My friend Karen turned 56 yesterday, and it was quite the celebration. Karen had been waiting for four weeks to begin a clinical trial for a new oral drug that might slow the growth of her stage four endometrial cancer, and she had finally been cleared to start. It was the best present she could get. After 25 years of phone calls from friends with the news that they had been diagnosed with cancer, I didn't think I could be surprised anymore. But when I heard in January that Karen had advanced endometrial cancer, it was really a shock. I have known Karen for more than 30 years. We met and became friends through the the Dallas nonprofit sector where she was a development director before working for a Dallas foundation in programming before managing a family foundation and now in her current job as CEO of an international medical foundation, a job that combines her love of science and her ability to bring people together to master a challenge. The shock of her diagnosis came because, even though I know that cancer is an equal opportunity disease that strikes without rhyme or reason, Karen is one of those people who has always cared for her body. She has eaten the 'beat cancer diet' since I have known her (lots of fruits and veggies), has always exercised, does yoga, and, in addition to working on her body, has done her head work as well as her heart and soul work. As I like to say when I give my highest compliment, she is a grown up emotionally.And it is a bad cancer. Initial debulking left her free of cancer for only a matter of weeks before pain and another scan showed it was back in all its fury. Six rounds of the trifecta of nasty drugs beat it into submission – but again, within weeks of the end of chemo in June, it was back. Karen has said from the start that she isn't afraid to die, she just feels like it's not time. And her oncologist agrees. The Phase II clinical trial has shown good results and some remarkable results, results Karen hopes she will be a part of. And yet, she knows that reality says she may not respond. With the first dose of the drug she begins the odyssey of living in hopeful reality where she is fighting to live while preparing to die. It's a place many of you know. I plan to keep up with Karen and let you know how she is doing – and offering you her advice on how to live in the valley of the shadow of death. Let us know how you're doing too.