Let’s make a hard pivot

I was just getting into the headspace of starting immunotherapy this coming week when my phone rang at the end of the day last Thursday. It didn’t have call display, so I debated whether to even answer. Who would be calling me that wasn’t already in my contacts? I’m glad I picked it up.

It was a colleague of my medical oncologist, calling to tell me that the tumor board had met. Instead of moving ahead with immunotherapy, the new plan was to proceed directly to surgery. The rationale was that the lesion in my colon is small, and my other CT findings are unrelated to the bowel tumor. A successful resection should complete treatment. Good news, right?

Good news delivered as a hard pivot, after you’ve spent three weeks orienting yourself to an agreed-upon plan, feels a little like treatment whiplash. When it’s delivered by phone from someone you’ve never spoken with before, it’s even more disorienting.

So, the last few days I’ve been making the mental adjustments to prep for a new, and very close surgery date—24 April—this coming Friday. And trying not to second-guess the tumor board decision. Why it happened after the plan had been laid out, I don’t know. And I have to have faith that this new plan is the best for my tumor profile. It helps that I trust my surgeon, who introduced the robotic colectomy program at my hospital.

Who’s on first?

I broke the news to my siblings via our group chat first—prompted by my sister, who was checking in because she knew treatment was getting close. News, there’s a new plan! A video chat followed, real-time, two-way, room for questions and good wishes. Both modes mattered. The group chat was logistics; the video call was everything underneath.

A surgical timeline lands differently than immunotherapy. Immunotherapy is weeks of cycles, gradual unfolding, week-by-week assessment. Surgery is one date, one event, hard stop. It’s on a much shorter clock. I’m working with a ‘put your own mask on first’ approach—I need to adjust, and then allow my family to adapt in their own time.

Work, work …

I’m fortunate that the professional ripples of this new plan aren’t a source of anxiety. Rather, for both my clients, a hard surgery date simply means rescheduling work I’d already mapped out. Both board Presidents have been nothing but supportive—genuinely, immediately, without making me feel I was imposing. A board meeting, which would have landed mid-first-week recovery, gets rescheduled—that’s exactly when I do not need to be on a video call with twelve people walking through a meeting agenda. And I know I have their trust to cover off other commitments while I recuperate.

Graciousness doesn’t erase the real cost of moved deadlines, though. I want to honour both: the support I’ve received and the work I’m asking others to absorb. My medical needs ripple outward into other people’s calendars, and I don’t take that lightly.

A moment with a spirograph

The inclination to spiral is real, and I know my own patterns. I could spend hours running mental simulations of what the tumor board discussed, what they might have known that I don’t, and why this pivot came after weeks of orientation toward immunotherapy. None of which I can answer, and none of which changes what happens on Friday.

So instead, I’m doing what I always do when the ground shifts: I’m getting organized. This week’s spiral management looks like systems and lists—mapping out the post-op timeline, building new tracking templates, drafting questions for my first follow-up appointment, and working through what week one and two of recovery will actually look like. The practical work of preparation is how I metabolize uncertainty. It’s not avoidance—the body works while the mind settles.

And since my knee is on the mend, there have been a few runs to make sure I can burn off any unsurfaced anxiety.

Where I find community

Besides my family, my running team is another community I hold close. I broke the news via our team Slack, and the response was immediate and warm. What I didn’t fully expect was what came back: two other teammates are navigating their own cancer stories right now. One has a parent with pancreatic cancer. Another is dealing with a recurrence of rectal cancer that’s now in her lungs. We run the gamut from new runners to masters, and apparently, we are also—quietly, separately—a community of people holding cancer in our lives.

That hit harder than I expected. There’s something about being part of a community that demands long-game patience and consistency in training, and finding that the same patience and consistency shows up in how we hold each other through hard stretches. Nobody made my news the centre of anything. Nobody made theirs the centre of anything either. We just acknowledged what was happening, offered what we could, and trusted each other to keep showing up.

The Brave Like Gabe race at the end of June feels more attainable on this new timeline. Who knows, I may even run some of it if all goes well?

Time to get cooking

This pre-surgery weekend is for the unglamorous work that matters most. Pillows washed, bedroom deep-cleaned, soups batched and frozen—tomato basil, carrot, butternut squash, barley—a recovery-friendly rotation. Something is settling about preparing a clean, fed, comfortable space to come home to—it’s a nesting instinct, I suppose. ERAS protocol means an early discharge—I’ll likely be home by Monday after surgery on Friday—so my home setup needs to carry me through the early days when energy will be limited, and my diet gradually transitions from broth to soft solids to something resembling normal eating. The freezer is my friend.

Getting from here to there

The next four days are full. Tuesday morning is my pre-surgery screening clinic—bloodwork, final assessments, and the formal handoff into surgical readiness. Wednesday and Thursday are for closing the loop on outstanding work and finishing prep at home. Friday is surgery.

This pivot has been uneasy. I won’t pretend otherwise. Being told mid-orientation that the plan you’d accepted is no longer the plan, by a voice you’ve never heard before, on a phone call you almost didn’t pick up—makes for an uncomfortable patient experience, even when the underlying news is good. Tumor boards are doing the right work, but that doesn’t mean their communication skills couldn’t use some work.

But the pivot itself is positive. A small lesion, unrelated incidental findings, a surgeon I trust, a robotic approach with a faster recovery, and the prospect that surgery alone may complete treatment. Three weeks ago, I was preparing for weeks of immunotherapy. Friday, I’ll undergo a single operation with a defined recovery curve. That’s a meaningful upgrade in the trajectory, even if the path to get here was bumpier than I’d have chosen.

So: organized, fed, supported, and ready. See you on the other side.