Surrendering to Peace With Metastatic Cancer

Life with metastatic breast cancer is life on a tightrope. Not too long ago, I experienced a moment that resonated with my struggle to find balance. At an event for patients with metastatic breast cancer — that is, people like myself – a woman representing a helpful local organization approached me to say hello. She asked about my attendance at the event, thinking I was a health care provider or a caregiver. When I told her that I am actually a patient, she produced the pity smile/grimace that I dread seeing on friends' faces.

Fortunately, that wasn't the first time I'd seen that expression and I knew what it meant. She was rapidly cycling through what would be appropriate to say. She struggled to regain her balance.

I can relate.

There are daily opportunities to seek balance in a life with cancer. My attempts remain achievable. They are simple things like choosing to be understanding of that woman who didn't know how to respond to my diagnosis, even as I gently reminded her that many people with metastatic breast cancer look like me — no head scarf required.

Nowhere is the struggle for balance more profound than when faced with a choice between continuing or discontinuing treatment. When Senator John McCain shared his diagnosis of late-stage brain cancer, his well-wishers reminded us all that fighting cancer is the acceptable choice, as does hard-working Senator Mazie Hirono with her stage 4 kidney cancer diagnosis. Meanwhile, in the realm of metastatic breast cancer advocacy, a woman many personally know and countless others look to for hope, has openly made her choice in favor of quality of life and time with her loved ones. This woman has exhausted her realistic treatment options. I can only speculate about the difficulty of this decision when all around us is the admonition that we have let cancer win if we don't fight to the bitter end.

While there are lots of new and exciting drugs for all cancers, including subtypes of metastatic breast cancer, most of us won't be outliers. We won't be the woman I met at my local farmers' market who's been living with HER2+ metastatic breast cancer for seven years. Someday she won't be exceptional, but not yet.

So how to find the balance between what is likely to happen and what each patient hopes for: a normal lifespan without debilitating side effects? Kelly Grosklags, a therapist who spoke at Living Beyond Breast Cancer's conference in April, reminded me recently of the importance of the word "surrender" in a plea for acceptance of patients' decisions to stop treatment.

It's a powerful word. Surrender is acceptance of what is now and what is to come. It is not the same as giving up. It isn't even in the same vein. Surrender means you've decided to fully accept the future as it comes. It deserves respect.

It is worth remembering that hope and eagerness for life, tips us strongly in one direction. For me, surrendering to what is joins hope on one side, while negative emotions, like fear, anxiety, hopelessness, and treatment realities weigh down the other. The truth is that when I acknowledge what is most likely to come while not relinquishing hope and love for myself and my family, I feel an overwhelming sense of peace. Peace and hope and acceptance won't save my life — only successful treatments will do that – but with them it's far easier to find the balance needed to keep moving forward.

There was a time when I believed that surrendering meant giving up. I like to tell myself that cancer hasn't taught me anything I couldn't have learned with something less life-threatening but that doesn't mean I haven't learned anything at all. When you're faced with choices that all lead to the same outcome, the peace that surrender can bring is a worthy thing to want. May we all find it in whatever form we need.