Eleven years, six months and two weeks, approximately, after being diagnosed with "terminal" cancer: stage IV non small cell lung cancer, I have begun my treatment for stage IV papillary thyroid cancer. I'll be taking three pills a day, all at once, same time every day. The list of possible side effects are as long and scary as it presumably gets (blood clots, arrhythmia, to highlight just a few). I doubt its bluster. Likely somewhere between it depends and probably. Every patient is different of course, so what happens next – to me, can only be forewarned. It cannot be foretold – with any kind of certainty, that is.

What I've read about these straight-on effects so far is somewhere along the lines of: the cancer untreated would be worse, so pick your poison, I suppose. I didn't exactly pick, but the poison – euphemistically speaking, if not literally, which has been prescribed, arrived by mail at my home as of 1:30 this afternoon and I see no reason to wait. Gulp. Let us go forth in hope because there are no guarantees here. The guarantees left the building late Feb., 2009 with my initial diagnosis. Maintaining a positive attitude and a good sense of humor has to remain my not-so-secret weapon. Granted, wishing and thinking a thing doesn't make it so, but moaning and groaning about it will be neither productive nor prudent. It would simply reinforce a negative and as Brian Dennehy (a k a "Cobb") said in the movie "Silverado" about a completely different subject: "We can't be having none of that now, can we?"

I think the reason I'm meandering about here and in life is that I don't have a clear understanding of my prognosis yet, though I have asked. Moreover, since my new normal has only just begun, I don't have my routine down and as a result, the treatment process has not become second nature. And until it's no longer first nature, I'll be more preoccupied and cognizant of what I'm doing and why, and when I should be doing it. Primarily, this confusion/series of arrangements has to do with coordinating taking the three thyroid cancer pills with my current and pre-existing – going back 11-plus years, pill regimen which involves upwards of 60 pills daily. It's not overly complicated. It's just new, and some pills shouldn't be taken together, as is the case with the synthroid medication, the anti-nausea pill and additionally, not all pills can be taken with food, without food and so forth. I realize this isn't rocket science, but my life sort of depends on it, so it's kind of important that I pay attention to what and when I'm ingesting.

And it's this newness that is scary because it represents the great unknown – for me: Will the side effects be debilitating, life changing? Will they be treatable/manageable? Will my life expectancy once again be front and center as I wobble back and forth from lab work, diagnostic scans and follow-up appointments? Previously I sort of knew where I stood. Now, I don't really know anything. Oddly enough, having been there and done that is not as comforting as I would have anticipated.

Even though I've switched over – so to speak, from lung cancer to thyroid cancer, I can't really say I've experienced a "Serenity Now"-type moment. I'm not nearly so confident in my outcome now as I sort of was when I

only had lung cancer. Being diagnosed with a "new" cancer, 11-plus years in the presenting, hardly reassures that all is under control. I mean, what about my "incurable" lung cancer? We're not treating it anymore. Is it going to now grow and reassert itself, and if it does, will we then stop the thyroid cancer treatment? It seems that there could be a return to sender situation here where I'll be back and forth between oncology and endocrinology. I'll figure it out. I'm not afraid to ask the tough questions. It's the answers that might scare me though.