I’ve seen 4 cancer-related doctors in the past few days, and have more appointments coming. Frank the MRI shows what the doctor who reads the scan is convinced is remaining cancer. Some of my doctors agree with that assessment, others aren’t sure. More than half my doctors want my colorectal surgeon to do a biopsy. (Due to the probably-remaining-tumor’s size and location it has to be a surgeon, not just a GI.) The shadowy tumor board hasn’t weighed in yet, and if I AM getting a biopsy they likely won’t until we have those results.

If it’s not cancer, everyone agrees I killed the little fucker and we just send me to Frank every few months to make sure it doesn’t come back. (“Sometimes They Come Back.”) But if it IS a tiny tumor of terror, there’s no consensus at the moment about a long-term plan of cancer care for me. One option is to just take on wait-and-watch, to see if it is trapped or dies on its own. Not all of my team is happy with that idea, and there are a lot of steps left before we decide to just wait-and-see with any cancer I have remaining.

Even so, it’s increasingly clear to me that what focus and energy I have now may be as good as things get. We had at one point thought I could be fully recovered from chemoradiation as soon as October, but that’s been pushed back to April 2025. My body seems to be having a lot of trouble keeping my electrolytes balanced, and while I am no longer at dangerously low levels, even supplements aren’t bringing it up to where my team wants me to be. We may find a fix for that over the next 9 months, or it may fix itself. Or… it may not.

Truth is, this may be as good as I ever feel again, and even if it’s not it’s likely I‘ll never have the levels of energy and focus. There’s also a risk (not yet a BIG risk, but a risk) that the decision will be made to put me on chemo again. But it won’t be the chemo I tolerated for 10 months over the past year-plus. No, this would be a much harsher chemo, that has as possible side effects things like permanent neurological damage.

So not only may this be as good as I ever feel, in the long-term its possible my productivity and even quality of life will be lower than it is now. That means I can’t keep putting things off until my cancer is gone, especially with my career. I need to manage to do more work. And, yes, friends, fans, and colleagues have gone to great lengths to make sure I know everyone understands my limitations. Tons of folks have done what they can to help me make ends meet, but the bundles and kickstarters and charity products only go so far. Unless someone steps up every couple of months to put together a new mega-bundle for me, I have to manage some income on my own.

Not only is cancer treatment itself expensive, I’ve now been mostly or entirely out of work for 18 months. Any further recovery is in a timeline of months, and may never be better than now. I need to move forward with plans for ongoing income, and that means working. I have seen what happens to ttRPG designers if they can’t work for too long. They drop out, and for the most part never return. Some drop out of this industry intentionally, and I can’t blame them.

Some burnout, and just never want to try design work again. But some just can’t find the job, fanbase, or opportunities they need to stay in, and fade away. Many of those people are great designers, and their departure is a real loss for the rest of us. I don’t hold myself in their ranks, but I have things I still want to get done

When I was diagnosed with cancer, several survivors and medical professionals told me fighting it would be a full-time job, and it’s been all of that and more. But I can’t let that be a full focus anymore. With luck, I will recover more or even entirely to pre-cancer levels. But that’s not the most likely outcome. I am 100% going to beat this thing, but I can’t pretend the battle may not leave some pretty nasty scars. And not the cool through-one-eye-that-turns-white-and-lets-you-see-the-spirit-world kind of scars. Man, it’s like every heroic story I ever read lied to me about how likely you are to get superpowers when you are exposed to radiation during a lightning storm.

For now, “more work” has to be projects of my own, or very short pieces of work. Until I have a better idea what my remaining health issues are and how we’re going to treat them, it’s not fair or ethical for me to take on big projects that involve other companies or people. I can’t be sure I can see a 20,000 words freelance project through, and given how public I am about my cancer and mental health, it seems super unlikely anyone would hire me on-staff atm. (I have tried, but no one even gives me an interview or non-form-letter response these days.)

And, I have work that’s long overdue, and work I owe people. So, I’ll try to focus on short projects and getting old things off my embarrassing overdue list, and see if I can make enough money to keep the lights on. And, as my medical situation clarifies—which should just be a couple of weeks, but I have said that before and had it be months—I’ll re-assess and re-plan.

meanwhile, every little but of support helps.

https://www.gofundme.com/manage/help-owen-kc-stephens-fight-cancer

I don’t want it to be too grim, so here’s an #OwenCat pic to go with.