Three years ago, at age 45, I found a lump in my breast that would mark the end of my life as I knew it.
I am not alone: In 2020, approximately 276,000 women in this country will be diagnosed with invasive breast cancer. Most will be cured. Their treatment will challenge their bodies and psyches, and they will be left with scars on both. But ultimately, most women diagnosed with breast cancer will come out survivors and get on with their lives.
A small percentage of women, like me, will not be so fortunate. We are the roughly 6% whose cancer has already spread to other parts of our bodies by the time it’s found. Metastatic breast cancer has no passage and no cure.
“ Having terminal cancer in the midst of a global pandemic can stir up all kinds of worries: Will I get this crazy virus and die alone? Will all the clinical trials for live-saving breast cancer drugs stop? Will my doctors be too distracted to give me thoughtful care? ”
I can still see the face of the oncologist, whom my husband and I were meeting for the first time, as she uttered, “We’ve seen some abnormalities on your scans.” I remember trying to listen as she explained what this meant. She began sharing a lot of information, which my husband and I tried to follow. We held hands tightly as this oncologist whom we didn’t know explained that my cancer, initially considered small and treatable, had somehow managed to jump the fence and spread to my liver and bones. My prognosis went from excellent to unknown, but likely grim.
My future unwound right there in that cramped exam room, under too-bright lights, with a strange woman who was apparently now responsible for keeping me alive. In that moment, I was kicked into the mystery of this dangerously stubborn illness, forced to find my way.
Since my diagnosis, I have lost a lot and I have grieved a lot, over and over again. Loss, grief, assimilation. Repeat. With each cycle, different pieces of me are stripped away. Sometimes it’s physical — different breasts, a thrust off the cliff into early menopause, and the challenging side effects of never-ending cancer treatment. Then there are losses of identity and purpose, roles I have long played, or roles I thought I might play in a future I once found reliable. Living with metastatic cancer requires a persistent relationship to uncertainty, loss of control and the prospect of death.
In the beginning, this new reality was terrifying. I am the mother of two young children. It is exquisitely vulnerable, if not impossible, to metabolize the fact that I may die before they finish elementary school. Yet I recognized early in my journey that I would have to try, because to live in a constant state of fear and distress would keep me from whatever precious moments I have left with them.
During this COVID-19 pandemic, it has been said (but bears repeating) that we are all navigating frightening and uncharted waters. We are a tribal species now being forced apart during a crisis. None of us knows what the next month will look like, and increasingly, it seems we may not even know what the next year will look like. Some predictions are dire; others are steeped in denial.
Alongside this collective trembling, each of us must also contend with our own personal circumstances. Whatever stress was present before March 15 will likely be exacerbated during this time. For many, it will be economic. For many, it will be familial. For me, it’s my own brand of existential dread.
“ In order to stay balanced amid this chaos and show up for my family, I have a moment-by-moment practice of staying present to what’s right in front me — whether it’s the freckle on my daughter’s cheek as I watch her learn to read, or the moon rising over the fog, or the emerging scent of spring. ”
Having terminal cancer in the midst of a global pandemic can stir up all kinds of worries: Will I get this crazy virus and die alone? Will all the clinical trials for live-saving breast cancer drugs stop? Will my doctors be too distracted to give me thoughtful care? Will I have to change treatments, again, to something so toxic I can’t home school my children? The list goes on. My anxiety levels have risen sharply in the past month.
But at the same time, I recognize this weird silver lining of the terminal cancer experience. My baseline is ridden with so much uncertainty that I feel very prepared to handle this collective moment we’re in. It’s as if the world has joined me for a brief sojourn, and I rather enjoy feeling less alone in the topsy-turvy reality of my life.
So I walk the delicate line between life and death, and I embrace this unexpected path for the spiritual boot camp that it is. It’s not all bad — facing mortality offers a clarity of the heart that cannot be bottled or shared. It is the gift in the wound. Facing mortality also forces me to reckon, repeatedly, with the anxiety that naturally creeps into my human body trying to survive. The metastatic cancer experience is appropriately called a roller coaster. I have seen the highs when my treatment works and the lows when my treatment does not work.
In 2019, I changed treatments seven times because they were not working. That’s a lot. It’s unbelievably scary. In order to stay balanced amid this chaos and show up for my family, I have a moment-by-moment practice of staying present to what’s right in front me — whether it’s the freckle on my daughter’s cheek as I watch her learn to read, or the moon rising over the fog, or the emerging scent of spring. This practice, like all practices, takes attention and perseverance. But it also builds muscle and resilience; it has allowed me to keep my feet on the ground in the midst of tremendous uncertainty.
Someday, our collective will get to the other side of this virus. Maybe in a couple of months; maybe not until a vaccine is developed in 2021. I can see the light shining at the end of this difficult tunnel. I can feel the warmth, the relief, as we breathe free and learn to touch each other again.
But I can also feel how my path will, once again, diverge from the world of normal into the precarious world of cancer. When we are through this, I will still be here with this cancer, with this relentless uncertainty, practicing how to stay present with all the beautiful moments I have left.
Leda Dederich is a mother, educator and patient advocate based in Berkeley, Calif.
This essay is part of a MarketWatch series, ‘Dispatches from the front lines of a pandemic.’