Thirtysomething With Cancer

Remember the 90s television show Thirtysomething? If you do, you likely are thirtysomething yourself. It was a great show about a group of baby boomers who had lived through the counterculture 60s, and were trying to reconcile that past with their present as responsible adults and parents. I was in high school when it aired, and remember watching and thinking how old thirty seemed. Now, as I approach 40, my perspective has changed a bit.

I heard recently that most Millenials think that the term “grown-up” now applies to 30 and above. To them, it is not just high school and college that are reserved for being young and wild and making mistakes, but their early twenties as well. Adulthood keeps getting pushed further and further into the future by each succeeding generation. We are lucky to have the luxury to postpone adulthood according to our timeline. We haven’t had a great depression, world war or other calamity to force maturity upon us. That may be changing.

There is a challenge facing young adults today, though it isn’t visible and doesn’t get a lot of press. It is cancer. It is the leading cause of death among 15-39 year-olds, excluding homicide, suicide and non-intentional injury. Particularly women in this age group, have a higher likelihood to develop cancer as incidence rates for women are higher starting at age 20, and for those 35-39, cancer incidence among females is more than 80 percent higher than among males. Additionally, those 25-34 face an increased incidence rate of invasive cancer. (Albritton, Caliguiri & Anderson, 2006)

While five-year survival rates have improved significantly for both pediatric and geriatric cancer patients over the past 30 years, they have not for those in the AYA group (Adolescents and Young Adults). There are many factors that impact this, including: lack of regular health screenings and the highest uninsured rate of any age group, as well as delayed diagnosis because younger people feel invulnerable and ignore symptoms, and the fact that cancer is often not suspected for younger individuals by medical professionals.

Luckily, people are starting to pay attention. There are numerous groups now advocating for the AYA community (list at the end of this article), and even a National Young Adult Cancer Awareness Week (in it’s seventh year), April 5-11, 2009. “Consider Cancer” is this year’s call to action for Vital Options International and all the advocacy organization members of the LIVESTRONG™ Young Adult Alliance with an emphasis on encouraging young adults to talk to their doctors, know the warning signs of cancer, understand what types of cancer they may be at risk for, and learn about cancer screening and healthy life style choices.

I never thought it would happen to me, and while I thought I was young to be getting cancer at 36, I now know many, many others who were diagnosed at a much younger age, including one friend who had a complete hysterectomy for ovarian cancer at age 27.

Here are just a few things I recommend to insure a healthier future:

• Don’t forego health insurance. That time between when you are no longer eligible for insurance under your parents (usually 23) and you finally begin to feel somewhat successful in your career can be a struggle financially. On their own for the first time, most young adults are busy navigating retirement contributions, leases, utilities, and new furniture. Health insurance can seem like a logical expense to cut out when you’re young and healthy. It’s not.
• Listen to your body. That strange ache or swelling or weird dry patch of skin could be telling you something significant. Don’t ignore it! The longer you wait to get something checked out, the more likely it is to grow and spread if it does end up being cancer. Being in a new town without a regular doctor, lack of insurance and other “excuses” can prevent you from getting help right when you may need it most.
• Consider disability insurance. If you can’t afford health insurance, disability insurance definitely seems like a needless extravagance, but you are far more likely to become permanently disabled than you are to die from an accident or chronic illness, and if you are insured before any of these problems pop up, then you can’t be denied later, and your rates are also likely to be much cheaper.
• Eat Right. There is more an more evidence that chemicals in processed foods and pesticides can lead to health problems of all kinds. Fast food is so cheap and convenient that it is difficult to forego, especially in this economy, but the cost of eating it could be your health. Michael Pollan says in his book, In Defense of Food, that in the past sixty years, Americans have spent the same portion of their income on two line items – food and healthcare – but the amounts have flip-flopped. As processed food has become cheaper and cheaper, healthcare costs have skyrocketed. Better to spend money on high quality, healthy food than doctors and drugs.
• Don’t Smoke or if you already do, quit. Most of the risk factors for cancer can be controlled by our lifestyles. Exercise, eating right, getting enough sleep and controlling stress are all key, but the best thing you can do to reduce your cancer risk is not to smoke or spend time around people who do.
• Get Screened. There are age appropriate screenings that you need to pay attention to such as colonoscopy, mammogram, pap smears and prostrate exams, and others that are dependent upon risk factors. Be aware of recommendations and get screened. You can also do self-checks at home for potential skin cancers and breast abnormalities.
  

Some organizations advocating for and providing services to young adults with cancer:

I’m Too Young for This
Empowering young adults affected by cancer through a weekly online radio show called Stupid Cancer, a great website full of resources, and a network of social groups across the country.

Cancer Care
Professional counseling, facilitated peer support groups, creative workshops and financial assistance for young adults with cancer.

Cancer Climber
Offering experiential and motivational adventures and excursions such as extreme mountain climbing and summit tours.

First Descents
An innovative camp experience for young adults with cancer offering kayaking, extreme sports and professional athletics.

Fertile Hope
Provides reproductive health information, support and hope to cancer patients whose medical treatments present the risk of infertility.

Planet Cancer
Award-winning young adult-focused community offering survivor retreat programs, social networking, and online forums with real world advice and inspiring stories.

Rise Above It
Provides grants and scholarships to young adult survivors and care providers who face financial, emotional and spiritual challenges.

Young Survivor Coalition
An international network of breast cancer survivors and supporters dedicated to the concerns and issues that are unique to young women and breast cancer.

Works Cited

Albritton, Karen, M.D., Caligiuri, Michael, M.D., Anderson, Barry, M.D., Ph.D., Nichols, Cherie, M.B.A., Ulman, Doug; Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer Report of the Adolescent and Young Adult Oncology Progress Review Group; August 2006; downloaded from http://www.livestrong.org/site/c.khLXK1PxHmF/b.2662637/k.DE41/AYAOPRG.htm

World Cancer Day

Cancer is the leading cause of death around the world. Up to 84 million people will die of it between 2005 and 2015 without intervention, according to the World Health Organization, sponsors of World Cancer Day on February 4th. Their website states that more than 70% of the 7.6 million cancer deaths in 2005 occurred in low and middle income countries.

Reading these statistics once again made me feel grateful for the standard of care I received during my own cancer experience. I have often reflected on how fortunate I am not just to live in one of the wealthiest countries in the world, but in the city that the most people say they want to live according to a recent poll, and one that has top-notch medical treatment facilities. Even people who live in rural areas of this country have a more difficult time obtaining cutting-edge treatment.

As Americans, most of us rarely stop to reflect on just how good we have it. We don’t have to worry on a daily basis about clean water, a comfortable and spacious place to live, access to food, energy and health-care. I had the luxury during my cancer treatment, of access to reiki, retreats and programs targeted to cancer survivors, and, more recently, services for people in my specific age group. Many people in developing countries might be lucky to receive a diagnosis in time to do something about it.

Some incidents in the past few weeks have given me cause to ponder the many modern conveniences we take for granted in this country. They both make our lives easier, and also make us reliant upon them. The electricity in my condo went out for 45 minutes one night last week, and I realized how little of what I normally do was possible or convenient without it. I had just arrived home from a trip and was anxious to do laundry, make something to eat and watch a little television. Couldn’t do any of those things without electricity. It was nice to be forced to sit with a flashlight and a magazine and relax for a little while.

My experience, by any standard, was a very minor inconvenience. Just a few days later, my family experienced a much larger inconvenience, but one that even they describe as “having many silver linings,” even as they are still in the midst of it. The two-inches of ice that blanketed Kentucky and the surrounding region recently was lauded as the storm of the decade for that area the day before it hit, but I’m not sure anyone imagined just how bad it would get. Weighted down by ice, trees and power lines snapped under the pressure, and everything from roads to cell phone towers were coated with the cold, slippery substance.

Electricity was interrupted almost immediately, and for many, their main source of home heat as well. Over the ensuing days, phone service – including cell phones – would be impacted as well, and finally, even water pressure couldn’t be maintained without the electric pumps used to get the water out of the tanks and into the pipes. Even though one large tree is leaning against both of their homes, and part of one tree came through my parents’ bedroom ceiling one night as they were sleeping five feet away, my parents and sister’s family count themselves lucky. They huddled together around the fireplace at my parents’ house, and were able to cook meals on the gas stove. They had plenty of batteries to power radios and flashlights, and a neighbor who still had cell service so they could let everyone know they were doing ok. As my other sister and I kept each other up-to-date on the latest news, we marveled at how quickly the myriad communication methods we all rely upon daily can be cut off. It seems unthinkable in this day and age that we couldn’t communicate when normally there are so many ways for us to keep in touch.

Estimates are that it could take as much as a month to restore power to many, and trees still block the road-ways a week later in much of the area. My mom commented that far from being bored, it was taking most of their time just to survive. Cooking meals, chopping wood, boiling water – all tasks that might have been common in this country 50-100 years ago, depending upon where you live, or in many third-world countries even now. When I remarked to my sister that many people in the world live like this everyday, she replied, “At least they are used to it.”

Good point – and brings us back full-circle to the fact that we are both fortunate to have so many modern conveniences, and also completely reliant upon them. It is only when we find ourselves without them that we are able to fully appreciate how much modern technology brings to our lives, and how much it increases our life expectancy. Today, on World Cancer Day, I will be thinking about those who are not fortunate enough to have the standard of care that we take for granted. But in harmony with the mantra, “think globally, act locally,” I will be supporting organizations in my community that are doing their part to make the lives of cancer survivors easier. I hope you will too.

Happily Ever After

When we were young, the stories read to us, or the Disney movies we watched in excited anticipation, almost always ended with the phrase, “and they lived happily ever after,” usually after the girl married the handsome prince and they rode off into the sunset. No wonder our expectations for love and life are so high! Happily ever after is a high standard - no fights, bounced checks, dented cars, screaming children or skinned knees - just sunshine and bliss and happiness forever and ever.

I have always felt that our entertainment was warping our view of reality. On TV and in the movies, everyone is beautiful and whatever problems they are having are wrapped up neatly in an hour (minus 15 minutes for commercials of course), their dialogue is full of the kinds of things you wish you could think of on the spot during your fight with your boyfriend, and they look better cleaning their house than I did at my high school prom.

There are studies that say people who watch a lot of TV tend to have a misplaced view of reality – feeling that the world is a more dangerous place than it is because of the violence and crime they see on the tube. For me, it has always been the opposite. I see happy people with great lives, love and talent, when I watch, and I wish my life were like theirs.

It’s easy to forget the wardrobe and makeup team and time it took to make Jennifer Aniston look effortlessly beautiful, and we rarely see the mundane parts of anyone’s life on television. No taking out the garbage, or scrubbing the kitchen floor or dealing with the clogged toilet. Their lives seem exciting and fulfilled, they rarely fight with their friends, and if they do, it’s always quickly and easily resolved.

The problem arises when we compare ourselves to the characters on television, in books or movies without the reality check of their personal trainers and chefs to help them keep in shape and eat right, and the overall fantasy of the silver screen. The truth is that behind the scenes even the beautiful people have problems and feel insecure.

We all want “happily ever after,” but there’s no such thing. Life is a journey filled with ups and downs, joys and sorrows, triumphs and disappointments. And what a boring life happily ever after would be anyway. What would life be without the occasional pain that teaches us our most important lessons? We have to be careful not to bring a happily ever after attitude to our own life events too. Weddings can be wonderful, but marriage will certainly be bumpy at best.

In cancer treatment, it’s easy to believe that life AFTER will be joyous again too. When you are doubled over throwing up or staring at your eyebrow-less face or bald head in the mirror, even normal life can seem like a fairytale. However, it takes a while to bounce back, though others in your life might not quite get that. Hair doesn’t grow back in a day, and neither does the idea that you are invincible. That might not ever return. A new perspective is born; and thank goodness for that. It can mean a new appreciation for the good things in your life, and a recognition that the challenges we feel are so insurmountable in daily life, are really not that bad after all.

Life is beautiful – and ugly, and desperate, and hard, and unfair, and peaceful, and loving, and joyous. And even if we don’t always have control of what happens to us, we always have control about how we respond. I have found that many of my biggest problems are of my own creation – they’re all in my head - and only I am capable of getting them out. Margaret Bonnano said, “It is only possible to live happily ever after on a day to day basis.” It might even be an hour-by-hour basis or a minute-by-minute basis, and when we find ourselves slipping into despair or life hands us a new challenge, we have the power to overcome it, and to find ourselves a stronger person on the other side.

Angels Among Us

Two things prompted me to think of angels today. The first one is related to cancer, and the second one isn’t.

Imerman Angels is a non-profit that pairs cancer survivors with cancer fighters – those in the middle of their treatment or the beginning of their diagnosis. While Lance Armstrong defines a survivor as anyone who is diagnosed with cancer, from the day they are diagnosed, Jonny Imerman has to have a way to distinguish the two groups.

Diagnosed with cancer at age 26, Imerman had great support from family and friends, but never met anyone his age who was a cancer survivor while he was fighting his own battle. His own experience was the inspiration for his organization now helping so many others, and his goal is to make sure everyone diagnosed with cancer can talk immediately with someone else who is similar to them in age, gender and cancer type. These “angels” are walking, talking, living proof to inspire the newly-diagnosed that they too can beat the disease.

Jonny is the most enthusiastic, kind-hearted and loving soul you could ever hope to meet. He does his work with tremendous passion, and brings hope to so many. In that way, he is like the other angels I was reminded of today.

Matthew Shepard died on October 12, 1998, ironically, just one day after National Coming Out Day, and – unbelievably – ten years ago. At his funeral, Fred Phelps and other anti-gay members of his Westboro Baptist Church in Topeka, Kansas, picketed displaying signs reading: “God Hates Fags,” and “Matt in Hell.”

As a counter-protest, a group of supporters led by Matt’s close friend, Romaine Patterson, dressed in white robes with huge wings, and stood silently with their backs to Phelps’ crowd, making a human barrier between the two groups. This You Tube video depicts the story with great music, but many misspellings in the text.

This week as we have so much to celebrate in this country’s election of its first African-American President, we are also reminded that there are still great divisions among us. I don’t usually get political in this column, but it’s hard to ignore the divisive rhetoric whipped up by a long campaign season, and the outcome of three anti-gay ballot initiatives across the country.

Proposition 8 in California passed by half a million votes, removing the right of gay people in that state to marry. I have personally, never understood how consecrating a loving relationship between two individuals of the same sex in any way threatens the institution of marriage, and I am deeply disturbed that we spend so much time and energy on a topic that should be a non-issue - especially when there are so many important and true problems to worry about.

The labels we all wear don’t begin to describe us as individuals: Christian, gay, Muslim, Black, Republican, liberal, cancer-survivor, disabled, Latino, leader, friend, husband. Even “angel” isn’t the complete story, but a picture of a moment in time when we are at our best. I hope in time the labels won’t be necessary, and we can recognize the commonalities rather than the differences when we look someone in the eye.

I voted for Barack Obama in part because I felt he could bring us together as a country. I was convinced by his 2004 DNC speech that he would try when he said, “We are not a nation of blue states and of red states. We are the United States of America.” It is time for us all to find some common ground rather than continuing to hurl insults from the wings. I created a blog called Meet in the Middle in hopes of starting a dialogue on the issues. Join me in the middle, won’t you?

Your Cancer Risk: How Much Do You Want to Know?

Sometimes medical advancements can give us more information than we want to know. With the discovery of the BRCA 1 and 2 genes, mutations of which are responsible for breast and ovarian cancer, women can now find out their risk of developing these two cancers. That is both good and bad news. There are many factors to consider before being tested. Is there a history of either disease in your family? Do you belong to one of the ethnic groups at a higher risk?

The test is expensive, and may or may not be covered by insurance, and there is still a chance of discrimination if you find out you do carry the gene mutation, though Congress did pass an anti-discrimination law this year to protect against this problem. Perhaps most difficult, though, are the decisions you will face if you find that you are positive. Would you have prophylactic surgeries, removal of your ovaries and breasts, to reduce or eliminate your chances of getting cancer? Many women have.

What if you are single? Want to have kids? How do those factors weigh into a decision that may save your life? It’s really an unfair position to be put into, and at the same time, gives us a new power to preserve life that wasn’t available before. One young woman, Joanna Rudnick, currently in her early thirties, documented her experience of carrying the burden of knowing, as well as that of others in her film In the Family.

The film is currently being screened at events around the country and on PBS during October for Breast Cancer Awareness Month. You can also watch it online here through the end of the month. In the film, Rudnick struggles with her own desire to have children, juxtaposed against the chance that she could die if she waits too long to take preventative measures. In her thirties and single, she hears the ticking of a potential time bomb in addition to the proverbial biological clock.

I recognized, as someone also stated in the documentary, that women and men who test positive for this gene mutation feel the same as those of us who are cancer survivors. Many of the same emotional and psychological issues apply. You are forced to acknowledge your mortality, and to make medical decisions that will “mutilate” your body, but could save your life. It is an impossible position, really.

I can understand Joanna’s need to do so much research and talk to other women faced with the same decision. Her search allows us to go along for the ride, and will help many women who are also struggling with finding their own path. At one point in the film, Joanna’s boyfriend wonders, “Does she only like me because she wants my babies, and she wants them quick?” All single woman of a certain age have probably dealt with this stereotype at some point, and those with a cancer history or probability likely feel it more acutely. As if finding the right person weren’t already difficult enough, the added pressure of a deadline is just so unfair!

I recently received my second cancer diagnosis. As always, the wait for test results can be the worst part. I knew when they asked me to call them for my biopsy results that it was “bad” news. If it had been all clear they would have just said so on the voicemail. Then when I told the receptionist my name, there was a long hold. I figured they were getting the doctor to deliver the verdict. Turns out it was a nurse.

Luckily this one was much less serious than my first. A small basal cell carcinoma (skin cancer) on my shoulder/back was dealt with in a minor office procedure at my dermatologist’s. Five stitches later, I will have a small scar, but we got all the margins, so it’s all gone this time. I have had two other scary-looking moles removed, but both biopsies were negative. This one was a tiny, innocuous-looking pink bump that I noticed back in the spring and was just too busy to worry about until fall. Meeting a melanoma survivor in July at the LIVESTRONG Summit in Ohio lit a fire under me to find a dermatologist when she told me her diagnosis began with a small pink bump on her shoulder in her early twenties.

My chances of getting more of these is higher now, so I will have to be even more vigilant about watching for changes in my skin and using sunscreen. I always figured skin cancer was in my future. I’m fair-skinned, and I life guarded for eight years starting at sixteen. I grew up on a lake, guide whitewater canoe trips, and I live in Colorado, where the elevation puts us closer to the sun’s rays and we get more than 300 days of sunshine a year.

Whether getting a genetic test or taking part in recommended screenings, there are many things you can do to reduce your risk of getting cancer. Go here to read more about them.

Find out more about genetic testing here.

Even if you missed the television event on September 5th, it’s not too late to Stand Up to Cancer. Find out how.

Watch a three-minute preview of In The Family here.

Cancer: By The Numbers

Statistics are used and abused so regularly that they have lost the power to impact us. We hear so often that 1 in 5 “this” and 30-percent “that,” and half “the other,” that we don’t really realize what the numbers are saying to us. I don’t know if the numbers I am going to share in this article will be any different. Personal stories are much more likely to tug at our heart-strings and make a real impact.

Given that, let me ask you this: Do you know anyone who has been affected by cancer? Lost a loved one, has a friend who was diagnosed, or is even a survivor themselves? I doubt there’s a person in the world who can answer no to that question. Everywhere you go, someone has a personal story – or several. In my family alone, my uncle and grandfather both died of cancer in the past year, and I was diagnosed two years ago. I’m sure you have a similar story.

Cancer is the 2nd leading cause of death behind heart disease, according to the American Cancer Society. In 2008, they estimate that more than half a million Americans will die from cancer. That number accounts for 22-percent of all deaths - one-third of those deaths from lung cancer alone. From 1950 to today, the death rate from heart disease has dropped dramatically, while cancer deaths have dropped only slightly.

In 1971 Richard Nixon declared war on cancer, and yet 1.5 million Americans are newly diagnosed each year. In terms of personalizing these statistics in order to help them hit home, the ones regarding people under 40 are especially significant to me.

• Cancer incidence in young adults (15-39) has doubled over the past 30 years to nearly 70,000 diagnosis each year.º

• Roughly 10,000 young adults (YA) die each year due to cancer.º

• The 5-year survival rates in YA has not improved over the past 30 years¹ and currently hovers on average in the low-to-mid 60% range. (As compared to high 80's in children and older adults)

• Why? Three reasons: delayed diagnosis, access to clinical trials and age-appropriate peer support that contributes to quality of life.º

These statistics were taken from the website of I’m Too Young for This, a cancer advocacy organization for young adults. The National Cancer Institutes is their source. These are the numbers that frighten me the most. Cancer diagnoses are hitting adults at younger ages – a population that “isn’t supposed to get cancer.” Another organization, SeventyK is advocating for this population and has developed a Young Adult Cancer Bill of Rights to establish a standard of care to meet the needs of this underserved population.

Young adults may also be at greater risk because of lack of health insurance. Between the end of college and the beginning of new careers, many twenty-somethings forego health coverage as an expense they can’t afford. Coupled with the fact that employers are placing more of the burden on employees and other expenses of this age group loom large, new workers who are young, and healthy assume they can go without. As many as 15 million people between the ages of 18 and 34 are now living without medical coverage.

Of course, medical care is becoming a larger issue for all Americans as costs skyrocket and coverage shrinks, even as premiums and deductibles rise. This article from The Philanthropy News Digest details the “perfect storm” of economic factors that is hurting working families. Additionally, President Bush has proposed deep cuts in funding to the CDC, NIH and NCI over the past two years, the first funding decreases since 1970. These three organizations play a vital role in our nation’s health, and the research they fund has the potential to develop new treatments and save thousands of lives.

This month (September) is Ovarian Cancer Awareness month, another fact that has personal significance to me. Cancer also got a prime-time slot on all three networks on September 5th, as Stand Up To Cancer aired. The show featured 50 celebrities and medical experts, seeking to raise money to support research since government funding has been cut every year since 2003.

Even as one person, you can make a difference in these numbers. Here’s how:

• VOTE – Who you cast your ballot for, donate to or volunteer for does make a difference this election year. Research candidates at all levels carefully for their stance on healthcare and support of funding for research.
• SUPPORT – causes that are important to you with your time and money. There are countless organizations working on this important issue. Get involved with one or more today.
• SHARE – these and other resources with friends and family members. Knowledge is power. There are great resources to help no matter what your circumstance. Help your loved ones access help.
• CHECK – your own body for signs of trouble. Suspicious moles, strange symptoms, unusual aches and pains could be signs of a larger problem. Listen to your body and seek the advice of a doctor immediately when symptoms occur.

Control

There are some aspects of my life that help me feel a modicum of control over my health, and these are becoming more important to me – exercise, eating right, getting enough sleep, and managing my stress through meditation and yoga. I do a decent job on most of them, most of the time, but when I get busy with work or travel, most of it goes out the window. I know I’m not the only one who struggles with maintaining a regular fitness routine. I love how I feel when I exercise, but still have a tough time motivating myself to do it. I have been told making an appointment with yourself is the key – to literally schedule an appointment in your planner and honor it as you would a commitment to anyone else. I vow to try that and see if it works.

I tend to think since I work from home, that I am flexible, and can wait until the right moment when I need a break, and then I will stop to exercise. The problem is the right moment never comes. Something pressing is always there to fill the time, and before I know it, another day is gone and it’s time to think about what to fix for dinner. I find it interesting that we have the most difficult time honoring our commitments to ourselves. Most of us would never stand-up a friend or skip a meeting with a client – we try our best not even to be late for these appointments. However, most of us find it quite easy to reneg on a promise we made to ourselves.

I marvel at the women who have families to care for, and still manage to find time for exercise and taking care of themselves. These days, most of us are juggling work, family, aging parents, volunteer work and countless other demands on our time. Why is it that I can’t prioritize exercise when I live alone and work from home, and have the most flexible schedule in the world? When I have more to do, I magically find a way to get it all done, and I have heard the same from many a job applicant during the interview process, so perhaps that’s the key. Flexibility is not always our friend. Typically, having a lot on our plates helps us to balance everything better.

These days, it is easy to feel that our lives are out of control 90% of the time – not only on a day-to-day basis, but for the long haul as well. So many of us are just trying to keep our heads above water that life can feel overwhelming to the extreme. I sometimes feel as if we are just going with the flow, doing what is expected, being good citizens and following some prescribed plan for our lives without any real thought as to what we want.

My 20-year high school reunion is coming up this summer, and I have been reading postings on the website about my classmates and what they’ve been up to since graduation. I was surprised to read that many of them have children in high school, and my jaw just about hit the floor when I read that a few of them are grandparents! It made me wonder how many of us wake up one day with surprise at the life we find ourselves in. Would it have been what we would have mapped out for ourselves, or is it something we could never have imagined?

I certainly haven’t followed the typical route in life, or the one I thought I would follow. I was doing an interview for a magazine the other day and the reporter asked me how my cancer diagnosis impacted my life. There are so many answers to that question, but I told her about my change in perspective. When you are suddenly faced with your own mortality, you view your life in a whole different way. I recognized right away that I might not live to see old age, or to meet my grandchildren; and then, almost immediately that I probably actually wouldn’t even have children, much less grandchildren.

At first, this was an overwhelmingly sad thought, and then when I explored those feelings more, I realized that children were never high on my list to begin with, but rather, something I thought I would do because it’s just what you do. That experience of being a mother is such a quintessential female longing it seems, and being a woman doesn’t feel complete in some ways unless you are a mother. I love children, but don’t feel the need to have my own. However, motherhood is such an expected role for women in our society that is almost makes me uncomfortable to write this, and I have friends who get tired of answering questions about when they will have children. It is difficult for society to accept that some of us don’t choose that path.

I have spent a great deal of time over the years, comparing my life to others’, and wishing for things I don’t have – a high paying job, a fantastic boyfriend, a new car, a big diamond engagement ring, an exotic vacation, adorable children – but when I really look at my life, I am very, very happy with what I have, and I wonder again if I wanted those things because some larger force is making me feel that I should? A good friend shared this phrase with me a long time ago, and it is so appropriate. I remind myself of it often: “Don’t should on yourself.”

When I am completely honest with myself, the most important things to me are: work that makes a difference (and supporting me at a minimal level of comfort is a bonus), good friends, time to do the things I enjoy – spend time outdoors, attend cultural events, read and travel – and family. I may not ever have kids, but I have the best parents and sisters anyone could ever ask for, and a great brother-in-law and amazing niece and nephew to boot. The fantastic boyfriend is still on the wish list, but I have no doubt he will show up eventually, and hopefully turn into a fantastic husband someday as well.

The truth is, we do have control of how our lives turn out, and if at any moment we aren’t happy with the way things are going, we can change them. Sometimes it takes a catalyst like cancer, divorce or getting fired, and other times, it just takes awareness. Too many of us are merely surviving, and not always paying attention to what we truly want. Take control of your life, and figure it out. There is nothing more important.