The other day I was talking to a friend who is a few months into a rare form of cancer of the appendix. She was second-guessing some of her treatment decisions. She wondered about her prognosis, since most of the relevant studies had been done on much older patients. And she desperately wanted to know if she would live to watch her two young daughters grow up. Finally she asked me point blank: “When does the uncertainty end?”
I didn’t have the heart to give her an honest answer: it can a long time.
This is one of the hardest truths about getting cancer. Few of us leave treatment with a certificate proclaiming “You Have Been Cured.” Our doctors rarely know if they have killed all the cancer cells yet. And so we begin the dreadful period of watchful waiting—when no one can tell us if we will survive the cancer or not. We just wait and see.
Having this cloud of uncertainty hanging over your head is difficult at any age, but it is especially hard on young adults.
Cancer enters our lives right when we feel most invincible. We can party all night. We can run marathons. We can power it out at work. We can recover fast when we stumble. And when we look into the future, we can see distant, unbroken horizons.
Cancer shatters that confidence.
First we lose our faith in our bodies. We thought we could count on them to do anything we wanted, but then we find out they betrayed us. One young survivor I spoke to said he felt perfectly healthy when he went for a routine physical before he and his wife started trying to conceive a baby. Three minutes into the exam, his doctor said, “You have a serious problem.” It turned out to be advanced testicular cancer. “You thought you were healthy, but then someone tells you, ‘No, you are very, very sick.’ Every pain, every twitch after that is terrifying.”
Next we lose our faith in the idea that everything will work out just fine. This is a hallmark of being young: we take risks and embrace adventure because we think we will come out ahead every time. Cancer brings no such assurances. Lisa, who was diagnosed with breast cancer at 33, told me, “I have lost the quiet confidence that nothing that bad will happen to me. Or if it does that I will always end up on my feet.”
Finally, we lose our faith in the future. In the first year after being diagnosed with breast cancer, I felt nearsighted when I looked at my life: I could see only a few months ahead, and beyond that everything was blurry. How could I book a major vacation when my next scan could put me back in the hospital? How could I change jobs when should have lots of sick leave stored in the bank? How could I move to a new city when I might need to spend my dying days close to my family?
Two years after treatment ended, my husband and I finally felt bold enough to try to have a second child. Yet even that decision was shaped by uncertainty. I had to ask him, “If the cancer comes back and I die, can you raise two children on your own?” Maybe every parent should ask that question, yet few do unless they have already confronted mortality.
Getting pregnant with my daughter was a turning point for me. Finally, my body was doing what it was supposed to do. I even had newfound admiration for what it could withstand: it weathered surgeries, extra doses of chemo, prolonged menopause, and still I could deliver a baby and nurse her on the side that hadn’t been radiated.
Each month that passed in which I got to watch my daughter grow and my cancer did not come back strengthened my confidence. Each screening that came back negative restored my faith. When my daughter was 18 months, I felt strong enough to move across the country, far from the mother ship of my cancer center—something I never would have dreamed of doing in the immediate aftermath of the diagnosis.
My long-distance vision has returned. Don’t get me wrong—I still panic before my mammograms and I still have tremendous gratitude for every birthday I celebrate. But I don’t feel as uncertain as I used to. I believe my friend who is dealing with appendix cancer will regain her own belief in the future. It will just take time.