The 'Talk': a moment no currently incurable cancer patient forgets

2014-07_Moores Warriors Team Triathlon2
Tom Marsilje after completing the running leg of his first team triathlon. Photo credit: James Cuevas.

“The Talk” is a moment that every single currently incurable Stage IV cancer patient never forgets.

The moment your doctor tells you that you have inoperable cancer.  A moment that is both searing and numbing. The mind whirling in a thousand directions as its own sense of mortality suddenly comes into sharp focus. The mind going blank as this overpowers all mental circuits.  Mental circuit breakers tripped. Fuses blown. Shock.

We’re all mortal but it isn’t something we tend to think about. It is the ultimate giant elephant in the corner of the room.  There but rarely acknowledged as we go through life. 

Until something happens in your life like the Talk.

My moment was 3 years ago this week.  I received a call on my cell phone.  An oncologist cell phone call on a Saturday afternoon?  Not a good sign.  I took a deep breath and answered.  My cancer was back. I got the Talk.

The harshest colorectal cancer chemotherapy cocktail, starting as soon as possible, was advised.

I felt great – the best health of my life!  I had been steadily training for a goal: to run my first half-marathon.  I wasn’t a runner before my cancer diagnosis.  I had recently made it up to 10 miles in my training and I was getting close to signing up for my first ever event.

Then the Talk occurred.

As my mind started to go blank from shock, a flicker of thought remained. The goal I had been working so hard towards – the half-marathon.  You would think I would be thinking about mortality.  But in that moment of shock, as my mental circuit breakers were being tripped, my blanking mind focused on worry that I would never achieve my goal.

I laced up my running shoes and ran out the door.  I might or might not live through my coming cancer battle but I needed to achieve something positive that day: something to feel alive.

Thirteen point one miles later I arrived back home. I had done it – not even losing my breath.  Diagnosis and prognosis aside, I truly felt alive.  My mind regained all function after achieving the goal.  It is hard to be in shock and panic of dying at a moment like that.  

That was three years ago.  I’m still currently incurable.  I’ve had my share of harsh chemo.  Since then I have run 13.1 miles numerous times, even more on occasion.

I have learned that getting the Talk and a dire prognosis isn’t the last day of your life.  It isn’t the end.  Like any day before the day you get the Talk is simply the first day of the rest of your life. 

It’s something I still think about when I run – 3 years later still currently incurable but still not losing my breath – only now with a few more lung tumors along for the ride.

A life I mistakenly never imagined possible during the Talk, 3 years ago this week.

Dr. Tom Marsilje is a 20-year oncology drug discovery scientist with “currently incurable” stage IV colon cancer. He also writes a personal blog on life at the intersection of being both a cancer patient and researcher “Adventures in Living Terminally Optimistic,” a science column for Fight Colorectal Cancer "The Currently Incurable Scientist", and posts science and advocacy updates to Twitter@CurrentIncurSci. This guest column appears on Diagnosis: Cancer through our partnership with Inspire, an Arlington, Va., company with condition-specific online support communities for over 800,000 patients and caregivers.


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