Ann Silberman

Ann Silberman

“I’m sorry, but your breast cancer has spread to your liver.” These may be the words my oncologist used when he told me that I was now metastatic, but to be honest, I can’t recall them clearly. What I can remember is the emotions: shock, disbelief, and the feeling of doom.

I knew that metastatic cancer was a death sentence. Metastasis, the thing that all women with early stage cancer fear, happened to me only four months after my treatment ended. “How could this be,” I thought. I had been stage 2a. I had no nodes. There was little to indicate that mets (metastasis) was going to be my fate.

I soon realized that “why me” is an unanswerable question. It doesn’t matter. It was me, and now my job was to live as long and normally as possible … or so I thought.

Metastatic cancer strips life away from you bit by bit. First, it takes your health. Then it takes your time, your job, and finally your future. Sometimes, horribly, it even takes your friends or family. Those who can’t deal with a diagnosis of metastatic breast cancer drop away.

Magically, you rebuild in this new world. You find kindness in people you never knew cared. Their friendship unfurls in front of you like a flag. They send cards, bring food, and give hugs. They’ll do chores, take you to treatments, and even laugh at your corny jokes.

You learn that you’re more important to some people than you ever imagined, and that these are the only people who count. They bolster you, and your spirits rise and fear dissipates.

The years since I was diagnosed haven’t always been easy, but you’ll note that I said years. Nobody gave up on me, including the most important person: my doctor. No end date was stamped on me, and progress was always expected. Some of the chemos I underwent worked for a time. Some didn’t, but we never quit.

I lost hair but grew spiritually. I felt happy that I was able to have surgery to remove the cancerous half of my liver, and sadness when cancer grew back in what was left. Battle metaphors applied: Like a warrior, I got out my gamma knife and radiated it.

I slept more than I knew a human could, but the times I was awake were simple and joyful. Hearing the laughter of my sons or the buzzing of a hummingbird’s wings — those things kept me grounded and in the moment.

Amazingly, I am now cancer-free. Perjeta, a drug that was not on the market when I was diagnosed, has done what seven chemos, three surgeries, an ablation, and radiation couldn’t. It gave me my future back. I tentatively step ahead, but I won’t forget the lessons cancer taught me.

The present is where you must live when you have metastatic cancer. The future is only a dream, and the past is vapors. Today is all there is — not only for you, but for everybody. This is the secret of life.

Ann Silberman chronicles her cancer experience on her blog, www.butdoctorihatepink.com.

Sarah Merchant

Sarah Merchant

On January 29th, 2010, I was told that I had breast cancer and that it had spread to both my liver and my sacral spine. I was 28 years old, three years out of college, with a great job and a beautiful eight-year-old son.

I’m not saying my life was perfect before the big C-bomb. We lived in a tiny two-bedroom apartment, and I worked crazy hours doing something I loved. However, at the time, I didn’t know that breast cancer would change my perspective on life.

The day I was diagnosed marked the moment that I went from being a money-oriented workaholic to fighting for my life. I lost my job — or, shall I say — I went on disability after the many surgeries, chemo regimens, and radiation treatments. But I’m not here to tell you what I lost. I’m here to tell you what I’ve gained.

I have learned to finally stand up for myself. I have learned that my health, friends, and family are the most important things in my life. But most of all, I learned to fight. I educated myself, became a breast cancer advocate, and made sure that my opinions were heard in the breast cancer community.

I volunteered for many organizations that I believed were doing real good and helping us get closer to an actual cure. I started a small volunteer-run non-profit called Beyond Stage 4 that raises funds for metastatic breast cancer research.

My diagnosis is so much bigger than just me. Though I have lost my ability to work in the career I was trained in, I never lost my passion. It’s men and women like you that inspire me to push forward every day.

I’m not saying that I don’t have my down days, days where I don’t even want to get out of my pajamas. I have probably had months where I didn’t get out of my pj’s. Grieving is a natural part of cancer, and there is nothing wrong with that. It’s a hard road to travel: always being on some sort of treatment, living scan to scan. When it comes down to it though, you just have to live.

You have to find the happiness that you were put here to find. Whether that happiness is sipping coffee on your porch, spending more time with your children, or taking that trip to Vegas. Set that goal for yourself and just push forward.

No doctor will be able to tell you how long anyone in this world has. The most important thing right now is to take care of you and to enjoy all the little moments. Like today, my slice of heaven was my 13-year-old son waking me up with a huge hug and a kiss on the forehead as he whispered, “I love you.”

Sarah Merchant documents her cancer journey on her blog, www.insertboobshere.com.

Terri Luanna da Silva

Terri Luanna da Silva

Living with metastatic breast cancer is the ultimate experience of living in the moment. It’s a reminder that all we truly have is the present. This day. This breath. This moment. When your own mortality comes knocking on the door as it did for me in 2011, the future can be a scary place. But it doesn’t have to be.

Of course, living in the moment is easier said than done. Even for someone like me with years of meditation practice under my belt and an intimate understanding of Eastern religion and philosophy. When I was diagnosed with metastatic breast cancer at age 37, I was instantly terrified, furious, and heartbroken. My mind went into overdrive as I poured through statistics and imagined worst-case scenarios. My daughter was two years old. I wondered how much of her life I would be around to see. How could I possibly live in the moment when there were so many thoughts swirling in my head and life-altering decisions to make? Are you kidding me?

But cancer pushed me into the present moment. Chemotherapy, pain, and fatigue left me unable to commit to future plans, never knowing how I would feel or what I was capable of doing until the actual day arrived. As an obsessive planner and control freak, I found this very unsettling.

Eventually, I realized how freeing it was to live in the moment. I no longer said yes to things I didn’t want to do. I didn’t stress as much about future events. I listened to my body. I started to honor my needs. I let go of the compulsion to have my days planned and instead just went with the flow, staying open to the uncertainty of life.

Now, as I continue on my journey with breast cancer, I keep coming back to the present moment. I try to be fully present with my daughter, noticing the sparkle in her eyes, her beautiful voice, and the warmth of her body as we lay together in the hammock.

I am aware of and grateful for the moments I am not in pain and have energy to go about my day. When I feel overwhelmed and fearful, I try to focus on my breath and remember that tomorrow is a new day. Anything can happen. And I often use meditation to center myself and find my inner wisdom when I’m faced with yet another treatment decision.

Of course, living in the moment isn’t always supported in our driven, multi-tasking society, nor is it always appreciated by family and friends looking to make plans. But for me, it has become an essential way of coping with the uncertainty of life as a cancer patient.

The new me understands that tomorrow is promised to no one. All we have is this moment. Right here. Right now. So I’m doing my best to be present for as many moments as I can.

Terri Luanna da Silva writes about living with breast cancer on her blog gracefulwomanwarrior.com.

Katherine O’Brien

Katherine O’Brien

I was diagnosed with metastatic breast cancer in 2009 at the age of 43. Although 90 percent of the 155,000 people in the United States currently living with metastatic breast cancer were previously treated for early stage breast cancer, that wasn’t the case for me. I was metastatic from my first diagnosis.

Getting my head around this diagnosis was challenging. Here are six things I wish I had known back then. I hope they will help other newly diagnosed metastatic breast cancer patients.

  • Understand that not all metastatic breast cancer is the same. My mom died from metastatic breast cancer in 1983 when I was 17. Mom lived for three years with the disease, and those were three very difficult years. I immediately assumed that my experience would be identical to hers, but Mom had aggressive, widespread disease. I do not. I have a minimal amount of bone mets, which have been largely stable for the past five years. And of course treatments have changed over the past 30 years. I have never had chemo and won’t have it until all of the less toxic options have failed. Some people with a low-volume of bone-only disease can do well for a long time. I’m fortunate to be one of them.
  • Remember that your mileage may vary. You may assume that a metastatic breast cancer diagnosis means massive changes, but that’s not necessarily the case. I see my oncologist every other month, but I do everything I used to do prior to having stage 4 breast cancer. I go to work every day. I travel. I volunteer. I hang out with my family. Not everyone with metastatic breast cancer can say that, but don’t write yourself off!
  • The issue is the tissue. Your pathology report holds the key to understanding treatment options. While other factors (age, prior treatment, etc.) must be considered, your ER/PR and HER2 are your guideposts. If you were previously treated for breast cancer, insist on a new biopsy if feasible. Cancers can and do change!
  • Get the help you need. If you had a headache, you would almost certainly take an aspirin. So if the stress and your emotions are overwhelming, speak up. Ask your doctor for help. There are effective anti-anxiety medications, and most cancer centers have counselors or can refer you to one in your community.
  • Find support — in person or online. Here is a listing of metastatic breast cancer support groups across the United States. There are many online groups (www.breastcancer.org and www.inspire.com are two examples) that have discussion groups for people living with metastatic breast cancer. Two associations (www.mbcn.org and www.lbbc.org) have annual conferences specifically for people living with metastatic breast cancer.
  • Take it one day at time. You can worry about what did happen or what might happen, or you can enjoy the present time for the gift it is. Stay focused!

Katherine O’Brien is a B2B editor and a board member with the Metastatic Breast Cancer Network. She also blogs at I Hate Breast Cancer (Especially the Metastatic Kind).