Living with out-of-the-gate metastatic cancer is different. Different than life before, and different than I would have expected breast cancer to be, experientially.
You see, breast cancer has a powerful marketing machine. It teaches us that when you are diagnosed, it will be early enough for a cure. That cure will be comprised of chemo, surgery, radiation, and possibly an additional hormone therapy, depending on the profile of your cancer.
But when your cancer has already metastasized to remote parts of your body by the time it is identified, the story is different. And then you learn that the horse has jumped the gate, so to speak, the cancer is already in your bones, and you hear the chilling words, "We are no longer looking for a cure."
Only then do you learn that treatment is completely different. They have no idea where your cancer might pop up next, so they don't put the body through the trauma of surgery to remove what's already there.
Instead, treatment is systemic and palliative. They try to beat back the cancer. If you're lucky (like I am) and your cancer is hormone positive, they try to starve it by taking away all the estrogen in your body and kicking you into permanant menopause. Unlike chemo, this leaves the rest of the body relatively unscathed. Hair doesn't fall out. Skin doesn't get raw and cracked. They treat pain with local radiation and opiates. And they try to keep your quality of life up, prolonging the time until you get to chemo.
Some women last a really long time on these kinds of treatments. And as much as cancer laughs in the face of my plans, I plan to be one of those women.
Just one note on the word palliative: Before my diagnosis, I thought it meant "taking care of the imminently dying" but now I understand that it also means "making people like me more comfortable." Not such a scary word after all.