Good News or Guilt: Living With Stage 4 Cancer


Is it always one or the other? Can good news in one person’s cancer experience do good for the community?

cartoon drawing of blogger and metastatic breast cancer survivor, Martha Carlson

I have called myself “lucky” too many times to count because it fills a space where there are no answers.

Why me and why not you?

To paraphrase an oncologist I respect, my living so long and so well with metastatic breast cancer is not a matter of luck, but simply a matter of biological processes.

That may be true, but it doesn’t change the fact that while I am sitting over here with good news, my friends with similar or even identical diagnoses are not getting the same news. Their news, in fact, can be the exact opposite of mine.

I have been with dying friends, have watched as treatment after treatment fails to deliver, heard the words “we’re just watching and waiting” so many times that they reverberate in my mind.

Saying my good fortune is just a matter of biological processes is like ice to me. It minimizes the emotional depth of living with cancer and takes away hope in ways more profound than acknowledging that I am, in this one respect at least, lucky.

I didn’t do anything to have this response, and you didn’t do anything to not have it.

Anyone with stage 4 cancer can tell you that this diagnosis gives cancer free rein over all the mind games. There’s an impolite slang term for that experience with the definition “a disturbing or extremely confusing experience, in particular one that is caused by deliberate psychological manipulation.”

Cancer working deliberate psychological manipulation sounds right to me. Does it sound right to you?

One of the ways it does this is through the difficult interplay between my good news and my guilt that hearing it will sting the hearts of others. Good friends have told me that hearing my experience with stage 4 cancer brings hope, and I hear that sentiment echoed on social media too. I know there is truth to those words. But there is also truth to the pain other friends feel because our two paths are so utterly different.

Like I said, psychological manipulation.

There’ve been many times over the past eight years with stage 4 cancer that I’ve been silent about good scans. There have been times when someone can’t see my pain because it isn’t the same as theirs.

How do we share good news even when it is challenging? Should we share good news?

Turns out there’s an easy-to-read essay by Zachary Whiteabout how sharing good news creates and strengthens community. This idea makes sense to me: “Your good news is no longer yours. It’s no longer theirs. This kind of collective intimacy makes it possible for us to know that the breadth of what we are experiencing—the good and bad—is not just a reporting of what is happening, but a reminder that, though others may not be physically with us, they are always co-authors shaping what we see and notice and appreciate in ways that can sustain us during the most difficult parts of our experiences.”

I want to live up to the truth of these words. I think it will probably be hard and require breathing room, this learning to both give and receive good news and bad. I have had times when I can’t bear to see some people because I know they can’t grasp my loss, so I think it’s unfair to urge people to hear good news and simply be happy for someone else.

But for me, most simply, it’s a reminder that my good news contains more than my own guilt. It may be a source of connection in a world that too often keeps us apart.

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