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My Cancer Birthday

BY JOHN PANZA

I am 42 years old. And I have malignant pleural mesothelioma. I am told I am Stage 3. Although I have probably survived with this disease for five years or so, I am officially three years out from awareness of the disease. I have a wife, one child, four cats, two cars, and six drum kits. I have one lung. I have three cancer dates.

And I cannot decide which one to celebrate.

I am told I have time, that my cancer is not active, that I am NED (i.e., no evidence of disease), that I should live my life vibrantly, that I should cherish every moment, that I should “make new memories” with my wife and child, that I should keep working, that I should continue being me. And despite the grim prognosis for those with mesothelioma — the five-year survival rate is around 5% — I live a vibrant and pleasurable life, without complaining or mourning or self-loathing. In fact, I am often told I do too much. But I was told this before I found out I have cancer, so I consider this concern of no concern.

But one thing challenges me: a date. A number, a block on the calendar, a 24-hour period that is part of the 8,760 hours that make up a year, a number. As I sit here three years out from diagnosis, I struggle with the very notion of what three years means. I struggle with my cancer date. Yes, a lot of people have cancer. I am by no means unique. But my date is unique. It is mine. I just don’t know which date it is. The numbers, usually so absolute, fail me.

So as I sit here considering my 36 or so months since diagnosis I also struggle with something that seems benign but carries with it great meaning in my now hyper-focused life: What day is my “cancer anniversary.” That is, what day truly is my official day to mark the beginning of a new, NED year? When I celebrate my new life, what date should that be? Because people want to know how long I have survived mesothelioma, I must choose a grim unbirthday to appease them.

My date deficiency differs from the struggle I have with dates when I stumble over them while teaching, a result of chemotherapy and, my doctor assures me, being 40+ years old. No, the date I struggle with is the one that should be carved on my psyche: the day that defines my cancer, the one that defines my survival.

Like an unholy cancer trinity, I have three dates. June 1 is the day I was awoken from blackness by my surgeon and told, “I’m sorry, John. It’s cancer.” Then there is June 4, the day I watched my wife, usually stoical, crumble when in my surgeon’s office we were told that it was definitely mesothelioma and that the average survival rate is 18 months. And then there is September 4, the day I underwent a surgery that removed the patches of cancer along with my lung, my pleura, half my diaphragm, the pericardium from my heart, and my sixth rib. This after three rounds of chemo, each nine hours in length. Then there were the 27 radiation sessions that began in haste and put me back in the hospital three more times in three months.

When you are diagnosed with cancer, numbers become guides to your health or lack thereof. They define you. Statistics, survival rates, CCs of fluid, number of radiation treatments, number of days in the hospital, the number of tubes emerging from your sides, the number of pills you consume each day, the phone numbers for the local emergency clinic, your child’s age and birthday, the years you have been happily married, the sum totals on the medical bills. Your acute awareness of numbers becomes a kind of drunken numerology that belches up your destiny. Numbers swim in your head and give you that feeling when you’ve had too many despite your now sobered reality.

One number makes you taller. One number makes you smaller. Even if you hated math in school, you are now a numbers expert.

When a person dies, we look at life dates as definitive. He was born on a day. He died on a day. But that individual was biologically “birthed” way before the birth date carved into that tombstone, and that individual might have died inside days, months, or years before the end date on the coroner’s report. The dates on a gravestone are constructs. They give us, the survivors, structure. We are born. We die. Numbers rule. And those who remain behind take solace in the numbers being conclusive.

But when you live with cancer, especially an insidious, incurable one, the numbers are indefinite. And the struggle is not just with the disease and the way it has impacted those around you, but with the very notion of what survival means. Yes, having some control over numbers helps you bolster your tax refund, win at poker, save money on gas for your car, even assist your child as she navigates her math homework, but your personal cancer numerology is not so easy to fathom. It is by no means carved in stone.

I am told I am young, that the average age of diagnosis for my cancer is 70. I am a rarity, an oddity, that my cancer is itself rarefied. “The numbers don’t apply to you,” I have been told by more than one oncologist. One even told me, “You are weird.”

I was never a numbers guy. I teach in the Liberal Arts and my subject area is literature, the most numerically anemic space within the academic world. While acknowledging that the skies here in Cleveland are often gray in a depressing way, I encourage my students to embrace the grayness of life, to feel empowered when they realize that black and white are constructs. Tweedledum and Tweedledee.

So this year I will celebrate all three dates. I will embrace the inexplicable world into which I have stumbled. I will drink some beer and wine, eat out with my family, play some drums, read a bit, watch some baseball. Each of my three unbirthdays deserve my complete attention.

Born and raised in Cleveland, OH, John Panza was diagnosed in 2012 at 38 years old with Stage 3 malignant pleural mesothelioma, an incurable cancer of the lining of the lung caused by asbestos exposure. After undergoing radical treatment for the disease at the Cleveland Clinic to prolong his life, he continues to live each day as a husband, father, professional musician, and college professor.

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