It was my best summer in years but it had to come to an end.  My end of summer CT-scan showed tumor growth – no surprise there – I had been off chemo for almost four months.

It was time to reenter the world of treatment.

The first time back to treatment always hits abnormally hard.  The period of time preceding it tantalizingly had returned me to "normal life" hyper-charged through the prism of Stage IV cancer.

This summer, my life was no longer filled with doctor's appointments and treatment schedules.  By side effects and efforts to manage them. Instead, life was ruled by more standard priorities.  I felt like I had rejoined the rest of society – a temporary glimpse back in time to my pre-cancer life.

The last workday of my chemo holiday was spent working on my experimental personalized immunotherapy project.  A day of trying to take command of my disease, using every piece of experience and knowledge I could muster.  A day of empowerment infused with hope in the possibilities of a research breakthrough.

Then Monday morning, I was sitting in a 5x10 exam room, a patient like any other, preparing for my impending chemo infusion.  A fellow Stage IV friend joined me for my infusion.  I was grateful for her company.  Perhaps a less joyful band of sisters and brothers reunion than I described last summer but just as meaningful in its own way. At that moment in time, I was at my most vulnerable, perhaps more so.

Arriving home afterwards began a week of blurriness – a much rougher infusion than normal.  It was hours upon hours of continuous sleep and nausea punctuated by glimpses of hope. Brief forays out of my bedroom that gave a hope lifeline that better treatment days may lay ahead – not only for me but for other Stage IV patients as well.

Tuesday, I mustered the energy for a quick lunch with two fellow patients who have responded fabulously to cutting edge immunotherapy treatments. Wednesday, during moments of mental clarity, I helped coordinate immunotherapy help for a close friend whose chemo is now failing. Thursday, I gave a blood sample for lab experiments related to my own immunotherapy hope.  A blood draw followed by a quick drive back home to return to bed: time for my 11 AM nap.

I honestly have few memories of last week – it is largely a void of chemobrain amnesia. A blur of sleep and nausea. The things I can clearly remember? Those brief periods of hope.  That lunch with immunotherapy success stories, their own hopes obtained.  The slight glimmer of hope heard in the voice of the friend I had helped.  The hope I felt myself as my blood was drawn – not for chemo but for future treatment possibilities.

These brief glimpses, coming during a dark week, filled my return to chemo life with hope. Throughout the cancer world, patients are currently living with hope – in research or otherwise.  Without hope, none of us – cancer survivors or otherwise – would truly be alive.

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 850,000 patients and caregivers.

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