I never want to look a gift oncologist in the mouth or take a "stable"-type CT scan with a grain of salt; however, self-preservation is a funny instinct. It can change from day to day (heck, even hour to hour) and dominate your pre-occupation or intrude into your thinking not at all. You can rationalize away the good, bad or indifferent (results) or irrationalize away the less-than-expected or the more-than-anticipated. Results from lab work and/or diagnostic scans are the axis on which your entire life revolves. You either roll with the punches or you get knocked down by them. For a cancer patient, the punches often keep coming.

The punches thrown in my direction occur bi-weekly, when I have my pre-immunotherapy lab work for my every-other-Friday 30-minute Opdivo infusion. (Although the actual lab work and even the infusion is more of a jab.) The left hook/right cross combination occurs quarterly. That's when I slide through the computerized tomography scan and wait for results (as I had been for most of the last week). Since I have generally been asymptomatic – other than for miscellaneous side effects from the various medicines with which I've been infused – the tale of the tape, to continue the boxing references, happens when my oncologist emails the radiologist's report to me with a brief sentence summary: "a little worse" (this time), "stable," or something less discouraging that needs to be discussed at our next face-to-face appointment, which generally is scheduled a week or so after the previous week's scan.

Regardless of what these mostly cryptic emails have said, until I hear exactly what my oncologist says, I am neither too high or too low. Granted, hearing "stable" is extremely encouraging, whereas "a little worse," not so much. Nevertheless, the fight goes on. Cancer treatment is a series of actions and reactions (punches and counter punches, you might even say) so how one's body reacts determines what action is recommended. I am living proof, literally. Over my nearly 11 years of treatment, I have been infused with upwards of a dozen different medicines. Once one treatment loses its luster, we change to another, hoping it will be more effective, and so on. It's science, not arithmetic. As such, any guarantees left the building with Elvis.

Being a cancer patient is not for everybody. One has to make the most of the least. It's easy to let the hard facts make you soft. Unless you find a way to be up, the cancer will take you down. Somehow, even when it's doing the worst to you, you have to be at your best. Being positive generates positivity in return. When I look at people, I try to smile so that they'll smile back (I'm being selfish, really). Do you remember George Costanza describing the look of disappointment on his mother's face when he told her he wanted to play the accordion? Like that, only the complete opposite.

When I interact with people, I don't want them to feel "poor, poor, pitiful me" to quote Warren Zevon from his song first sung in 1976. And I don't want them to see cancer either. I want them to see everything about me. I may be diagnosed with a terminal form of cancer: stage IV, non-small cell lung cancer, but I don't want to be defined by it. Just because I'm living with cancer doesn't mean it's who I am. It's what I have, that's all.

And what reminds me most that I have cancer and what challenges my reactions to it more than anything, is when I have these quarterly CT scans (and the annual MRI, too). As much as I try to fend off the possible effect on my mortality (my true sense of insecurity), I'd be lying if I said I was always successful. In truth, I'm always worried about it. How could I not be? I guess I'm not quite ready to throw in the towel. I suppose that means, regardless of what my oncologist says at our next meeting, I'm still ready to live and fight another day.