When timelines collide

The thing about managing multiple primaries, I’m learning, is that overlapping timelines are unexpected triggers. I’m POD14 — 14 days post right hemicolectomy — solidly on a recovery timeline, albeit slower than I expected. And at the same time, my social media is serving me memories of starting chemotherapy two years ago for my endometrial cancer. That intersection has me feeling unsettled in a way that isn’t simply waiting for pathology results. It’s more of a reckoning with just how much my body has been through, and is still processing. Today, that feels like a lot.

The waiting is the hardest part

Ask any cancer patient, and they’ll tell you that waiting is the worst. You wait for appointments, for scan results, for pathology reports — and then rinse and repeat. You learn to manage the highs and lows of the pattern, but the anxiety is never far away. Before my most recent diagnosis, I was moving from 6- to 12-month monitoring for my endometrial cancer. It felt like progress. I could feel myself breathing a little easier.

Now, working to compartmentalize my anxiety about my pending surgical pathology while being reminded of my anxiety about starting chemo makes that effort so much harder. It doesn’t help that I navigated chemotherapy pretty much intact, because the sense memory is of the unknown and that anxiety, not the successful outcome. The body remembers the before, not the after.

Coping strategies

My instinct when facing uncertainty isn’t to sit with it—it’s to research my way through it. Understanding my pathology scenarios, knowing the treatment landscape, having questions ready for my oncologist—none of that makes the anxiety disappear, and sometimes it surfaces new things to worry about. But it gives the anxiety somewhere to go. My research is often deeply clinical—one of my doctors told me I know more about my case than most residents—and can take me down rabbit holes. I’ve made peace with that.

But research only goes so far. I’ve also reached out to my clinic to find a peer mentor—someone who has navigated multiple primaries. I don’t know what that conversation will look like, but sometimes what you need isn’t information. It’s someone who has simply been there.

Managing complexity

This is where holding the reality of two primaries gets complicated. I’m realistic about my pathology scenarios: hoping for a profile that means surgery is the endpoint, but preparing for one that leads to treatment based on the high-risk factors I already know.

I don’t hate the idea of further treatment, but I have specific goals if it becomes necessary: preserve future lines given my Cowden-like syndrome, and manage toxicity in light of my past treatment. That combination points to immunotherapy, but it’s going to take advocacy if that’s where we land, because what’s covered doesn’t always keep pace with the science.

There’s also a cross-tumor argument. For someone with my molecular profile, immunotherapy may offer a guard against endometrial cancer recurrence. When you’re managing two primaries, a treatment that addresses both simultaneously isn’t just efficient—it’s strategic.

I’m not there yet, but I’m thinking ahead, and grateful that my medical oncologist is a partner in that work. She’s been part of my team since I was first diagnosed, so she holds my complete cancer history. Even better, her research includes optimizing treatment for patients with GI and gynecologic cancers.

Still here

Three weeks from now, I’ll be sitting with my medical oncologist, pathology in hand, mapping the path forward. I’ll be prepared, I’ll have my questions ready, and I’ll have done the research. What I can’t prepare for is the feeling of sitting in that chair again—the particular mix of dread and hope that no amount of preparation fully touches.

Until then, I’m walking. A little further each day, finding joy in exploring my neighbourhood at a different pace. I’m working towards my 5K in June, which I plan to walk rather than run, and calling that reframe its own kind of bravery.

The body that has been through a lot is still moving forward. Some days, that has to be enough.