Illustration by Marley Allen-Ash
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My friend was right, and it was a moment of uncomfortable recognition. Yes, Sue, I am a bit like an old-school, girls’ hockey coach – used to being in charge and super enthusiastic about improvement. Modelling perfect posture, of course.
Now, as I turn 70, friends have (kindly) called me “intimidating” after I post videos of me doing deadlifts with honking big weights.
But I am also dying of metastatic breast cancer (MBC). There’s no cure. Sometimes, my friends and family are a bit confused about what that means. As am I.
I am the poster child for physically fit aging. I do not show any signs of circling the drain.
But I also have a dozen or so metastases in my bones. They’re in my skull, my spine, my pelvis and one of my femurs. I don’t feel them, but they are a sure sign that there are tens of thousands of cancer cells roaming around my body looking for more places to set up home.
If those cells (the evil little buggers) find a niche and flourish in some vital organ (liver, lungs, brain), I’m a goner.
The song that brings my wife back from the fog of Alzheimer’s
But in the past 15 years, cancer researchers have blazed new trails in treatment for people like me (people with “garden variety” MBC). What used to be a get-your-affairs-in-order-and-here’s-the-morphine-pump situation now has a median survival of 63.9 months on the standard initial treatment, based on a 2021 phase III clinical trial.
Medians being what they are (and breast cancer being as common as it is) means that many of us will likely meet (or be) someone who has been living with this particular death sentence for five, 10, maybe 15 years.
When you encounter a long-lived MBC patient, you may think they don’t look sick. In fact, they look great!
Maybe don’t say that to them?
Because the reason they’re still walking around like a normal person, looking great, is that they’re taking drugs that target cell metabolism and hormone production. Brilliant drugs that mess with the evil buggers. But those drugs don’t work forever.
It’s like what Keith Richards sang about cocaine: “They say it’ll kill you / but they don’t say when.” Treatments stop working, new treatments come along – it’s amazing and it’s terrifying.
And like cocaine, the drugs for MBC are a mixed bag. At 70, I’m kept alive by a medication that gives me, once again, a monthly cycle. Hurray. In week four of that cycle, there’s fatigue, irritability and those old cravings for ice cream. My whole premenopausal life taught me how to plan around that unpleasantness. It’s fine.
Many other MBC patients find the drugs harder to bear than I do (so far): Side effects can include depression, joint pain, gut issues and more. All the miseries of old age amplified, if you’re already old. Young women who get this horrible thing can find themselves feeling like 90 at 35.
My job as a fake patient is an exercise in improvisation and empathy
Most weirdly, at 70, my relationship to time and planning has changed. My “hockey coach” personality flails around, bewildered. During my working life, I used to have 10-year plans. Now, my oncologist can’t promise that I’ll be fit to travel in six months. (I likely will be, but there are no certainties.)
I read and hear coping advice of various kinds: Be here now. (Sure.) At 70, we’re all living on borrowed time. (Of course.) But I miss my 10-year plans and the kind of project that bears fruit on that time scale.
Aging means loss. I knew that long ago and (as much as possible) I planned for it. I have been lifting weights since 2010 or thereabouts. The idea was to delay the loss of strength and mobility that inevitably comes to all of us, whether in our 60s or our 90s.
And yet. I didn’t know that I could keep all that fitness and still lose reasonable expectations of a long future. Without a time frame, I don’t quite know how to plan longer term things like money and housing. Should I even try to look two years ahead? Or not?
It’s confusing. Except in week four, I feel great. I’m pretty good at not peeking over the cliff edge. But I’m fundamentally – and uncomfortably – uncertain. And whatever that looks like, that’s how I look.
Shirley Tillotson lives in Halifax.