Dilation therapy is a reality for endometrial cancer survivors who’ve undergone pelvic radiation. It’s preventative to ward off long term side effects such as stenosis, which can impact your quality of life and your medical care.
Though there’s differing opinions on how long you need to maintain it, the first two years post treatment are definitely considered essential. So after taking a break while I recovered from my hemicolectomy, I picked up my therapy schedule again – twice a week — and for the first month, everything was fine. Then, at the beginning of August, I bled after using my dilator. Twice.
The first time was nothing — a smudge on the toilet paper, the kind of thing you note and move on from. The second time, five days later, was more: a smear, bright red, fresh. That’s when I stopped being able to talk myself out of paying attention.
I know my own pattern well enough by now to know what ‘paying attention’ looks like for me. I didn’t panic in any visible way. I opened my spreadsheet and pulled the dates: dilation on the 3rd, spotting. Nothing on the 5th, 6th, 7th. Dilation on the 8th, spotting again. Ten out of ten correlation, if you’re grading on that curve. I called my clinic and emailed my doctor directly, because I’ve learned that a voicemail can sit in a queue longer than a symptom deserves to wait. My scheduled September appointment got moved forward by a month—not time to panic, but serious enough to come in early and evaluate what was going on.
Does feeling good have a shelf life?
Here’s what nobody tells you about the after — your body doesn’t know that treatment is over. It doesn’t read your chart. Common irritation as a side effect and an abnormal lesion are not mutually exclusive. Knowing that meant it felt a little like the bottom dropping out if I stopped to sit with the reality. It’s the anxiety that any cancer patient knows intimately.
I want to say I sat with the anxiety gracefully. I didn’t, particularly. I did what I know how to do — work it, turn it into tasks, convert the dread into a to-do list because a to-do list is a thing I can do something with and dread is not. But underneath all that, and the carefully worded email to my doctor, the actual feeling was much simpler and much less organized: not again. Really, not again. Even when your rational brain reasons this is nothing more than irritation, two independent primary cancers in two years will do that to you. You start wondering about the shelf life of your NED status.
Running away from the nerves
The beauty of a running habit is you can use it as a diversion. So the last two weeks have been productive, in a way that only a body given somewhere else to put its adrenaline can be.
I’ve been rebuilding my mileage since the hemicolectomy — nothing dramatic, five to ten miles a week, mostly on the treadmill. It’s slow, deliberate work, and most weeks it feels like the least interesting thing I do. Not this time. This last two weeks, it was the thing that kept me from living entirely inside my own head. There’s a specific kind of stress relief in a treadmill display counting up in tenths of a mile, and seeing your base pace inch up correspondingly.
Stronger than yesterday
I’ve also been building strength training into an actual habit, working with my coach through PrehabRx — a program built specifically for people rebuilding after cancer treatment.
That word — strength — gets used so loosely in this world. Everyone wants to tell you how strong you are for going through this, and most days I want to hand that word back — enduring treatment isn’t a strength I chose to develop. But this is different. This is literal. It’s a coach designing my program. It’s me discovering one more rep than I think I have. It’s measurable, physical strength being built on purpose. It’s moving beyond nerves of steel to muscle through anxiety, to building real muscle as insurance to underwrite my NED status.
I’m training towards my 10K in October, the Marathon Beneva de Montréal. Having a date on the calendar that has nothing to do with an oncologist has done more for how I carry the ‘after’ than I expected it to. In my two-calendar life — the medical one and the one I’m actually trying to live in — these two weeks of running and lifting sessions did the heavy lifting this time.
And then it was all fine … mostly.
My appointment happened today. 8:15 for bloodwork, 9:00 with my oncologist. It was irritation — not a lesion, not a recurrence. The word I’d been avoiding even thinking directly about didn’t apply.
I felt the relief land the way it does now — real, but with an asterisk. It didn’t erase the two weeks of low hum in the background, the checking, the rehearsing of how I’d tell people if it wasn’t nothing. It doesn’t un-happen that I’d already started running the tape of what a third diagnosis would even look like, logistically, emotionally, in terms of who I’d have to call and in what order. That tape doesn’t rewind just because this particular scare closed clean.
This is the part of survivorship nobody puts in the pamphlet: it is not just that bad things might happen again. It’s that the fear itself is it’s own recurrence, with its own triggers, its own two-week arc from first symptom to resolution. And mostly it just goes quiet for a while, waiting for the next scan, the next unexplained ache, to bring it back up to the surface.
I don’t have a tidy lesson from all of this. I said I’d live this out loud: the parts that resolve well and the parts that don’t resolve at all. This one — a scare, a scan, a shrug from tissue that’s just doing what damaged tissue does — is a truer picture of what ‘after’ actually feels like than the version where I tell you I’ve made peace with it.
I haven’t. I’ve made logistics — a new training schedule — with it. And some days that is enough.
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