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The everyday reality of living with Stage IV (also known as metastatic or advanced) cancer is not something you will hear about on the evening news. Nor will it make the front page of the New York Times. Instead, you will hear or read about the latest medical “breakthrough,” regardless of whether there is any significant scientific evidence of efficacy, of benefit over a similar drug. What those of us who read the fine print of such articles, work in the cancer field, or participate in a drug trial learn is that these therapies generally carry an enormous price, both personal and financial, affecting most intimately the person receiving treatment and their loved ones, but also society at large. Indeed, conventional cancer treatments and trials are trials to patients and families, not only physically, but also psychologically and emotionally. This is not something many doctors talk about or care to hear about from patients. Descriptions of emotional and existential pain, and the unpleasant, intrusive side-effects of personal and familial suffering, such as fear, anger, and uncertainty, does not make it into the patient’s clinical chart. One person, in a recent cancer support group, compared the long term impact of living with metastatic breast cancer to the symptoms of PTSD (post-traumatic stress disorder). The term survivor, applied to anyone who has ever had a cancer diagnosis and is still living, is apropos to people surviving the extreme ups and downs of treatment. In this sense, family members and significant others are survivors too. As with other crises that threaten our sense of safety and security, bonds either strengthen or break. For individuals and relationships that survive cancer, as not all do, it is a shared journey.

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