For years, I have remembered the moment the lab tests showed I was worse than the previous week. I was sitting in an examination room, listening to my oncologist discuss my results. Crinkling paper was the only noise in the room, and I could feel my heart beating faster. My oncologist’s expression did not give away whether she was worried. I could not tell. If she was worried, she was better at hiding it than I was.
That difference felt huge to me.
Here is what many patients wish they were told, but cannot find out, and desperately need to learn: chemotherapy does not follow a linear path upward. Chemotherapy will never follow a linear path upward. No matter how well designed the treatment plan is, no matter how skilled the oncology team is, and no matter how good the chemotherapy regimen is, there will be periods when progress slows down or may appear to go backward. Lab test values fluctuate. Tumors grow and shrink in ways that do not give clear proof of response. The human body does unpredictable things because of both disease progression and treatment side effects. On Tuesdays, failure appears. By Fridays, success often seems possible again.
The oncologist knows this. The patient, understandably, does not.
And that gap, between what one person knows and what the other is living through, is where fear comes to live.
I have experienced the situation above from both perspectives. As a surgeon, I watched patients search for answers to what they believed I knew but refused to reveal. As a patient, I have asked my doctors similar questions. I know what it feels like to look at a number printed on a sheet of paper and think, “This is the beginning of the end.” But based on decades of treating patients, I also know that numbers rarely mean what patients think they mean, not immediately, and certainly not by themselves.
A person’s need for reassurance is valid. Let me be very clear about that. A person’s need for reassurance should not be dismissed. Your body is under attack, and your physicians are using weapons meant to kill cancer cells, while also hurting you in different ways. Because of that, reassurance matters. It is not weakness. It is part of getting through this. You need to know that someone with more information about your case does not see hopelessness where you see it.
That need is basic to being human. It is normal. It is reasonable. It is healthy.
But reassurance can become a trap when you hold onto it too tightly.
Once every lab result, every MRI or CT scan, and every new symptom becomes a verdict, you stop seeing a battle and start seeing only the immediate fight in front of you. Skirmishes are disorienting. The ground changes. Yesterday’s progress can feel lost today. Good days and bad days can arrive without warning. From where you are standing, in the middle of it all, everything can look chaotic and grim.
Cancer treatment teams understand that a war gets fought on more than one front at the same time. Oncologists track overall tumor response across treatment cycles, not appointment to appointment. They look for patterns over weeks and months, not only at the latest data point. When an oncologist says, “I am not concerned about this right now,” she or he is looking at the whole picture, not just the small part you happen to be standing in at that moment. There are many examples of people whose lab results dropped sharply in cycle 6 and who still went on to complete remission. Your oncologist has seen those cases. You have not, yet.
So ask about them. Ask your oncologist directly: is this one piece of data, or is it a pattern? Ask: what would you want to see over the next couple of weeks to know that we are still on the right path? Ask: please help me understand what treatment failure would look like, so I do not mistake fear for fact.
Asking those questions does not mean you are difficult or unwilling to listen. It means you want to work with your healthcare team and make informed decisions about your cancer treatment.
There is another issue I want to address, and I want to address it from my own experience with cancer, not from a medical text. The fear that your treatment plan is failing, even when the evidence is still unclear, reaches far beyond lab results. It touches your sense of control, your identity, and the story you told yourself before cancer entered your life. Once cancer changes that story, every setback can feel like the end of everything. Every bad result can seem like proof that your worst fear is coming true.
Acknowledge that. Sit with it. Do not let that fear push you into uninformed medical decisions.
Your oncologist is fighting for you. Your oncologist is also fighting with limited tools against a disease that does not always move on schedule. Your oncologist needs you to keep fighting alongside her or him during the uncertain stretches, not because your fears are unreasonable, but because this battle takes persistence. Bravery is for moments. Persistence is for the long middle.
If you are sitting in that room right now, on paper that crinkles every time you move, and looking at a face you are trying to read:
Breathe.
Ask questions.
Demand honest answers.
Accept that honest answers may include uncertainty.
Remember, one skirmish does not define the battle. One bad week does not define the war. The struggle you are in is larger than this moment, and the people beside you have not stopped fighting either.
If you want more support and educational materials, compassionatevoices.org offers stories and resources for people affected by cancer.
