The Shadow

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There is a woman whom I've never met, but who is friends with some of the same women I am friends with. She had early stage breast cancer, like me, and had a double mastectomy, like me. About a month ago, she found out that she had a mass in her liver, and now they think it's in her bones too. She is the first person in my breast cancer world whose cancer has metasticized. She may be the first person in my breast cancer world to die. She probably won't be the last.

I think most people don't understand the sharp divide between early and late stage breast cancers - I know I didn't prior to my diagnosis. Early stage breast cancer is local, meaning it occurs only in the breast, and it is highly curable - as high as 98% in some cases, according to some sources. Late stage breast cancer is metastatic, meaning it has spread to other parts of the body, and it is incurable. Chemotherapy and other interventions may be able to keep it at bay for months, sometimes even years, but eventually, metastatic breast cancer causes death. End of story.

When I learned of this reality, I was deeply shaken by its cruelty. There are few things in life that are so absolute, so inescapable, so hopeless - but metastatic breast cancer is. It still seems inconceivable to me that one day a patient can be early stage with a good prognosis, and the next day one single cancer cell breaks away from the tumor in her breast, slips through her lymphatic system, and enters her body - and now her prognosis is death. She won't know it for a long time, and she'll never know exactly when that fateful day happened, but it is as simple - and terrible - as that.

This is the shadow that every early stage breast cancer patient has to live with for the rest of her life. It is the shadow that Seth and I have begun to see darkening our horizon, which used to seem so sunny and vast. However, if I've grown to accept one thing in the last nine months, it's that we all live with shadows all around us all the time - illnesses, accidents, misfortune, unhappiness - we just don't always recognize that they're there. I'm not sad, and I'm not scared, and I'm much more aware now that the worst thing is not a life cut short but rather a life squandered. I no longer assume that I will get to live a long life - though I'd like to - but I'm determined to live a good life, however long it may be. 

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