So when Elizabeth Edwards greeted the waiting media with a smile, a frank account of her worsening illness and a declaration that her life would go on exactly as before, it was an important reminder to many in the cancer community of how far things had come — and how people like Edwards are representing a new face of the disease.
It wasn't just the striking openness displayed by Edwards and her husband, former Sen. John Edwards. It was the message that a patient can approach cancer, even the serious metastatic disease that Edwards now has, as a manageable condition similar to diabetes. As something that, while grave, can be lived with — even in the grueling contest for the White House, and perhaps even as first lady.
"I expect to do next week all the things I did last week," Elizabeth Edwards said, "and the week after that and next year at the same time, all the same things I did last week ... I don't expect my life to be significantly different."
And her husband, acknowledging the cancer would never be cured, quoted their doctor as using the analogy of diabetes: "The disease never goes away. But you treat it ... you take your medicine. And that's exactly what we intend to do."
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To Dr. Richard Wender, president of the American Cancer Society, looking at advanced cancer this way is relatively new.
"The comparison to something like diabetes — that's a whole new concept," says Wender. In large part, he says, it's a function of new treatments and better drugs that can preserve quality of life, for months or years. People like Edwards can show that "cancer has been converted from a short battle that you either win or lose, to a chronic siege," he says. A chronic siege, he adds, that you can fight while still enjoying life and pursuing your goals.
Edwards "will have a very important impact for many individuals," Wender says. "She can offer hope and courage to others facing more advanced disease."
When Dana Kaplan watched replays of the Edwards' news conference, she says she immediately felt as if it were she and her own husband talking. "That's exactly how we felt when I was diagnosed a second time," says the two-time breast cancer survivor from Westfield, N.J.
Kaplan and her husband had just returned from their honeymoon when the second round of cancer was discovered, five years after the first. She elected to have a double mastectomy.
"We said, 'You know what, let's get through this and move on and keep as normal a life as possible,"' Kaplan says. "And I think it was John Edwards who said, 'You can cower in the corner and hide or you can be tough.' It's true — you can't just stop life when something like this happens."
"It's wonderful that they've decided that it will be empowering for them, to fight back and pursue their goals," said Kaplan, now 41, a partner in her law firm and a mother of two young sons.
Dr. Linda Vahdat, an oncologist, remembers how not long ago — perhaps 15 years — people wouldn't talk about cancer. "They spoke about it in hushed tones," says Vahdat, director of the Breast Cancer Research Program at New York-Presbyterian Hospital/Weill Cornell Medical Center. "People wouldn't even say the word."
But now all that has changed, with huge marches for breast cancer research and people wearing pink ribbons, Vahdat says. And patients like Edwards.
"She can send a message of hope — absolutely," Vahdat says. "She's not letting breast cancer run her life, and I think that's great." Of patients who have stage 4 cancer like Edwards — meaning it has spread beyond the breast and lymph nodes, in her case to a rib and possibly elsewhere — Vahdat says "the majority are living normal lives — taking care of their families, going to work, and living their lives."
That wasn't always the case. "Decades ago, a diagnosis of Stage 4 breast cancer meant not a very favorable prognosis at all," says Margaret C. Kirk, CEO of the Y-ME National Breast Cancer Organization, a Chicago-based support group. "But we see people living for a long time with cancer now, realizing there IS life after a diagnosis."
Of the Edwards' decision to continue the presidential campaign, "I applaud them for it," says Kirk, whose organization runs a 24/7 hotline staffed by breast cancer survivors. "They obviously sat down together, discussed what was important to them and decided to go forward," she said. "It's their decision, and no one else can second-guess them."
Of course, the course of the campaign depends on how Elizabeth Edwards fares with treatment. And no amount of positive thinking can erase the fact that with breast cancer at any stage, you can never be sure you're home free. Edwards spoke of the constant fear of recurrence that survivors feel. And the singer Sheryl Crow, interviewed on CNN Thursday night, said that like many others she couldn't help but feel a tinge of fear when she heard Edwards' story — even though her own cancer was caught early and she believes she has been cured.
One grandmother of seven who's survived both breast and ovarian cancer says she still has fears, even at 73. Mickey Scherl was diagnosed at age 57 — the same age Edwards is now.
"I've never stopped worrying about recurrence," says Scherl, "but that's the reality. I can't live my life thinking about it. I have things to do, and people depend on me."
Scherl watched the Edwards' joint appearance, and was struck by John Edwards' words of support.
"He's obviously totally devoted to her, and to the country," Scherl said. "He said he'd be there for her, and I believe that. As long as she's feeling well, they should go for it."
And, says Scherl, she and countless others are rooting for them — politics aside.
"If I have anything to do with it," Scherl says, "she's going to make it."