Katharine Smyth, expectations and reality
When we get cancer, we think we have to act like the cancer patients in the movies. People who have no experience with cancer also expect us to act like these stereotyped, sanitized, devoid-of-personality presentations. Don’t act when you have cancer. Let yourself experience what you are feeling and thinking.
For example, if we are going into chemotherapy, we think we have to be nauseous and throw up every day. If we have surgery, we expect to be in a lot of pain, and that surgeons will always have to go back in and cut away more flesh. If we have radiation in our abdomen, we know that we’re going to lose weight from bowel disruptions and have constipation and diarrhea on alternating days as we try to wrestle our intestines back under control. While most of this may happen, it doesn’t always. I had two kinds of radiation, didn’t have diarrhea, and gained weight.
No matter what treatments we get, the mass media tells us that we will be exhausted, grow weaker, lose the ability to do the things we love, and die. Such a lovely, predestined scenario. Except it’s not true. Cancer is not a black and white experience; it has many shades of gray and many variations of reactions. While cancer used to be the mark of death, advances in cancer research have resulted in 80% of people surviving at least ten years who were diagnosed early.
In her book, All The Lives We Never Lived, Katharine Smyth talks about how people expected her to grieve her father’s death, as well as how she thought she was supposed feel. And she doesn’t feel that way. She isn’t weepy for weeks, and she doesn’t fall apart. She does grieve, but in her own way.
The same cancer and the same treatments don’t affect every person in the same way. It’s not a monolithic experience. But cancer does shock us awake to see life differently. Katharine writes of waking up one day: “here was a raw new world, clear and hard as a diamond, in which everything that normally pleased was dripping with death….” Probably all of us, when we think back to the weeks after our cancer diagnosis, felt lost, scared, and sure that we would be dead within five years.
Not everyone who seems stoic about their cancer is repressing their emotions. You don’t have to fall apart when you have cancer. Find your own way to cope, and choose how vulnerable you want to appear to others.
Katharine talks about there being a culture of grief worship in Virginia Woolf’s day, as well as in our own, that expects grief to alter us, to explain us, to weary us to our knees. It’s the same for the culture of cancer. Yes, cancer hits us hard and rearranges our life, and it takes up a lot of our time as we’re being diagnosed and treated. But it’s not our entire life, even though there are months when we seem to be doing nothing but going to appointments with our oncologists, endocrinologists, urologists, gastroenterologists, radiologists, dieticians, and counselors in order to give us the best chance of surviving.
In the “M.I.A.” episode of N.C.I.S., Navy Lieutenant Laura Ellison has ovarian cancer, and the N.C.I.S. crew is pushing to solve a murder before she dies. What its writer, Jennifer Corbett, gets right is the portrayal of the dying woman. According to Katherine Cunningham, the actress who portrays Laura, Corbett based Laura on a person she knew. For her part, Cunningham goes beyond the stock presentation of someone dying of cancer and conveys deeper emotions—the physical struggle of dealing with a terminal disease, her wry humor, concern for someone who was under her command, despair when treatments stop working, and resolve in facing her finality when the last experimental therapy fails.
Cancer impacts us. It is a body blow, especially while treatments are going on, and the fear of dying is a real and persistent worry that never quite goes away. Does cancer always transform us into a different person? While we physically don’t feel the same, we have probably altered some of our behaviors to align better with our values, like not constantly pushing to get more work done, taking more time to be with others, and responding to people who are suffering with compassion instead of judgement. Maybe cancer becomes our wakeup call to live the way we’ve always wanted to live because we realize that life really is short, even if we didn’t have cancer.
What I’m trying to say is this. Don’t pretend that having cancer is easy. Don’t brush off people who honestly want to know how you are doing. Don’t act like how you think a cancer patient should act. Be yourself. Don’t look at the life expectancy chart to see how long you are predicted to survive, because then you will dial down your expectations to an artificial timeline and settle for less.
You deserve more than this. You don’t know how long you will live, so live until whenever. How you cope with your cancer, how you think and feel about your cancer, is up to you. Be proud and heroic, or scared and depressed. Whatever. Just be real. Find a way that nurtures you. Let yourself feel what you feel, and do what you feel like doing.
Be open about having cancer, especially if you don’t look like you’re sick. Share what you are discovering with your friends. They need to know what having cancer is like, how they can help you, and they want to know that they are still part of your life. Don’t shut them out.
Cancer doesn’t just affect us; it affects everyone who loves us. Invite them in.
© 2026 Mark Liebenow
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