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Remission

2023-08-25 · letter vlog · Hank · 6:39 · watch on YouTube

Topic: Personal life (also: Health) · mode: Personal essay · tags: heavy topic

Hank announces his Hodgkin lymphoma is in complete remission and argues that cancer is not a single binary saving throw one 'beats' but an ongoing process: lasting side effects, raised risks, a chance of relapse and permanent anxiety.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Survival odds of Hodgkin lymphoma, the D&D saving-throw comparison, the remission news and the before scan

  • ★ Hank says John has traditionally thought more about death; Hank thinks about it only in fun, silly ways, not wrestling with its implications. — 00:00:12 · John Green
  • ★★ Hank says untreated Hodgkin lymphoma has about a 90% chance of killing you within five years, and about a 10% chance if treated. (hedged) — 00:00:21 · Hodgkin lymphoma
  • ★★ Hank says his doctor, who sees cancer patients all day, finds these numbers great, but to Hank, who mostly sees people without cancer, they sound terrible: nobody intentionally risks a 10% chance of death. — 00:00:29
  • ★★ After staging showed the cancer was only in one part of his body, Hank's chance of being dead in five years was more like 5%. — 00:00:44
  • ★★ A friend who plays a lot of Dungeons & Dragons told Hank that was like a DC2 saving throw; Hank protested that the friend has seen him roll many ones. (playful) — 00:00:58
  • ★★ In Dungeons & Dragons a constitution saving throw decides once whether you are affected by a disease or poison; Hank says life is not like that. — 00:01:05
  • ★★★ Hank announces that this week (week of 21 August 2023) his doctor told him he is in complete remission from his cancer. — 00:01:14 · cancer
  • ★★ Hank says Hodgkin lymphoma, when it responds to treatment, tends to respond very well, and in his case it worked about as well as it does. — 00:01:22 · Hodgkin lymphoma
  • ★ Showing his before scan, Hank explains a PET scan shows glucose uptake; his cancer mass consumed a lot of glucose because it was dividing fast. — 00:01:33 · cancer

00:01:46 — Scans after chemo, how well treatment went, lasting side effects, elevated risks, relapse chance and anxiety

  • ★★ After chemo the mass was mostly gone, rated Deauville 2 and basically clinically not cancer; radiation then targeted any remaining cells. — 00:01:52 · chemotherapy
  • ★★ Hank says treatment went about as well as possible: no dangerous chemo side effects, little chemo thanks to radiation, and his cancer was susceptible to treatment, which sometimes it just isn't. — 00:02:10 · chemotherapy
  • ★★★ Hank says cancer treatment is no joke: he has lasting effects, perhaps for life, including pain from radiation and surgery, and he can't really lie on his left side. (hedged) — 00:02:24
  • ★★ Hank says chemotherapy has significantly raised his lifelong chances of heart and lung disease, leukemia and other cancers, as does having had cancer once. — 00:02:47 · chemotherapy, cancer
  • ★★ Hank says the highest risk is relapse: in remission you can relapse, and for him there is about a 10% chance of that in the next five years. — 00:03:14
  • ★★ Hank says all this brings another side effect, a permanent anxiety; some people may avoid it, but he doesn't think he will. (hedged) — 00:03:28
  • ★★★ Hank says the saying 'what doesn't kill you makes you stronger' is wrong. — 00:03:35

00:03:38 — Against 'what doesn't kill you'; rolling the die every day; in what sense he 'beat cancer'

  • ★★★ Hank says he most definitely did not roll a one, but cancer is not a binary saving throw: it is a process in which he rolls again every day for life without seeing the result. — 00:03:45

    “I get to like roll the die again every day for the rest of my life.”

  • ★★ Many people said 'Hank Green beat cancer'; Hank agrees in the sense that he did the hard things he was supposed to do, and that should be celebrated. — 00:04:07

  • ★★ Hank says treatment was the hardest thing he has ever done, though not that hard compared to what many people go through. — 00:04:30

00:04:41 — Is there cancer left: remission, cure, relapse versus recurrence as statistical categories

  • ★★★ Asked whether there is cancer inside him now, Hank says he is also confused: nobody knows whether cancer remains, whether his immune system will clear it, or whether he will relapse. (unsure) — 00:04:41 · cancer
  • ★★ Hank says Hodgkin lymphoma is a cancer where doctors say you can move from remission to cure, yet after cure recurrence remains much likelier than in the general population. — 00:05:03 · Hodgkin lymphoma
  • ★★ Hank explains that relapse (in remission) and recurrence (after cure) differ not in what the cancer does but statistically, by how unlikely its return is after certain periods. — 00:05:15
  • ★★ Hank says if his cancer came back in 10 or 20 years that would probably be great, because by then he guesses there will be even better treatments. (hedged) — 00:05:51

00:06:09 — A changed relationship with his body, wanting to be happy; sign-off

  • ★★★ Hank says he is still in the process, and his relationship with his body has changed forever; he will never feel the same as before. — 00:06:09
  • ★★ Hank wants to be happy that he is through treatment, that he did it and that he probably won't get lymphoma again; feeling better, sometimes almost normal, feels amazing. — 00:06:18

In the description and comments

  • ★★ The description says having had almost only good news leaves Hank waffling between expecting something terrible and feeling he shouldn't be so harmed when others had it worse: cancer imposter syndrome. — video description
  • ★★ The description says Hank is still taking time away to rest and recuperate because treatment has done a number on him physically. — video description

Threads in this video

Where the stories that moved here went next

Mentioned

Central: cancer · Hodgkin lymphoma · remission · saving throw

Also: Works: Dungeons & Dragons

Terms: the truth resists simplicity

Concepts: cancer staging · chemotherapy · immune system · leukemia · lymphoma · positron emission tomography · Radiation therapy · what doesn't kill you makes you stronger

Only in the description or credits: impostor syndrome

Also centred on remission: The Worst Things About Not Having Cancer

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