I first discovered a lump in my right breast towards the end of August last year, went to my G.P. who immediately referred me to the Nigel Porter Breast Unit at the Royal Sussex hospital in Brighton, but it was a further eight weeks before there was a confirmed diagnosis and operation. I recovered quickly and well from the mastectomy, but it was discovered that I had a rather aggressive tumour which had already spread beyond the breast and the lymph nodes. I am now in the middle of chemotherapy, which is administered at three-weekly intervals, and I have just had the fourth out of six treatments. I get the impression that I have been fortunate, as apart from hair loss I have suffered fairly minimal side effects and have been able overall to maintain a very good quality of life. After the chemo I move on to radiotherapy, which is administered five days a week for five weeks. There is then the possibility of my participating in the international trial of a relatively new drug (herceptin). This has already been approved for use with patients with my specific type of breast cancer when it has already spread to other parts of the body, and they are conducting trials to see if it is beneficial for patients like me where, as far as they know, the cancer has not yet produced any secondary tumours.

So much for the medical details, but the reason for writing this article is to share with you some of the thoughts and feelings which I have experienced as a result of having what may be a terminal illness. It has been a huge learning experience, and I tend to feel that the insights I have gained outweigh the obvious downsides. The first words that flashed into my mind when I found the lump were 'This is it!' I don't think I meant by that 'This is the end', but rather 'This is the big test'. I have always felt that I have never been truly challenged, never really tested out, and I knew that this would be the occasion to find out. I felt that how I responded to this would reflect the sum of who I was and how I had led my life. The eight weeks before the operation was a very anxious period, when I thought a lot about death and focussed my worries largely on what would happen to my little dog Joe, who is now my life's companion. Nevertheless I still managed a few wonderful days with friends in the South of France, which were rendered even more intensely enjoyable because of the uncertainty about my future. It was there that I began to learn how to live fully in the present and to make the most of every moment. As a consequence I have experienced some of the happiest moments of my life and sometimes great peace of mind. I now try consciously to make every day worth living, and it works!

Knowledge of the seriousness of my cancer has actually had a very liberating effect. It has freed me up from the constraints of social obligations and other people's expectations and allowed me simply to be myself. This has come about partly from all the messages of friendship, support and encouragement which I have found immensely moving and which have made me realise that people value me for what I am, not for what I do. I have always felt the need to justify my existence and guilt that I wasn't doing enough, but now I realise that what is important is being true to oneself and living one's life with integrity. For some people this means being very active on the local, national or international stage, but we are not all called to this kind of work, and we are not always aware of the contributions we make in apparently small ways. Sometimes a word of friendship or encouragement said quite casually at what happens to be the right moment can make an immense difference to another person on their life journey.

The next stage for me on my journey is to decide whether to participate in the herceptin trial. It is not a clear-cut decision. If I am randomly selected for the control group, I will not get the drug but will be monitored along with those that do. If I get the drug, it means treatment at three-weekly intervals for one or two years. It would be a huge commitment, whereas all I want is to finish treatment and get on with my life. There would not be the side effects of standard chemotherapy, but it would be administered in the same rather unpleasant way. My initial reaction was to think 'No, I don't want the next possibly two years to be tied up with cancer and to revolve around hospital appointments.' But I have to accept that my particular type of cancer is likely to spread, and this is leading me to ask why, given that we all have to die, I should try to extend my life. For many people the answer the answer would be because their family needs them, they want to see their children grow up, they feel they still have important work to do. I do not have any of those aims, yet I need to feel that there is some meaning to my existence. The experience of cancer and the warmth and love that has come to me as a result has made me feel that perhaps I have a responsibility to those who care about me to do what I reasonably can to be around for as long as possible. Perhaps my life, like everyone else's, is worth preserving just because I am me, and like everyone else I have the inner resources which will help me through. Whether one puts a religious label on these resources or not does not seem to me to matter.

Christine Russell