"You can do it, look at Lance."

There is hardly a more awkward thing to drop into polite conversation than, "I have terminal cancer" so if somebody asks me how I am,  like the rest of you, I say "fine." I do sometimes run across people who know I've got cancer and who ask specifics, and in that case, I tell the truth.  I don't have anything to be ashamed of, but I like to be sure they really want to know.  If they use the word "prognosis," I spill.   I usually soften it a bit,  "I'm terminal but my doctors don't give time estimates."  That way they won't feel like I might drop dead before they've finished their coffee.

The most common response I get to that news is, "Well, don't give up, look at Lance Armstrong.  He was near death and he went on to win the Tour de France and now he's cured."  That response is so predictable it might as well enter the Cancer Cliche book, along with "New Normal" and "Battle with Cancer."

I am not here to bust anybody's hero or rip their yellow wristband off, and I know that having cancer - any cancer - is a bad and frightening thing.  But, Lance Armstrong did not only lie about performance-enhancing drugs, and did not only (cruelly) sue people who told the truth about him. Lance Armstrong, World's Most Famous and Inspirational Cancer Patient, exaggerated his cancer story too.

He admittedly perpetuated the story that he was on death's door with metastatic testicular cancer, and only by sheer grit, determination and will to live is he standing today.  But in the end, Lance was not only standing; that is for mere mortals. After "battling" a near fatal cancer, Lance comes back to win the Tour de France.  That's an amazing story.   And in creating that comeback myth, he inadvertently made it even harder for us who actually do have unbeatable cancers and are facing that hard fact, because now, hey, if Lance can do it, why can't we?

Didn't you know that overcoming cancer is merely a matter of willpower, like giving up your nightly ice cream?

In his book he asks, "The question that lingers is, how much was I a factor in my own survival, and how much was science, and how much miracle?"

It's a good question. Lance, I have the answer for you. The main factor in your survival was your luck in getting one of the most survivable cancers known to man.  You can call that a miracle if you want; all I can say is I certainly wish I'd had testicles.  (Although, I really don't know how you guys walk around with those things.)

(Quick cancer lesson:  when cancer metastasizes, it is still the original cancer.  Lance had mets in his brain, but it was still testicular cancer in his brain - I know, it seems every guy has testicle cells on the brain, right?  I have mets in my liver, but I don't have liver cancer, I have breast cancer in my liver. Although this is simplistic, it helps to know.  Type of cancer matters, even when it spreads. Some can be cured, no matter where it decides to live, and some cannot.)

Metastatic testicular cancer of the type Lance had has a poor prognosis for that type - which means he had a more than 50% cure rate.   Many men with metastatic testicular disease have a 70% cure rate, but Lance's was aggressive so he had a 50/50 shot, as he has admitted.  People who catch it early have an almost 100% cure rate.

A 50% cure rate sounds like heaven to me, although I've not a doubt it was a scary number to Lance at age 25. Personally, I would have found those odds to be excellent.  Back in the good old days, when my odds were 70% chance of survival, I never doubted I would survive.

Now though, I have metastatic breast cancer (to the liver).  It has a 0% cure rate.  The average life expectancy for me is 3 years.  Five year survival in women with mets to the liver is 8% but survival does not equate to cure.

Lance had two surgeries, one to remove his testicle and one to remove a lesion in his brain.  He did four rounds of chemo. The entire experience apparently took four months. He was diagnosed October 1996 and was declared cancer-free in February 1997, start to finish.   He is considered cured, and held up by everybody as the ultimate cancer survivor, the one who Lives Strong - the Standard Bearer for Cancer Patients, the one we should all look to for hope and inspiration.

In his book, he has allowed this myth to be perpetuated, and according to what I hear, what people have taken from that, and from what I've heard from Lance's own lips is that strength of will and determination is what it takes to survive cancer.  When somebody says to me,  "Hey, if Lance can do it, you can too" it implies some sort of failure of spirit and will on my part if I happen to die.

Which I will.   Die.   I am not going to live through this, no matter how good my attitude is, how much I want to, how much I fight.

No, I cannot do what Lance has done.  I don't have the cancer he had.

The real question is: could Lance could do what I have done?  Rather than 4 months from start to finish,  I have finished my third year in treatment.   I am on my 7th chemo and my 3rd targeted treatment.  I had 3 surgeries.   I have been on chemo for pretty much three straight years in a row, I have had half my liver removed, recovered from sepsis and c-diff pancolitis.  And, I still pick my son up from school every day, I make dinner when I can, I do chores if possible.  I am declining, I'm tired, I sleep a lot, but I manage.  I laugh with my family, I try to be with friends, I blog and I find inspirational stuff to post on facebook to try and keep other cancer patient's spirits up. I do my best without hurting anybody but while facing that fearsome reality.

I don't ride bikes or do athletic endeavors because I cannot, and in my place, neither could Lance.  Walking and breathing at the same time is hard now, as it would be even for Lance.   I would like to see Lance Armstrong, or anybody else, live in my shoes for a few days and then write about willpower and miracles and mental strength overcoming cancer.

I'm not here to beat up on Lance.  I don't care about sports, and the media has him now.  He can use this "outing" to turn into a good guy or not.  I don't care.  I'm truly glad he survived his very survivable cancer.   I am just using his name for one reason - anybody searching for Lance Armstrong and Cancer and finds this blog should know one thing:

Don't tell your terminal friend to "look at Lance" for inspiration.

We can't see him, relate to him, or be him. When you say that to us, what we are hearing is:  "My friend thinks Lance is stronger than me.  That he has more mental power than I do.  If I die, I am lacking. I just am not trying hard enough. I did it wrong.  It's my fault."  When the truth is, we were never on the same cancer plane.  He had a curable cancer.  Many of us just do not.

When we tell you we are terminal, believe us.  Validate us.   Tell us you are sorry.  See if you can help.  Don't push us away and tell us that it is survivable because some remarkable athlete survived a very survivable cancer.  It doesn't help - it hurts.  It invalidates our real and painful experience.

Lance's survival story has impacted the dying experience for many of us.   People - many people,  perceive it as a failure of strength when we don't beat cancer, as many of us cannot, no matter how positive and wonderful we are. Graves are filled with positive, strong people who died of cancer.

Remember, my friends,  it is possible to "live strong" and with a sense of humor and sense of strength - while knowing you are dying.  It is also possible to face your disease and your treatment and your death with grace.  I am doing that every day, or trying to.

Bottom line:  Living strong is not the only way to handle cancer.  Dying strong, when there is no other option, is powerful too.  And, life, Mr. Armstrong, is not all about winning and losing.  Sometimes, it is about how you play the game, even when you are destined to lose.

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