Diagnosed with invasive ductal carcinoma at age 26, Beth Silverman initially chose a lumpectomy in trying to preserve her natural figure. However, she was then diagnosed HER2 positive, a rare but aggressive form of the disease for which the odds of recurrence are high. After chemotherapy she chose to have bilateral mastectomies and immediate muscle-sparing free-flap reconstruction. Happy with her new breasts, she wanted the world to know that, although cancer takes many things, it could not diminish any part of what made her a woman.

Rather then wonder “Why me?,” Beth always says, “Why not me?” Beth works tirelessly supporting and motivating survivors. She is certified as an American Cancer Society Reach for Recovery volunteer. As a society representative, she visits hospitals support groups to counsel women and offer support and hope through her story.

Beth has been featured in Allure magazine, Self magazine, Newsday, The Washington Post, New York Magazine, and USA Today. She regularly gives speeches for Making Strides Against Breast Cancer, Relay for Life, and the Celebration of Survivorship. Beth was named the Executive Director of BreastReconstruction.org in 2006 and aims to educate women across the globe about their options for reconstruction. 

    Anyone can tell you about their life before breast cancer. It was perfect, they’d say. Okay, maybe not perfect, but perfectly normal. Tales of budding careers, buying a house, getting married, spoiling a new grandbaby, or finally entering retirement. All of these people can tell you exactly what they were doing before and exactly what they were doing when cancer interrupted their perfect lives. This is usually the “unfair” phase. It’s not fair. Why me? This wasn’t supposed to happen. I did everything right. I ate well, hardly drank. I have no family history!

    Once the realization kicks in that life isn’t fair and that cancer hardly plays by any rules, you’re usually in the throes of your diagnosis. You’re making decisions that feel rushed, while you’re searching for information; only, you can’t find quite what you’re looking for, and you are completely overwhelmed.

    Everyone around you is a cancer expert. From doctors to friends, everyone seems to know everything about cancer: Why you got it, what you need to do to “cure” it. You are trying to keep some semblance of your past life. Maintaining the kids’ schedules so as to not displace their comfortable routine, staying on top of your workload while becoming an HR expert, learning about paid leave and disability. You’re rearranging your life, all while cursing cancer.

    Why me? Why now?

    Cancer changes you. You can point at the lovely sign you have hanging on the wall which lists all the things cancer cannot do. You probably received this as a gift from one of your cancer-expert friends; on some days you draw inspiration from it, and on others you just want to throw it out with yesterday’s trash. 

    Life during cancer is a whole new ballgame. You walk past the mirror and hardly recognize the person looking back at you. You hardly have the energy to move from the bed to the couch, yet somehow you find strength to argue with the insurance company and get dinner in the oven. When no one is around you crawl into the bathroom and completely melt down as the warm shower trickles over your bald head. You cry for the woman you once were. You caress the spot where there once was a lively breast. Even if it was droopy and sagging, it was still yours, and it had nursed children and brought you pleasure. Only now, that seems so far away. You endure all the chemo and radiation and whatever else they tell you to do, because somewhere in your tired body lies a strong woman who will do whatever it takes to beat this beast. You will not go down without a fight.

    And then one day, you are done. You’ve finished your treatment. You’ve completed your reconstruction. You even have hair sprouting on your head. You bring gifts to the oncology nurses and turn and wave with a smile as you leave the building. You get in your car, holding an appointment card in your hand that says you don’t have to go back for six whole months. Think of all the things you can do! You can live again, you think to yourself. You can actually make plans that don’t depend on your blood counts, you can take a vacation, you can juggle work and a myriad of activities, you can have the holidays at your house again. You can be you!

    Only, you find yourself still sitting in the parking lot with the car in park, and you are overcome with emotions. You don’t know whether to be totally happy or totally scared. This isn’t the seamless transition you had hoped for. You had heard people in your support group talking about finding their “new normal,” but you never really thought about what that meant. And what if your new normal doesn’t fit in with everyone else’s plans? The non-cancer people in your life, the people who supported you in your darkest hour, want you to go back to the old you: the person you were before cancer came and messed things up. And you sit there, paralyzed with fear, because you know you will never be that woman again.

    You have the “I’m All Better!” celebratory dinner with family and friends and keep mum about the thoughts racing through your head. Whenever you’re asked how you are doing, you smile and nod and respond that you are doing well and everything is fine. But inside you are screaming, “It’s not fine. I AM NOT FINE!!” You can feel your blood boil, and you want to shout out at the world, “I am not okay! I am tired, and I don’t feel like myself, and I AM SCARED! Every time something hurts I think it is cancer again, and I feel vulnerable. Quit telling me how strong I am and how amazing I am for what I just went through. Open your eyes! Don’t you see I’m frightened? Don’t you know that I feel robbed and angry and broken? Do you know I struggle with guilt? Do you know how bad I ache for the women who were my cyber-support system and have mets or will not live to see their babies grow up? I beat cancer. I beat the beast, and I’m supposed to be okay. But I don’t feel okay. Why isn’t there a handbook for this?”

    There really isn’t a handbook for life after breast cancer. I often tell the women that I counsel through various support groups that moving beyond cancer is sometimes harder then being in active treatment. They always look at me like I’m crazy, but I know in time they will understand. When I was asked to write for There Is Life After Breast Cancer, I could have written about my journey. I could have told you how I was diagnosed at age 26, was dumped by my long-term boyfriend after my bilateral mastectomies, lost my job, fought for Herceptin before FDA approval, and was almost bankrupt, only to turn it all around and come out with incredible breasts, a loving and dedicated man, and a career that allows me to empower women with breast cancer around the world. But I chose not to. Instead, I’d rather talk about real tips, real things you can do in your life to help you move beyond cancer. It’s not easy, and it doesn’t happen overnight, but it will happen.

    First things first. Have real expectations. Your body has just been through a war. It takes time to get your energy back. If you’re on the five-year pill plan for estrogen-positive breast cancer, there will be an added adjustment period, and you have to be patient with your body. The first tip in moving into your life beyond cancer is managing your doctors’ appointments. If you had a lumpectomy or a unilateral mastectomy, the healthy breast needs to be monitored with mammograms. If you had one breast reconstructed and the other breast lifted or reduced, that breast still needs to be monitored. Make your appointments, and do not miss them. Is there fear when it’s time to have these appointments? Yes. Does it get easier with time? Yes. Is it okay to get tense, nervous, or scared? Of course it is. But you didn’t beat cancer in order to start giving it back any power over your life. You are in control. Spacing out your appointments with your oncologist and breast surgeon will give you the feeling that you are continuously being looked after, and your days off won’t be filled with various doctor appointments.

    Feeling down about your looks? Your hair not growing quite fast enough? Think about the cancer “hotness factor.” I came up with this after my treatment was over. I got color back in my face and pep back in my step, my hair was so healthy and shiny, and I had no worries about my new breasts sagging any time soon. My friends were panicking about hitting their milestone birthdays. I was celebrating! They were worried about wrinkles and gray hairs. Please! I just got over being bald, bloated, and miserable. There’s no way a tiny wrinkle could get in the way of my celebrating being able to wear mascara again or buying my first ponytail holder.

    Of course, there are more challenging issues. You’re back at work or shopping at the grocery store and everyone asks, “How are you? Are you cured?” It’s best to have a blanket statement for these situations. Non-cancer people need to hear that you are okay in order to feel better themselves. Kind of twisted, but it’s just the way it is. You might say something like, “It feels good to be able to say I had cancer, and I’m enjoying taking back what cancer tried to take away.” If you’re passionate about the fight against breast cancer and raising money, you might want to say, “Just because I got better, the fight against breast cancer isn’t over. I’m involved in . . .” and then hit them up for a donation. If it’s someone in your inner circle and they really want to understand if you are cured, you can say, “There isn’t a cure, but right now I am NED (no evidence of disease), and I am not going to live in fear. And sometimes I might need a little help with that.”

    Fear. Let’s talk about it. Most people talk about fear of the unknown. But that’s not what this is. You had cancer. You have friends with mets. You know the game. Your fear is not of the unknown. Your fear is of the beast rearing its ugly head again. You beat cancer. You want to reclaim the life that cancer tried to steal. But how do you beat the fear?

    The biggest fear is that you have a recurrence. Every ache and pain becomes an instant battle in your mind. There are some simple survival tips that have been passed down through the sisterhood. The two-week rule, for example.  If a pain is consistent for two weeks, that is when you should call your doctor. You will have all sorts of aches and pains. It takes time to accept the fact that you are a normal person again and that the pain you have in your back is from overdoing it in the yard, not from cancer. If you do have a pain or a mammogram that gets called back for further clarification, your mind will immediately run away with you. Rule #2: Do not board the train without a ticket. You cannot let fear rule your life. You are in control. Someone once said something to me that I will never forget: “Beth, you can live your life in fear of having a recurrence, and if it never happens, you’ve wasted your life. Or you can live your life in fear of having a recurrence and if it does happen, you’ve still wasted your life.”

   Those words have stayed with me always. I live fully, to honor our sisters who did not get the chance. I still have my share of bad days. I still sweat the small stuff, but I don’t get down on myself about it. I’m doing the best that I can, and that’s all anyone can really ask for. It does get easier with time. I’m not just saying that, I’m living it. With each cancerversary I reach, I look back in amazement. I can’t believe I’ve come so far, and I’m excited that there is still so much left to go. With each day that passes, I discover new purpose, more passion, and a yearning to experience all that life has to offer, and I hope that you will find the same.

    I’ll leave you with my favorite quote, by Orison Swett Marden: “There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something better tomorrow.”