try not to think about cancer lurking in my dark recesses.
I won’t kid you, it’s been rough wondering every day if my cancer was going to start up again. Yet believing that I am surviving cancer gives me an emotional boost.
As my treatments went on, I was able to find reassurance and create order in cancer’s sandbox by making connections to people who understood cancer. When any of us sit down with another person with cancer, and if we are truly listening, we take their suffering into our body. We feel their pain, loneliness, fear, and anguish. There we connect own experiences of suffering with theirs, and out of this, words of compassion and hope rise and fellowship develops.
Unfortunately, there is no test that can prove my, or anyone’s, cancer is gone. The most accurate scan my oncologist has is the PSMA-PET, and while it is good at locating small groups of cancer anywhere in the body, it can’t pick up individual cancer cells. We will do blood tests every couple of months. If my PSA rises too quickly, or rises two points over its lowest point, then I think we’ll begin salvage radiation to take care of the residual cancer, and maybe chemotherapy or a targeted therapy drug that can prevent the cancer from taking root. At that point, a cure would no longer be possible, and I would be on maintenance for the rest of my life. Some of the friends in my cancer support group are in this situation. “Surviving” then would be a more accurate term than “survivor.” To me, “survivor” says that the danger is gone forever and I never have to worry about it again. Cancer seldom affords any of us the luxury of saying this.
Cancer is brutal. It’s also quite feral, and something inside me shifted because of it. I have a renewed desire to not put off celebrating life in order to get more work done. Work can wait. Today is a new day and I want to celebrate everything that is good.
I am surviving cancer, and I will be until my doctors say otherwise. Yes, there is now a door in my room called Death, but cancer is really not about dying. It’s about finding a new way to live.
© 2026 Mark Liebenow
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