Crossing the bridge from early to advanced cancer

Bob Riter is the retired Executive Director of the Cancer Resource Center. His articles about living with cancer appeared regularly in the Ithaca Journal and on OncoLink. He can be reached at

A collection of Bob’s columns, When Your Life is Touched by Cancer: Practical Advice and Insights for Patients, Professionals, and Those Who Care, is available in bookstores nationwide and through online retailers such as Amazon and Barnes & Noble. All royalties from the sale of the book come to the Cancer Resource Center.

When you’re first diagnosed with cancer, you cross a bridge that separates the “healthy” from those with cancer. You’re entering a scary place, but the focus is on curing the cancer and getting back to the land of the healthy.

There’s another bridge that’s less visible to the general public. This bridge separates people with early-stage cancers from those with more advanced cancers. When cancer is advanced – spreading beyond its initial location – treatment generally focuses on controlling the cancer as opposed to curing the cancer.

Those of us who have been diagnosed with cancer know this second bridge. People with early-stage cancers are afraid of it. People with advanced cancers are aware that they’ve crossed it. Not only are they different from healthy people, they’re different from most other people they know with cancer.

Living with advanced cancer is living with uncertainty. If you take time off from work for treatment, you wonder if you’ll be able to return. You wonder what will happen if your current treatment stops being effective. You wonder what the future holds for you and your family.

You may hesitate to share your fears with your family members and close friends because you want to protect them. And you may hesitate to share with people with early-stages cancers because you see the frightened look in their eyes.

But people with advanced cancers often live for many years with a good quality of life. Some advanced cancers are increasingly thought of as chronic diseases that can be managed with on-going treatment and close monitoring.

While everyone handles advanced cancer in his or her own way, those who do best emotionally (and often physically) seem to share certain traits.

First, they continue on with their lives. That is, they maintain those activities that give them pleasure and meaning. Perhaps the illness causes them to reduce their level of activity, but they find ways to stay connected and involved.

Second, they don’t try to control what they cannot control. One of my favorite expressions is, “It is what it is.” This is nowhere more true than with advanced cancer. There’s no pretense that everything is rosy. But there can be pleasure in each day and people with serious illness often find delight in the daily pleasures that most of us take for granted.

Finally, they have faith, but that faith can take many different forms. Many have religious faith. Some have faith in the recurrent cycles of nature. Others have faith in their doctors. Whatever form faith takes, it provides the opportunity to relax. Someone or something is looking out for you and everything will be OK.

Living with advanced cancer requires an understanding of reality while maintaining hope for continued well-being. Life doesn’t have to be perfect to be good.

Reprinted with permission of the Ithaca Journal. 

Click here for all of Bob’s columns


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