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Karen Stewart, MA, and David Stewart, PhD, are psychologists who work with individuals, couples, groups, and organizations in their Durham practice.

Living with Cancer

By Karen Stewart, MA

Karen Stewart, MA

Four years ago, David had an unusual mole, which was diagnosed as melanoma. In contrast to me, who grew up in Texas and loved lying out in the sun when I was younger, David really had pretty minimal sun exposure, so this came as a real surprise. I think we both felt a bit incredulous, like the nonsmoker who gets lung cancer.

He had the mole removed; margins were clean and lymph nodes were clear. We were relieved. He kept regular appointments with the dermatologist, bought and wore protective clothing and hats, and used sunscreen. We were very optimistic because many people have a small tumor and never have another. We pretty much put the episode into the background and things went back to normal.

Then two years ago David noticed some swelling in a lymph node. Initially it was thought to be the result of an infection, however when antibiotics had no effect more tests were done. He was diagnosed with Stage 4 melanoma. We were shocked. We had been so naive and uninformed. We were watching for more melanoma spots on his skin, while all along the cancer cells had been growing inside his body, metastasizing into his lymph nodes and other organs. David reported a strange sense of betrayal by his body—he felt good and had no other symptoms, how could he be this ill? Until very recently melanoma at this stage had a very poor prognosis—nine months was the expected life span.

We spent the next several weeks gathering as much information as possible. Advice from oncologists ranged from “get your affairs in order” to “don’t be so worried, there is a new treatment available that is revolutionizing the prognosis for this disease.” We are fortunate to have friends who are involved in health care systems and who provided important information and support. We wound up taking a road trip up to Boston to see an expert in the Dana Farber Cancer Institute. David was placed in a clinical trial and given two infusions of two immunotherapy drugs. David’s cancer responded very well and within about six months the tumors had all but disappeared, leaving few traces. He was exhausted and had some side effects but they resolved with heavy doses of prednisone. We were very grateful.

Immunotherapy is a revolutionary new treatment and the side effects are unpredictable and relatively idiosyncratic. The second year, just as David was feeling better and things were getting back to normal, he experienced his most serious, life-threatening side effect. He was hospitalized and successfully treated, but he experienced a level of exhaustion that was beyond anything he had ever known and was unable to drive for six months. We are very fortunate that, over the course of the year, the side effects have largely resolved. Once again David is feeling better and life is getting back to normal.

This has been a wild ride. From my perspective, the second year was harder on our family. The first year we all had a lot of energy to deal with what came our way, by the second we were more tired and worn down.

I can only relate my side of this story. When David received the diagnosis, we didn’t waste a moment on feeling that it was unfair, or like victims. Acceptance came easy. We also never lost sight of how lucky we were to be a part of a wonderful supportive community with excellent medical care and Medicare coverage. It may sound weird but one of the first things we did as a family was to decide to go ahead and throw the dance party we had been planning. We wanted to celebrate life and love even as we faced this terrifying illness. Friends came and it was a joyful uplifting event and the energy from it buoyed us for what was to come. Carrie Newcomer’s song, “You Can Do this Hard Thing” became a kind of theme song.

Friends offered emotional support, meals, and even helped with chores and projects around the house. Our children were incredible sources of support and help. A year after the diagnosis, our daughter gave birth to our first grandchild, a little girl who sparks love wherever she goes. We have had kind attentive physicians who provided excellent medical care. Really, for dealing with cancer, we could not have had a better experience.

Old Conflicts

But even under the best of circumstances it is very hard. Facing death is a huge challenge. Most of us spend our lives working hard not to really accept that we or our loved ones will die. There were times when we would wake in the middle of the night in terror. Facing all of the issues around end of life planning made the possibility very real.

All the normal same old conflicts that existed in our relationship remained. In the early phases of this crisis the conflicts receded. However, as we were worn down by the constant level of stress and David’s physical state, the same old conflicts were triggered and we often did not have the patience and resilience to handle them well.

As I look back over the past two years, I am struck with several things. First, feeling held in the love of family, friends, and the Divine was crucial. I also had to be able to be with the experience, alone. At those times, I had to face what came, feel its intensity, accept it, and realize that I am more than physical, emotional, and mental pain. Most of the time I could get to that place where I was able to feel that peace “that passes all understanding.” In the silence and stillness, I could feel surrounded, strengthened, and sustained by the love of family, friends, and the divine. Ultimately, I knew I would be okay.  Even during dry spells when the peace did not come, I knew it was still there and that eventually I would find my way back to it.

I also realized was how important it is to stay in the present. Worrying about the future or dwelling on past stories only increases suffering. While it is important to acknowledge and accept the feelings that come, letting the thoughts just slide by rather than being caught up in the story or the fear, really makes life better. Staying in the present and letting go of expectations helps open my heart to the joy of what is and there is much joy to be had even in the darkest night.

What lies ahead? We are cautiously optimistic. None of us knows when our end will come. I am deeply grateful for the lessons I have received from this experience:

  • how precious, fragile and ephemeral our time here on this amazing earth is
  • how grateful I am for the love I am given and am able to give 
  • that the present moment is all we have
  • to try always to be aware, accepting and even loving what is.