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One year ago today, I stood at the door to my cancer centre and rang the bell.

It marked the end of twelve grueling sessions of the dreaded FOLFOX chemotherapy, from which I still suffer frustrating and permanent side effects.

At the time, I had mixed feelings about it.

Deep down, I knew that I was likely to be back in the chair at some point. The aggressive nature of my cancer all but guaranteed that.

On the other hand, there was a very minute chance that I had sat through the last session of curative chemotherapy. That I’d be on the long road to survivorship, watching cancer treatment fade into the past, was an exciting prospect.

Carrot and stick

When I undertook treatment for highly aggressive Stage IIIC colon cancer, the motivator of cure dangled tauntingly from the metaphorical stick: a beautiful, fresh carrot awaited.

It was always a long shot, but the possibility was.

In the context of cancer, knowing that cure can be achieved is a shot of willpower and adrenaline. It provides fuel for rationalizing and tolerating surgeries, treatments, and the psychological aspects of the illness.

“This might be hard, but if I get through it, I’ll be cured. It’ll all be worth it.”

It’s the ultimate embodiment of short term pain for long term gain.

Unfortunately, the carrot turned out to be rotten, the stick a weapon, and the goat listless.

C’est la vie.

A fresh crop, a new stick, and a shepherd

Since my progression in May, I’ve been struggling to put to words the undeniable mindfuckery that comes with having Stage IV cancer.

There have been more treatments: chemotherapy, radiation, and possible surgery on the horizon.

There have been new side effects: broken bones, the pain to go with, and the accumulation of various chemo-induced unpleasantries.

In spite of all of the difficult, painful, and uncomfortable realities, I have some optimism that we’ll continue to beat back the cancer enough that I can continue enjoying life for a couple of years.

Even alleviating some of the bone pain through radiation has been enough to remind me that things can improve. I was worried that I’d be forced to live out my days in excruciating pain. Instead, I discovered confidence in my palliative care team and radiation therapy.

My pain is largely under control. With the cancerous lesions in my spine defeated, my hope is that the vertebrae will heal naturally so that I can avoid surgery.

The carrot—no longer cure, but quality of life—is still a great motivator to continue forward.

On those dark days when the carrot is obscured by fog, there’s a shepherd to remind me which direction to take: my palliative care team.

The point

In the metaphor, the carrot is never actually awarded.

But that’s kind of the point, isn’t it?

That we all have our goals—our carrots—and no real guarantee that we’ll receive the rewards.

The uncertainty isn’t a deterrent. It’s a motivator.

It’s a case of the journey being more important than the reward itself.

Goals change. Paths change.

The most important thing is to keep walking.


My name is Jason Manuge. I'm an early onset Stage IV colorectal cancer survivor. You can find me on social as CancerCanuck!

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