Since my diagnosis, I’ve had a lot of people ask me things like “Are you allowed to eat that?” and “are you allowed to drink alcohol?” I usually tell them that my oncologist told me, and I quote, “Under no circumstances should you give up chocolate or bacon” and that after one of my appointments, he said, again a quote, “You should go have a margarita now.” He’s probably embarrassed that I’m sharing this, because I doubt that’s the advice he gives most of his patients. But those of us with terminal diagnoses live in a different world than the rest of you.
Here’s the thing: a lot of what you read about cancer is information that comes from studying people with early stage cancer, not metastatic disease. It’s aimed at “curing” early stage disease, and preventing recurrence. When you already have metastatic disease, you have an incurable illness. The goal isn’t to prevent recurrence; new tumors are going to happen.
Let me say that again: for us metsters, new tumors are going to happen. The only people they don’t happen to are dead people. The only people who don’t die of their metastatic breast cancer are the ones who die of something else before the cancer gets around to killing them. As others have said, we metsters all die of or with our disease.
So, since the goal isn’t to cure us, and we know we’re going to die, what is the goal? It’s to let us have a good quality of life for as long as possible. If eating bacon and chocolate and drinking a margarita makes me happy, my oncologist sure as shit isn’t going to tell me to stop doing it, especially given the dearth of research supporting the idea that eating bacon and chocolate and having the occasional margarita is going to shorten the lifespan of metsters like me. While I’m alive, I want to live. I can abstain when I’m dead, which will be soon enough.
It’s the same with treatment decisions. Early stage disease comes with the traditional slash-and-burn treatments designed to kill every last stupid cancer cell, in hopes that your cancer will never return. Metastatic disease comes with an understanding that even if you cut out every tumor, more will eventually pop up. That’s how metastatic disease works–it spreads, that’s its MO. So, why put you through treatments that make you feel horrible, if they’re not going to cure you? That’s why you don’t get 6 weeks of radiation after your mastectomy; you get 3. In fact, you might not even get a mastectomy. You don’t get 6 rounds of chemo; you get 4. Because, again, the goal is to give you a good quality of life for as long as possible, not to cure your cancer. So, treatment for metsters is a balance, between doing things that will buy you time, and making sure that time isn’t filled with pain and puke and otherwise feeling like shit.
That’s why I’m so glib with people when they ask about whether I’m allowed to eat this or that. If cure was on the table, of course I’d be doing everything imaginable to get to cure. But cure is NOT on the table. I hate to keep harping on that, because I know it hurts the people I love when they have to face that, but it’s the truth. There is no cure for metastatic breast cancer. So, while I’m alive, I’m going to live. And that includes eating bacon and chocolate, and drinking a margarita once in a while.
As my college BFF’s mother-in-law, who died of metastatic breast cancer, used to say, “What’s it gonna do, give me cancer?”