I don't want to self-indulge too much, but given the potentially life-changing seriousness of my upcoming Sept. 26 CT scan, I'm having a little trouble getting myself started in the morning – and throughout the day also, if you must know the truth? (I realize you all have your own lives to lead, so that last sentence-ending question was more rhetorical than actual.)

Nevertheless, if you're still reading, you're still interested, so I'll try to string together some "insightful commentary and thoughtful humor," (an original characterization of my columns) to keep you on the page. Although, given the subject of this week's column, it might be hard to tiptoe through the tulips.

The difficulty I'm having is being unable to ignore, "totally," (my mother loved to mimic the generation that popularized that word) the reality of my situation.

Typically, I've been able to maintain a relative calm and detached disposition as I go from one cancer-related thing to another. None of the tasks I must perform or the responsibilities I've assimilated into a routine (24-hour urine collection, pre-chemotherapy lab work, chemotherapy, quarterly CT scans, annual brain MRI, quarterly appointments with my oncologist) have changed who I like to think I am compared to who I was pre-cancer diagnosis, 2/27/09; despite having the weight of a "terminal" diagnosis/original "13 month to two year" prognosis on my shoulders/literally in my lungs.

To quote Popeye the Sailor Man: "I yam who I yam." (And I still don't like spinach, certainly not out of a can.)

And though I've done a pretty good job of flicking these flakes of pressure and anxiety off my shoulders like unwanted dandruff, the fact is – as with dandruff shampoo or any other personal hygiene product for that matter – unless one is diligent, vigilant and cognizant of its likely recurrence, nothing will change.

Unfortunately, cancer doesn't quite react that way. It will change and it can overwhelm even your best efforts and can cause harm not only internally but externally as well (emotionally). Fending off these emotional pressures is challenging and dare I say, presents as many problems as the growth and movement of one's tumors and the side effects of one's treatment does.

What makes my present situation feel different and a bit off-putting is that what has happened has happened after nearly five years of relative peace and quiet (I was never characterized as in "remission," by the way). It seems the possibility of having to go back, so to speak, and return to the scene of the crime – against my body/life expectancy; and moreover, having to restart the process, ratchets up the stress to previously unknown heights.

And part of me is wondering (worrying actually) if I'm up to the challenge again, emotionally and of course, physically as well; whether my body can sustain the damage it's likely to experience if we have to reload.

I use the word "reload" for a reason. Without invoking too many war metaphors, being diagnosed with cancer is like being drafted into the Army, except you have little training for the battles you're about to fight. And as much as fighting against cancer is a battle, it's more a war against attrition in which the bad guys (cancer) regularly defeat the good guys (people diagnosed with cancer). In general, the cancer experience is no picnic.

It reminds me of a long-ago M.A.S.H. episode in which the doctors operated through a particularly difficult surgical session, after which Henry (Lt. Col. Blake) and "Hawkeye" (Capt. Pierce) went outside the operating room/tent for some relief. "Hawkeye" was clearly agitated over a patient he couldn't save; Henry tried to offer him some comfort with the following words: "There are certain rules about war. And rule number one is young men die. And rule number two is, doctors can't change rule number one."

What scares me about cancer is, it follows no rules and like war, leaves devastation in its wake. I just hope I'm not about to be another causality.