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Cancer is messy...just like being a human. I'm starting to get my feet back under me (and also finally getting away from waiting for the other shoe to drop.) I've pretty much only had good news since the diagnosis, which has left me waffling between feeling like there's definitely something terrible right around the horizon, and like I shouldn't be so harmed by this experience with the experience of other people has been so much worse.

Cancer imposter syndrome?? Absolutely.

I'm still taking some time away to rest and recuperate because treatment has done a number on me physically, but obviously I feel really good and am very glad to be receiving (and delivering) good news.

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Good morning, John.

In the last few months, I have learned a lot about cancer and about myself and about, like, what it means to be a living mortal animal. Of the two of us, you are definitely the one who has traditionally thought more about death. I think about death, but like in fun lil' silly ways. I'm not like actually wrestling with the implications. But untreated Hodgkin lymphoma has like a 90% chance of killing you within five years, and it has like a 10% chance of killing you if you do treat it. My doctor, who all day long sees people who have cancer—most of them worse than mine, thinks these numbers sound great. But I go to the grocery store and mostly see people who don't have cancer and so the numbers sound terrible, like nobody does things intentionally with a 10% of death even if they're very fun.

Now, after I got staged and we knew that it was only in one part of my body, it was more like a 5% chance that I would be dead in five years, which is better. I told this to a friend of mine who plays a lot of Dungeons and Dragons and he said, "Hank, that's like a DC2 saving throw." And I was like, "Why would you say that to me!? You've seen me roll so many ones!" But also, in Dungeons and Dragons you roll a constitution-saving throw and to find out whether you will be affected by, like, a disease or a poison and then you are either affected or you are not. That's not what life's like. This week, my doctor told me that I am in complete remission from my cancer, which you might be thinking, "Gosh, that happened fast." Hodgkin lymphoma, when it responds to treatment, tends to respond very well. It worked really well in my case. It, uh, worked about as good as it does. I'll show you pictures. Here is my scan before, which I don't love looking at. This is a PET scan which shows glucose uptake, so you see like my brain is eating a lot of glucose. It's getting filtered out by my kidney at the bottom, and then the armpit, you see this big black mass of cancer that's just consuming a lot of glucose because it's dividing really fast because it's cancer. And after chemo, boom, like mostly gone. Now they call this a Deauville 2. There's still a little bit of increased activity in the lymph nodes, but that basically is clinically not cancer anymore. And then, we hit that same area with a bunch of radiation to get rid of any individual tiny little cells that are still hanging out in there.

Now this has gone pretty much as good as possible for me. I didn't experience any of the most dangerous side effects from the chemo. I didn't have to do very much chemo. It was in a really good spot for radiation which meant we could do the radiation which meant we could do less chemo. And most importantly, my cancer was susceptible to the treatment. Sometimes it just isn't and we're not even sure why. But also like, cancer treatment's no joke and I've got stuff that I'm gonna be like living with for a long time, maybe the rest of my life. I've got pain from the radiation and from the surgery over here. I can't really lay on my left side. Maybe someday I will be able to again. Because of the chemotherapy, my chances of heart and lung disease are significantly elevated for the rest of my life. My chances of getting leukemia are significantly elevated for the rest of my life. My chances of other kinds of cancer, which is just cancer in general, are all increased both because of, like, all the treatments and the scans, but also because I got cancer once and you just are more likely to get cancer again once you've had cancer once. And then most importantly, like the highest risk, is relapse. So they say that where I'm at right now is remission, and when you're in remission, you can relapse. For me, there's about a 10% chance of that happening in the next five years, and if that happens, that's something that we're gonna have to take on. And as you might expect, all that comes with another side effect, permanent anxiety. Like, I don't-maybe some people can avoid that, but I don't think it's gonna be me. They say what doesn't kill you makes you stronger, they're wrong.

So I had a DC2 saving throw. I rolled my dice, looks like I almost definitely did not roll a one. I couldn't see 'em for a long time, which was annoying. Probably, I rolled like above a 10, but this isn't like a binary thing. It's a process. I get to, like, roll the die again every day for the rest of my life. And I don't get to see what I rolled! Fun! When I posted that I was in remission, a lot of people—and this is very kind—said, "Hank Green beat cancer." And I've been, like, thinking about that and feeling a lot of different ways about it. Like, one way that people helped me understand was that like, look, I did the things I was supposed to do and it was hard, and that should be celebrated, and I agree. Like in that way, I beat cancer, like, I did the stuff, I took care of myself, I even at times was able to, you know, get up and out of bed and do things that I love. All that was very hard. It was the hardest thing I've ever done, um, and it wasn't even compared to what a lot of people go through that hard, uh, but it sucks. But the truth: Resist simplicity.

I had someone ask after I posted about this, they're like, "I'm confused. Is there any cancer inside of you now?" And I was like, "I'm also confused. Like we don't know whether or not there's still cancer inside of me. We don't know if there is-whether my immune system will take care of it on its own or if I will relapse and we'll have to do more treatment." Hodgkin lymphoma is one of the cancers where doctors will say that you can move past remission into cure. Though even after you are cured, your chances of recurrence remain much higher than the regular population. Like the difference between relapse, when you get cancer again while you're in remission, and recurrence, where you get cancer again after you've been cured, isn't like a functional difference in what the cancer is doing. It's like a statistical thing that we decide based on how unlikely it is for the cancer to come back after certain periods of time. And I kinda I wish I didn't know that. I kinda wish I just thought, "Oh, if you're cured, then it won't come back." But it might still come back after you're cured. You are-you remain at a much higher chance of getting that same cancer again, even if it's been 10 years or 20 years. It's just much much lower than it was in the first two or five years.

It's messy. It's medicine. It's bodies. And look, if it comes back in 10 or 20 years for me, that would actually probably be great because my guess is we'll have even better treatments. Different cancers are very different from each other and I feel very grateful that, probably, I have had a very short if unpleasant experience with this cancer. But also, I'm still in the process. I'm still in the journey. My relationship with my body is changed forever. It's just-it's never gonna be that-I'm never gonna feel the same as I did. Right now, I guess I just wanna be happy. I wanna be happy that I'm through treatment. I wanna be happy that I did it. I wanna be happy that I probably won't get lymphoma again. It feels amazing to be feeling better and even on some days occasionally almost normal, whatever that is.

John, I'll see you on Tuesday.