When Fear Becomes a Date on the Calendar

I have been avoiding posting an update because once I put the words out there, it makes everything feel even more real—and that reality still scares me. The June 5 appointment with the urologic oncologist came and went. When I arrived, I was asked to provide a urine sample for the urinalysis and urine culture, and then we were taken to a room overlooking a beautiful courtyard. I found myself grateful for that view. There is something tender about the way some cancer centers try to soften the edges of fear with light, trees, and open space.

That day, I was nervous and trying to hold onto every question I wanted to ask, even though my mind felt crowded with fear. My husband was my rock. He asked the questions he knew were sitting in my chest, and he kept checking in to make sure he had not missed anything. My doctor never told me not to Google. Instead, he asked whether I had read about treatment options for renal cell carcinoma. I nodded, and he gently reviewed everything anyway. There are three options: active surveillance—waiting until it grows and then doing something; renal ablation; and partial nephrectomy. He said that, considering how healthy I am right now, the best option is a partial nephrectomy. That also matched what my own research had shown. My husband offered an analogy for the latter two options that made me smile in a moment when I really needed one: renal ablation would be like zapping the tumor but leaving the trash in the kidney, while a partial nephrectomy would be like popping a pimple—getting it out. Somehow, in the middle of all the clinical language, that little bit of humor helped me breathe.

Scheduling the surgery was a little complicated because of my heavy work travel schedule and because it requires the availability of two surgeons: a urologic surgeon and an oncologic surgeon. They will work together to make sure the procedure goes well. The urologic surgeon will focus on protecting my kidney function and keeping everything intact and connected, while the oncologic surgeon will focus on removing the tumor and the margins. We agreed on August 5. It was the second available opening; the first fell during a work trip that cannot be rescheduled. It feels strange to have something this significant placed on the calendar like any other appointment, even though I know that date will divide my life into before and after.

In the MyChart portal, I have this “journey” that highlights all the tasks I need to complete before surgery. One month and 15 days to go. Ahem. The first pre-operation preparation task was completed last Friday, and there will be more for me to complete in the upcoming weeks. There is something surreal about seeing fear broken down into checkboxes, appointments, and reminders. Part of me appreciates the structure; another part of me wishes this were not a journey I had to track at all.

The procedure will be done laparoscopically, which usually means a quicker recovery than an open surgery. However , the recovery itself will still be long. He said I cannot return to remote work for three to four weeks. He said I cannot fly for at least four weeks. He explained that he will make seven incisions across my abdomen to insert the probes, with the largest one above my belly button. They will work through the abdominal wall and move around organs such as the colon and intestines to access the kidney and remove part of it. I will spend one or two nights in the hospital so they can make sure my kidney function is restored. I understand the plan, and I am grateful there is a plan—but knowing what will happen does not make it any less frightening to imagine my body going through it.

Admittedly, I am terrified. I remember how long it took me to heal from my hysterectomy, and those who have experienced this surgery warned me this surgery may require even more recovery time. I am also scared of getting an infection. After my hysterectomy, I developed a serious infection that required another surgery six months later. That second surgery was performed at a hospital that did not provide an interpreter, and I kept telling them in writing that I needed medication to prevent post-operative nausea and vomiting (PONV). They did not give me that medication, so for two days after surgery I was throwing up nonstop and in extreme pain. That experience stayed with me—not just in my body, but in my trust. I keep reminding myself that this time is different. I have the tools I need to advocate for access, and my husband has taken notes on how he can advocate for me when I am not able to. I am exploring approaches that may help me feel more comfortable about the surgery, but I can honestly say I am not there yet. I am trying to let courage and fear exist in the same room, because right now they both live in me.

I also wanted to address some of the frequently asked questions, partly because I know people care:

Why is the surgery in August? Why not get it done sooner? The tumor grows very slowly—about 1 to 3 mm per year. The amazing and resourceful renal cell carcinoma support group on Facebook was impressed that I got the surgery scheduled this soon. I had to take this opening because my next window of availability is in December, when I will not be traveling for a few weeks—and I already have an orthopedic surgery scheduled then. I know waiting can sound unsettling from the outside. It is unsettling from the inside, too. But this is the earliest realistic path forward, and I am trying to trust the timing even when my anxiety does not.

What stage are you? I admit I struggled with this question during my first round with cancer, and I find it difficult this time as well. They cannot determine the stage until the tumor is surgically removed and sent to pathology. The urologic oncologist is optimistic because it was caught very early and the tumor is very small. I am holding onto that optimism while also giving myself permission to feel the uncertainty, because both are true.

What causes this cancer? Who knows? There are a few possibilities, but my urologic oncologist cannot pinpoint anything specific in my case. That answer is hard because my brain wants a reason—something to blame, something to understand, something that would make this feel less random. But sometimes there is no neat explanation, and I am learning how uncomfortable that can be.

You can function with just one kidney, right? I know people may say this as a way to reassure me or rationalize that I will be fine with one full kidney. Technically, yes. But it still scares me. What if something happens to the good kidney and I am left with only part of the other one? The positive thing is that the tumor is located at the very bottom of my right kidney, so they will be removing the bottom portion. Still, that question/comment does not feel helpful to me. Sometimes reassurance lands differently than intended, and right now what helps most is being allowed to be scared without having that fear immediately explained away.

So that is where I am right now: trying to prepare, trying to stay grounded, trying to trust my doctors, my body, and the people who love me. I am scared, but I am also deeply grateful—for early detection, for access to care, for my husband’s steady presence, and for everyone who has checked in, listened, prayed, sent good thoughts, or simply made space for me to be honest. I do not need anyone to fix this or make it sound less scary. I just need grace, patience, and love as I move through the next part of this journey one step, one appointment, and one breath at a time.