I had a significant crash out last week which unsurprisingly peaked after my (fourth) cancelled chemotherapy appointment and lingered long after my 8am oncology appointment the following day where I was encouraged to seek yet another second opinion. While in some ways chemo has felt less lonely and easy(er) than doing this the first time around – like every goddamn thing related to cancer, the ease lasts only a season.

Don’t get me wrong, I will be glad when I no longer need to make a weekly commute for my central line of poison. But there are things about chemo that I appreciate.

And what I mean by that, is it’s time-bound and contained.

Because having a cluster of life-threatening cells in my armpit means I know, not hope or assume, I know what I’m doing for the next five months – period; something I haven’t had the luxury to say since before 2023.

I’ve built rapport with nurses and medical assistants who have become community. By some miracle (ty cold capping & Gladys) I still have my hair. And when chemo side-effects pop up, there is almost always a path to remedy the situation. Diarrhea? Try my Pedialyte Mocktail!2 Painful mouthsores? Have a spoon full of Magic Mouthwash3 (albeit 3 days late, because #GWPharmacy). Worried about the deep loneliness of going to treatment alone? Call in your community and let them to support you.

This chapter of active treatment has brought some of most loving moments with those who decided to show up. They made it through the great filter of cancer 1.0, and want to be here for the second round. I cherish my community. They want and get how to show up, and their expression of love makes it all the easier to get through the long tunnel that is chemo.

Even still, I naively forgot that just because I answered the: how do we get through chemo? and who will show up? questions, didn’t mean I wasn’t also tasked with answering bigger and tougher questions while still in treatment.

A month ago I saw a radiologist, my oncologist, and breast surgeon all in one week (chemo was in there too). And although I was building my sanity around my chemo end date of Aug 25, cancer has no brakes.

My surgeon disagrees with my oncologist. My oncologist says to ask the radiation oncologist their opinion, who already recommended I get a second opinion. And then there’s days spent scheduling scans and consults. All so that I can make a surgical and radiation plan, not for the next five months, but for the next two months which will impact at least the next five years.

In some ways I feel like I’m being dramatic, but then I think of the giant arm I googled researching lymphedema.4 Then I think about a relative chastising me that looking at the internet isn’t helpful, to which I think if you had a bomb living in your body, I bet you’d learn the difference between cutting a red wire or blue wire.

I still am not finished with chemotherapy and it’s already time to make a choice on what’s next.

Choice.

What an interesting word.

Because I see my peers making choices. Even if they stem from inertia or convenience, they get to make their lives. Choosing what jobs to take, who to build a life with, and where to travel to in 2028.

My choices are currently to do an axillary lymph node dissection5 and potentially fuck up my right arm (lymphedema) + radiation OR opt for a targeted lymph node dissection (and give any remaining microscopic cancer cells the potential to return) + radiation.

Oh, and did I mention I turn 35 in less than a month?

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Last Sunday, I was driving friends back to DC after a gorgeous trip to a friend’s home in North Carolina. I made an impulse choice to go because I had chemo Tuesday (or so I thought) and wanted to get out there living6 – I am dedicated to doing as much as I can, while I can. And it was great!!! I swam in the water, Roscoe got on a boat, and this was all after a very lovely Friday at Jazz in the Garden and friends in town.

So Sunday night, my oncologist called me as I drove three friends home in torrential rain and heavy traffic. And I can’t not pick up those calls (regardless of who is around) because I spent at least a week trying to get a hold of her.

So there I was me, my oncologist, and everyone else, hearing me weigh options that are the things of fiction to 98%7 of anyone under the age of 40.

People throw around the word unfair.

Cruel feels more appropriate.

Because no matter what, cancer lives with me; it’s part of my story and it never won’t be. And I don’t know what to do with this other than feel incredibly irate or grief stricken.

No amount of love or support negate that the isolation of having to make medical decisions and being the sole person living with the consequences, is too much. At best it feels like my friends take turns leaving their warm homes to stand with me in the rain…until they go back to the real places they reside.

And how, in that start contrast, will I ever love my friends again? Properly? The way I used to? Especially when the consistent character of my thirties was cancer and theirs was [insert 30something milestone here]? Because I don’t know how I’m supposed to make choices like these and cut pieces of myself out one after the other while having a front row seat to their lives.

So when you ask how I’m doing, I’d say: I’m losing my mind, I’m overwhelmed, or I’m scared. But I’m really only feeling those feelings when I have a break from begging to get things scheduled, and identifying which decisions I can or cannot live with.

August 25 already feels in the past because I’ve got more shit to do.

And that just feels shitty.

So imagine my surprise when last Tuesday my nurse told me to pack up and go home due to a low ANC1 count. Instead of feeling relief that I wouldn’t be poisoned that day, I felt something closer to disappointment and dread.

By that point, I had sat in the chemo chair six different times. I’ve experienced the slog of waiting for labs, my cold-cap tech coming in late from a literal car accident, and the regular office assistants taking their sweet time acknowledging me for check-in. But I’ve never seen concern on the face of my support staff. Three hours into my wait, already knee-deep into my emotional support Ativan, nurse Olivia opened the door with a lingering “heyyy” and I immediately thought: something is wrong. I’ve been through enough cancer diagnoses to know that face. After three hours, an initial port draw, cold cap fitting, and then a second port draw to double check, my companion and I were told to go home.

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A “healthy” person would hear this as good news: “yay! A week off from chemo!” But my mind immediately went to logistics. “Does this mean I need to do another treatment? Are we delayed a week?” So when the nurse couldn’t answer those questions and needed to confirm with Dr. C, I internally panicked.

The thing about not being poisoned on schedule is that there’s no time to enjoy a temporary “reprieve.” I have meticulously whiteboarded and calendered all sixteen chemotherapy treatments. Aug 25th is my holy grail – the symbolic finish line of the five-month saga of discovery, diagnosis, and treatment (and that’s just for chemo, there will be radiation and surgery after that!). So when there’s a whiff that we’re off schedule, my brain doesn’t think, “a week off!” It thinks, “Does September 1 become infusion day? Four days before my thirty-fifth birthday?”

I HAVE THINGS TO DO, PLACES TO GO, AND PEOPLE TO SEE, DON’T YOU GET IT!?

Luckily, the answer was we just skip a week, but I certainly felt validated when my chemo companion said she had the instinct to cry too when the nurse broke the news. Because it’s not just a schedule change, it’s a change within an existential and physical pressure cooker where my life is already subject to the whims of cancer. I don’t get to decide treatment, and I certainly don’t decide when cancer shows up (or shows up a second time). The only thing I can do is plan around it and hope for the best.

Cancer reminds me how little control I have, while my peers are lucky enough to make consequential age-appropriate life decisions under the assumption that tomorrow will look like today. For most, it will. And that life is easy to construct when the floor isn’t likely to cave in underneath your feet.

With the unexpected free time Tuesday, I took myself to King Spa. It was wonderfully empty and I cried in the rooftop jacuzzi. Somehow I felt more disheveled with no treatment (you can ask Stephanie) because not recovering gave me ample time to ruminate. I have been so accustomed to recovering, I hadn’t considered what to do with a day not spoken for. Luckily for me I can bring that unresolved irony to my friends, when I can’t make sense of things.

So here we go again tomorrow. Hopefully poisoned right on schedule (and no don’t congratulate me on that). One more infusion down, one step closer to getting back to my life—or whatever version of it exists beyond active treatment.

This is three Mondays in a row now, so according to what I know about comedy, we now have established the game of the scene. And the “game” is that day-before-chemo dread is real, and it’s one of the few things my psyche gives my body permission to feel in real time. I cried randomly at church Sunday – not because I felt something, but because I saw hope within an established community, longed to feel anything, but I couldn’t.

Or how last Thursday night, while journaling, I finally cried, out of profound gratitude for the people who have stepped up, and fear because their very care that keeps me grounded might disappear. This being my second cancer rodeo, I know you can’t always tell who will be there when treatment is over and the feelings actually show up.

Or that endless scrolling on Redfin is somehow hopeful? Because it means I’m choosing to live as though there is a curative approach to this recurrence, as though I can still make big future plans. But somehow, the thought crashes in that these plans are lofty because not everyone makes that kind of recovery. It’s the simple grief of living as though you have time but knowing maybe you don’t.

And honestly, that fear is an avoidant one. Because life down the line isn’t what’s at stake. What’s in front of my face, the day before infusion, is that I have to make yet another step on this marathon. It’ll be round 3 of 16 rounds, and then surgery, and then radiation.

Are you exhausted yet? Me too.

5 Random Things within 5 Random(ish) Categories

1. Ways I compartmentalize:

   1. Rearranging my entire apartment and putting a Wayfair coupon to use! We’re building a 30 sq ft resting nook!

   2. Reading Jane Eyre for the first time (this little girl is great)

   3. Approaching cancer as my ‘manager’ self – she’s good running the 501c3 that is Keep Simone Alive

   4. Setting up dates and shooting my shot in your mom’s DMs 😛

   5. Taking Roscoe to the dog park

2. Things I’ll process if I ever have the time

   1. Getting a second diagnosis – I’ll let my therapist correct me, but until then – no, I’m not thinking of my recurrence as traumatic, because I can’t take one more “thing” to process in my 30s while peers frolic and build lives

   2. Lymph-node surgery and the risks it poses (tbd when, but that’s a Fall problem)

   3. Cancer ghosting – people who sat in waiting rooms in ‘23 are nowhere to be found in ‘26

   4. The person who floundered at ‘in sickness and in health’ with me, feeling confident enough to promise that to someone else after one seemingly crisis-free year.

   5. Family and loved ones still not being able to meet me where I’m at

3. Observations (or judgements lol) on the outside world from inside the infusion center

   1. Most things have solutions – they’re just hard. And people don’t like hard

   2. In sickness and in health is bullshit – or rather something I doubt anyone under the age of 55 knows much if anything about

   3. People can be avoidant forever or as long as nothing forces them to take radical inventory

   4. If you don’t sit down, life might make that choice for you – take care of yourself

   5. “No help is coming, so you’d better start saving yourself”

4. Second time around surprises

   1. I cry far less – meaning I probably am feeling a lot more than I can access

   2. People can show up, want to show up, and will love me the way I need to be loved. I love the people who want to be on the journey with me; friendships deepen, and I’m still surprised and honored to be loved by some of the best.

   3. My Libido! Existing!! And showing up (God bless Sativa and that 4-day window before infusions)

   4. Enjoying the benefits of doing cancer uncoupled – I have nothing and no one to manage but myself and my health *shrug*

   5. Having a dog even in treatment is good for the spirit – we’ve made great progress on the words “ball” and “around”

5. Future plans I hope to make:

   1. Enroll in an EMT class

   2. Take a road trip either cross-country or down the PCH

   3. Stay in NYC for a month to help out the family + explore

   4. Explore and live in new cities

   5. Take a risk and go all-in on building a life that excites me

While I am certain that sixteen rounds of chemo is going to kick my ass in one way or another (I don’t make the rules), all in all April 14th was a good infusion day. For a Monday hangover that included a delayed train, walking over literal rocks to deboard the 55 Vermonter, and getting home at 2:30am, I surprisingly had good spirits 6 hours later on infusion day.

The cold cap I’m using (courtesy of a clinical trial) isn’t horrendous, because of said cap, my mom and I had a room with a door (!!!) and also the biggest news of all, I’m obsessed with my port or (as I joked last week with the surgical nurse), my “M3gan power button.” Seriously, one prick!? that’s it? To take blood, run labs, and administer drugs – my formerly bruised and fished through IVF veins can’t believe it.

I’m no Pollyanna but I will admit my attitude the second time around is different. Not better, just different. Why? Because three years ago a very resilient 31-year-old was plunged into cancerland with 0 information, 0 medical consensus, and had to learn a shit-ton fast.

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And despite being originally dismissed by her doctor, deciphering the hellscape that is US insurance, scheduling & showing up to every doctor appointment, withstanding heartbreak, cancer ghosting, and a depressive episode…

.…she lived.

And hopefully, if I could do that then, I can survive this too. Like having the foresight this time around to whiteboard out every possible thing I’ll need during active treatment and knowing who to ask for help is an enormous leg up in and of itself.

That prior knowledge, plus an incredible amount of love and support received (thank you <3), are about the only things keeping me grounded and interrupting the despair loop.

Because I know I could not make it through one single minute of this alone. That despite waiting 3 hours to be seen at MSK the Monday before infusion day, getting to say goodbye to my loved ones in NYC the day before chemo was worth every minute. That after everything last week, I was fortunate enough to have three people drive me to my port placement surgery, and do things around the house and tell me to sit the fuck down while they fold my laundry. Because even though some assholes might minimize your “outpatient” experience, this shit is real and it is not only okay, but necessary to let people help you.

Good spirits notwithstanding, the situation is still hot garbage.

While discussing how trash the whole being sick and young thing is, my sister aptly asked, “is there ever a good time to get cancer?”

No. Definitely not.

But I do think there are seasons of life when cancer is fundamentally less destabilizing than getting it in your thirties.

I can’t help but find myself internally screaming: can’t I just get a soft life too? The kind I see my friends have? And even if they wouldn’t call their lives soft, anything without mortality dangling in their face, looks soft from where I sit. Finding a chosen family, growing your own, settling into careers, and caring for aging parents are hard enough without a side of ductal carcinoma getting in the way of whatever foundation you’re trying to build.

And it’s hard to not see the differences between them and me. Because I know that the hardest part of cancer for them is witnessing me go through it – not surviving it. And it makes me furious, because I wish I were that fucking lucky. Like when people say they’d never get out of bed if they were me, I think: yes you would, if the alternative were death. That’s the choice. My peers hold their breath, hoping for my life to get better to “after” treatment, but I know deep down there is no clean “after,” even if chemo does its job and is curative. That hitching my life to an “after” feels precarious when a) survivorship is a lifelong journey and b) I’m unsure if I get another 10 years cancer-free or otherwise. And the only reason I can type that fear without crying is because of the clear PET scan early this month that showed no sign of metastasis.

Because what I’m looking at, the road ahead, and the lymph node that is buried deep inside my chest, feels like holding an unstable bomb and hoping for the best.

I want to know I can still be in control of my life – have a life – and have treatment, not just survive a series of random biological events happening to me. To have something, anything in my personal life that grows. The way I see the lives of my peers grow, just by continuity alone.

That I’m not just a corpse. That singing still matters. That dancing in Penn Station with Stephanie Monday night waiting for the delayed 55 mattered. That even in between the port draws and holding breath for good news, that I too can have a life, in these circumstances, that is still full and joyful and expanding. One where people don’t want to pull away but come close. Even if that’s impossible to believe given what we learned the first time around. That one day I will finally have my post-treatment-hot-girl-non-depressive episode, summer. Seriously, I am liable to do heaux shit well into my fifties as vengeance.

That people can still love this messy, imperfect, sharp version of me through it, anyway.

But I truly only want to do it, if there is promise of a life braided through.

Side Quests:

1. Yes, I really made a chemo whiteboard. Despite what some people at work may have believed, I do in fact know how to make a project plan.

2. Not an MSK doctor dramatically saying “suicidal ID-A-SHUN 👁️👄👁️” while reviewing my chart to spell it it phonetically.

3. You need thick skin to survive this. Gladly, mine has grown.

4. If you are able, please donate or share: https://gofund.me/326f1e7d5

   1. If you’d like to sign up for chemo care, text me and I’ll send you the spreadsheet link.

      More on That Later: Notes on Being Young(ish) and Sick is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

But as of this morning (and well into the afternoon) I waited IRL not just in (single cancer survivor) existential dread.

I had my 6-week oncology follow up, but I also had felt a lump in my right armpit (the cancer side) that needed to be addressed. As evidenced by my increased wine intake last week, it was stressing me out.

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So today, I waited. For my 9:45am appointment. For the follow-up labs across the hall. For the nurse to find my good vein after a bad stick.

I waited to check out after labs to get my 6-week Onco follow up and CT scan on the books (April 28 + Mar 26). I waited for the script of capecitabine to be filled. For the front desk woman to stop talking to her co-worker and check me in. I waited to be called for the ultrasound (bless my Dr., who got me in the same day). For the sonographer to stop swimming in my armpit. For my body to feel like a body, not an arm being painted on with lube by an ultrasound — grossly intimate and deeply depersonalizing. For it to end. For her to send me to another room to wait for the doctor to say what she saw.

I should have known from the box of tissues that this was not the place to be. Then a very kind radiologist came and sat down and had the face I hoped she wouldn’t have.

“Your lymph nodes appear abnormal, so we’ll need to schedule a biopsy.” She was very kind and touched my elbow to give me a second and a human moment.

I cried. Because what else was there to do?

As much as I feel ambivalent about my upcoming cancerversary (Mar 21), a 3-year anniversary is a whole lot better than a 3-year anniversary plus a potential relapse or actual relapse.

Post diagnosis I think of my life as me passing cinder blocks on scorched land in the middle of a cul-de-sac where my friends have running water and plumbing and I’m still trying to stand steady and strong enough to lay a foundation. But today, and especially post-diagnosis, it feels like there’s a house of cards on which my life is built. And it’s one lump, one lab result, one scan away from it all blowing over.

Sometimes I kvetch to GPT about being behind (the existential waiting, remember?) and they keep saying that my ‘timeline was interrupted’ but the truth is, this is the timeline. There is a hanging possibility that the wind can knock it all down because it could be benign, or…it could be another traumatic event – like what already happened to me.

It’s not an abstract “hit by a bus scenario,” it’s the remaining numbness in my right breast, the lack of range of motion when I bend, or the oral chemo I need because of an amputation I had to have for a cancer I found either just in time or too late. Now, it’s a biopsy on Thursday.

A needle, some lidocaine and a lot more waiting (7 business days give or take). And then, I will need to speak with my doctors to decide what comes next.

Now, we wait.

Medical 101

Capecitabine (Xeloda): Oral chemotherapy drug often used after breast cancer treatment to reduce the risk of recurrence. Taken in cycles and can come with side effects like fatigue, nausea, and hand-foot syndrome.

Lymph Nodes: Bean-shaped areas of tissue that filter fluid in the body (lymph) for harmful substances or cells. Immune cells in lymph nodes remove germs, damaged cells and cancer cells.

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What exactly comes next?

Whatever it is, will I feel held? Consistently?

Is there another side of heartbreak? How many?

Will I be excited, big-picture, about my life again? How?

Will it be full, or will this loneliness stick?

I feel okay today, great, even, thanks to: espresso, Roscoe, and a few good friends. And yet there’s an awkward distance between feeling comfortable in the now and imagining what comes next. ’Tis the season of reflecting on the year behind you, where you are in life, and what you hope to manifest or change. However, the New Year highlights the antithesis of how I have to live as a cancer survivor.

They say grief changes over time. But how does that work when the grief centers around cancer, something as alive and unpredictable as life itself? It’s not a death. It’s not final. My CT scan this Wednesday is proof of that. It’s a monkey on your back that won’t leave, and who knows what that asshole is liable to do; or who’s willing to sit with you and your monkey.

Things are infinitely better. Liberation from a two-year medical menopause will do that. TMI, but the ability to have a satisfying conclusion to a long intimate moment with Ilya Rozanov and myself on New Year’s Day was an impossibility two years ago. Horniness helps.

Even so, I can’t plan ahead. Not really.

That monkey keeps the schedule unpredictable.

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We love to say, “you never know what will happen,” and that’s technically true. But because life follows patterns of probability, we build our lives around what we expect to happen. Of course we do. You don’t plan your life assuming electricity, currency, or mass transit will suddenly stop working. Why would you?

You could get cancer at 31, but you probably won’t. Instead, statistically, your thirties are when you start having better sex, progress in your career, cohabitate with one or two people, and settle into something resembling forward motion. You don’t believe—and shouldn’t—that a biological bomb is waiting to announce itself. So you build your life looking ahead.

I did it myself. I left my job in January 2023, the month before my symptoms began, on the cheapest possible healthcare plan. #AskMeAnything #NoRegrets.

Whether we admit it or not, we’re all hedging on a future we expect to exist.

It feels like nails on a chalkboard when I hear how clear things look for muggles. We’re going to Aruba in 2028, start saving. We’re moving into a house this year. I’m moving abroad by the end of 2027.

All I hear is this: when you’re not ill, you hedge on a future with options. You trust the stability of your body and your relationships.

When I think about my future, I think: Will I be in treatment in 2028, or will I be NED? How much money do I need in the bank if I lose my job and have to pay for platinum health insurance on Obamacare (thank Christ that’s still a thing as of January 2026). Will I meet someone? And if I do, will they stay when and if things get hard? Especially when we know that with cancer, being a woman is the biggest predictor of partner abandonment. Love, it turns out, has nothing to do with the capacity to sit with someone in the mess.

There’s a bubble of safety that comes with being free to imagine the future. It’s lonely, and spiritually limiting, when you can’t.

Shortly after diagnosis, I listened to a meditation about Buddhist mandalas. They create epic artworks, ring a bell, and blow everything away – a ceremony honoring impermanence. I was furious. Not because impermanence isn’t real, but because they rang a warning bell. Cancer gives no warning. No pause to look at the beauty of who you used to be. No sacred space to breathe it in one last time.

Cancer is messy. It’s bloody fascia and deep solitude. It pulls the ground out from under you like a rug.

I don’t know how to live in that. I don’t assume most people do. Planning life injection to injection, ctDNA score to ctDNA score, day to day, for years is traumatic in and of itself.

Last year I went through my second cancer breakup. My dad went on dialysis. I started oral chemo, froze my eggs, and was poked and prodded more times than I can count. And in the midst of this surviving, rebuilding, and grief in my thirties, I

watch friends step onto the escalator toward what looks like stability.

Yes, I still do cool shit. Yes, I am still living. And the inability to plan—without factoring in medical scenarios and other people’s reactions to them—matters. Because in this kind of suffering, the AYA cancer kind, it becomes impossible to believe there’s an escalator or staircase for you. That the misdiagnosis, the gaslighting, the suicidal side effects, the solitude will be worth it. That facing your mortality, abandonment, and pain – showing up for your life – will lead you somewhere good.

And when the uncertainty is too much, it’s hard to imagine where this all goes.

But while I am able – here the fuck I go.

P.S. I am posting this sub SECONDs after Michelle Williams got a GG for Dying for Sex. Molly Kochan, you changed my life and so many others thank you <3.

Like any good coming out – you’re boldly living in your truth. Good for you – you did a really scary, brave, hard thing. It also means a deep identity shift for you and everyone who thought they already knew you. (Shout out to Shekeima for this metaphor and inspo for this post).

Overnight, you have a set of considerations you never had to factor in before. Like the government deciding which rights and benefits you are, or are not, entitled to. Can you be your real self around your family – or do we have to hide pride flags when the children come over? Or, what does parenthood even look like – can you afford it? You know, the small stuff.

Everyone thinks they understand, but they actually don’t – they can’t sit with some of these new pieces of you. So in turn, you diversify your social circle because this version of you needs air and community.

Screaming through grief in a soundproof glass box.

It’s the hardest and loudest your lungs have ever blown in your life – obviously something is wrong, but no one can hear what you’re saying. Some people walk past. Some people stay. Those who stay try to come and visit as often as they can. They place flowers down at your feet or put a hand on the glass, but your hands will never quite touch, and somehow it makes it all the harder. That the only thing you can communicate, no matter how hard you yell, is silence.

You’ll never breathe the same air and a part of you dreads that truth. But in-between cries, you remind yourself, maybe that’s true of everybody’s grief.

Randomly waking up Black.

Picture it – your immediate family is white, your community is white, your friends are white. Then, one unceremonious morning, you wake up with brown skin and 4C hair. People are fine with you living in the community – I mean it’s still “you,” but somehow, no one, I mean no one in your community is equipped to handle you. You just don’t fit.

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It’s evidenced by the growing pile of micro (or macro) aggressions. You speak exactly the same, but now everyone calls you “articulate.” At your regular store run at Target, Linda asks you for a price check on towels. You barbecue at the local park, like normal, but somehow the police show up.

Your anger builds and when you vent to your family that people are treating you differently, that your life is different, they only chirp back to say, “slavery ended 200 years ago – can’t you get over it?” You start understanding how things work now, and your place in it.

Getting through a horror/sci-fi/fantasy movie.

You’re the main character going through a gnarly change. Freaky, relentless kind of change. It’s Goldblum doing some of his best work (The Fly) as the lovely Geena Davis watches in horror while he quite literally falls apart. Neo going deeper and deeper down the rabbit hole. Harry Potter and Luna Lovegood seeing thestrals, creatures visible to only those who have witnessed death.

Having deep kinship with the witch of the woods.

There’s something about going through cancer at this age that I know has made me a little unhinged. But is it unhinged or just radicalized? For me, it’s noticing an increase in cackling. Literal cackling – I can’t help it. The way this country does health care and culturally avoids grief, shows up in everyday life – I cannot help but smile and think what a ridiculous mess.

It’s too absurd to not laugh. Like insurance sending me a letter that my fertility preservation appeal was denied, many weeks after my procedure wrapped (Cackle). Or the OneMedical sales rep who, in response to my anger about my delayed diagnosis, suggested she connect me to the Chief of Diversity, Equity, and Inclusion (Cackle. Cackle).

The interpersonal absurdities though – those guttural laughs hit.

Living alone, taking myself to every single appointment, and holding down a job to pay my bills, only to hear someone say they ‘feel like a caregiver.’ Watching a grief tourist explain to me – instead of a therapist – that my possible 20-year recurrence is a factor in how much they can engage. The insistence that I hold space and accept other people’s abandonment because they are grappling with emotional avoidance – which obviously Simone, is different but just as hard (Cackle. Cackle. Cackle).

I like to think, maybe, witches cackle because the idea of living in a world run by men, who’d rather see them dead than the powerful beings they are, is a ridiculous notion. And how funny for the puritans, thinking they stood a chance.

After making that noise over and over again, I searched the web and read that while witchy, maybe a cackle is a maniacal purge of everyone else’s bullshit. Maybe it’s just all you have left to say to a world hell-bent on dismissing what you survived.

Medical 101

Delayed Diagnosis — when a medical condition isn’t recognized, taken seriously, or followed up on in a timely way. For cancer, that can mean symptoms are dismissed, imaging is delayed, or referrals aren’t made until the disease has progressed, and is more prevalent among AYAs.

Recurrence Risk — The possibility of cancer returning after initial treatment. It isn’t a guarantee — it’s a spectrum of probability that varies by cancer type, stage, and biology.

For hormone-receptor–positive breast cancer, recurrence risk can stretch across 5-20 years. That timeline doesn’t mean you should live in fear, however, it does mean ongoing medical follow-up, lifestyle considerations, and long-term treatment plans are part of survivorship.

And what then do we make of our exhausted heroine? When the version of herself no longer fits inside the carefully constructed, limited society we live in?

I joked with a friend that I feel like the most clear, direct, and (post Tamoxifen & Zoladex) emotionally mature I’ve ever been. And yet, I can’t help but feel like people like me less. Not in a sign-my-high school yearbook way, but in that speaking from my heart or sharing how someone hurt me or stating my needs – is met with hostility. Be it: dismissiveness, invalidation, patronizing lectures. A response that is reminiscent of the many hospital visits that assert: you feelings don’t matter that much. And why are you even bringing them here?

Who am I to bother people with my honesty?

Maybe, I’m just a girl who has been pulled apart by surgical hands and confronted with existential dread – which makes me far too alive to be anything else but true.

Things said to me IRL. None of these things were said in bad faith, but hopefully you get a sense of why vulnerability and trust feel like a gamble (more on that later).

Responses to Vulnerability (with 0 context)

• “So [with the mastectomy] are you planning to go a size up – I always wondered about getting bigger breasts”

• “Do you know what it’s like to see the person you love on a gurney!?”

• “We are all going through a hard time Simone”

• “At least you’re young”

• “Well, you look great”

• “You made me realize, the commercials where they list suicide and depression as side effects, really are telling the truth”

• “You act as though we let you down because we can’t hold your feelings”

• “How long are you going to be this way until you let it go?”

• “Just take it a day at a time”

• “You have to write our board a letter as to why you switched fertility clinics”

• “I already said I was sorry”

• “Your appeal has been denied”

• “You’re an inspiration”

• “It’s also hard for us. We don’t know what to say”

  

• “I have to take myself to the hospital too you know”

• “At the same token, we should talk about how you show up as a friend”

• “Worried? From what my friends tell me, [egg freezing] is a straight forward procedure”

• “You were so much more joyful when I met you, and I’m worried about how angry you are”

• “You’ll beat this”

It’s more akin to a the reality show Survivor.

Each week, contestants perform that strange, chaotic ritual where the tribe votes someone off the island. Sometimes, the vote is obvious. Sometimes it’s a blindsiding upset – alliances shift, deals are made, the island is abuzz with whispers, and suddenly the unsuspecting player of Team Jambalaya gets their tiki torched snuffed with an idol in his pocket.

It’s frenetic but it’s not hard to follow — it’s just that everyone’s logic makes sense to them. The only thing that matters is what’s good for your game.

And that, dear reader, is exactly what it’s like trying to decide a cancer treatment plan.

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To explain where we are now, we have to go back to 2023. Although my mastectomy was a tough decision to make, every single doctor — radiologist, surgeon, second opinion — said the same thing: you need a mastectomy. Did I want to hear that at 31? Of course not. But they all said it individually. And with medical consensus, I made a choice.

When the pathology report came back, I learned a lot: 11cm of DCIS, Grade II, IDC with microinvasion (largest at 3.5mm), and an oncotype of 32. Meaning recurrence risk over 10-years is non zero…more like 20% give or take.

From there, the opinions diverged fast:

• Onco #1: “Just take 20mg of Tamoxifen for five years. Also, why did they even send the oncotype? It shouldn’t apply to such a small tumor.”

• Onco #2: “You’ll need chemotherapy in 2 weeks. High oncotype overrides tumor size.” (Note, when pressed on this issue of tumor size, I didn’t get much else than the study said so).

• Onco #3: “It’s complicated. In France, we wouldn’t even discuss chemo.” (When I asked what she’d tell her own kid, she said: “Depends on which one.” Helpful!)

So, after listening to second, third opinions, I took the meds. Two years of hormone therapy — 20mg Tamoxifen daily and monthly Zoladex injections that hit your belly like a hole punch. Eighteen months of chemically-induced menopause and a depressive episode that could’ve been its own horror film.

With encouragement from my oncologist, we paused said meds in April 2025 and began measuring ctDNA – a liquid biopsy to measure your cancer levels. This way, we could take a break from endocrine therapy and keep an eye on where we’re at.

Then, between May and August, my levels jumped 100 fold. Cue scramble.

And everyone — I mean everyone — had a different opinion.

• Onco #1: “Try oral chemo — I believe you’ll metabolize it better.”

• Onco #2: “We shouldn’t have even use this test. A micro-dose of Tamoxifen should work.”

• Onco #3: “If you couldn’t handle medical menopause, what makes them think you can handle chemo.” (Reader, I rolled my eyes so hard they’re still in Patagonia. Every male doctor should live with a uterus and try to navigate the healthcare system for at least 2 years. And I mean that.)

• Onco #4: “Have you had a PET scan? You should get a PET scan, because if anything lights up in your body, we can nuke it.” (Yes, literal words from a literal doctor. Not all men, but also…men.)

So where does that leave me?

After 2 IVF rounds, four ctDNA checks, and too many opinions to count — I’ve started Xeloda, an oral chemotherapy pill. Because my blood (and gut) said so. For the next 3 months (at least) I’ll be taking Xeloda twice a day and go in for ctDNA monitoring every 3 weeks.

In some ways, I feel like I’m back where I was two years ago — lost in the forest, relying on my own medical compass. But this time, I’m wiser.

I’m choosing a plan within a relationship of trust. I trust that my oncologist knows how harsh endocrine therapy was on my body and well-versed on alternatives. I trust myself to do what I need to do to stay on top of my health, course correct, and/or dissociate when fixating isn’t helpful.

I’ll never know if this is the “right” plan, but if nothing else, it’s my plan. One I’m willing to bet on it — one I hope is good for my game.

Medical 101

• ctDNA - Cancer’s digital footprint — tiny fragments of tumor DNA floating around in your bloodstream. Detecting it doesn’t always mean cancer is visible on scans, but it can be an early sign something microscopic might still be active.

• Oncotype - A test that gives early-stage breast cancers a “recurrence score” (0–100) to estimate how likely the cancer is to come back and whether chemo could help. Mine was 32, which is considered “high,” and my tumor size is nowhere near the median size of those in the study this is based on.

• Xeloda (oral chemo) - Chemo, but less intense and in pill form. It turns into its active form inside cancer cells, ideally attacking the malignant cells while sparing the good ones. You still get side effects (nausea, hand-foot weirdness, etc.), but it’s less IV-drip-of-poison-and-a-blanket and more maintenance to keep cancer away.

(See what I did there!?)

Before I reach the end of this long CCRM journey, before I start oral chemo next month (yes, that’s happening), and before I write another mighty fuck you to Livestrong and the infallible process of paperwork… I’m pausing to celebrate my 34th birthday, and the people in it.

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First, thank you to everyone who reached out to wish me well. I love you. And thank you to those who checked in on my health updates — I love you too, thanks for leaving space for me.

As I told my best friend this week, I’m a Cancer Moon, which means I feel big and hard — and birthday blues are no exception. The annual question “what do you want to do for your birthday?” sends me into a tizzy. I worry about aging (The Substance anyone!?). I scrutinize my relationship or lack thereof. I resign myself to the fact that since my birthday falls around a federal holiday, it’s not worth celebrating. Not because I don’t deserve it, but because as we’ve gotten older, couples’ trips and wedding weekends always take precedence and are now sacrosaint. And if I do throw a party — who will show up? What would we even do? Will we have a good time?

So imagine my surprise that somehow, I’m still smiling two weeks (and a day) later, looking back at photos from my first birthday abroad.

I’m not a “gratitude cancer girly” — you can confirm by flipping through the array of empty pages in gifted gratitude journals and coloring books. But when I do feel grateful (for life, for another day, for friends, for mess, for my mess, for any of those things together), I better document it.

This might have been my first joyful birthday on my actual birthday since diagnosis. Third time might really be the charm :).

Lauren, The Jordans, MJ, Mommy, Ryan, Stephanie, and Stephanie — thank you for making the day and weekend grand. I can’t say much more than: I love you, I love you, I love you.

So here are some pictures to capture what lifted my spirits in a way I’ll be forever grateful for. (Oh, and God bless Orna’s eyebrows — they’re doing the Lord’s work.)

Having people who love you and show it in their actions and the way they love, is a big blessing. Also: leave America whenever you can. The difference in tension in your shoulders is PALPABLE.

Until then — more on that later and a photo for the road. <3

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Pro Tips for a Successful Cancer Birthday

• Your oncologist can wait (unless they can’t). Even *I* resisted calling my doctor before our 9/15 appointment to discuss treatment plans. Sometimes it’s OK to take a break.

• Surround yourself with love. That might mean friends, parents, a book, OR a group of people who generously travel internationally to say, let’s have a good fucking time.

• Live in the cone of ignorance (within reason). I hate that this is true. Hate it. But my mom made the choice to wait until I got home to share some big, messy news — and as much as I hate to admit it, I’m glad she did.

Up Next…

Upcoming Topics include:

• Single & Survivorship

• The fine line between of hope & pain

• Making medical decisions

• The never ending joke that is (US) healthcare

• (Sacred) Rage is underrated

  Share More on That Later: Notes on Being Young(ish) and Sick

Remember when I said I wait 8 weeks at a time to determine the length of my break from these horrid medications? The tests where they see how much cancer we got swimming around in there, measured in parts per million (ppm)?

Well, my results came in.

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The MyChart alert arrived Sunday afternoon with no warning, no interpretation, no doctor on call to explain what’s next. But what I do know is 216ppm is a lot bigger than 24ppm, and that’s not good. My oncologist said in July: if scores stay low, we monitor, if they rise, we consider more aggressive options – possibly chemotherapy.

Fifty-one hours (and two prodding emails) later, she called. This isn’t a knock on Dr. C — she’s diligent — but diligence can’t conquer the clusterfuck that is privatized American healthcare. She said at our visit next week, we should discuss aggressive therapies since I do not tolerate anti-estrogen medications well.

Five minutes after hanging up with my oncologist, I hopped on survivor’s Zoom. When the MyChart hit, I’d packed my calendar with support groups—needing to speak with someone who’s been down the road once, twice, even thrice, to tell me it’s worth walking. Especially when each step feels like walking blind through glass, while people from the outside (in the light) cheer you on.

The facilitator pushed us to challenge our notion on how we view being sick. I disagreed – strongly, but I’m still glad that I went. No one can understand this unless they’ve been through it.

No amount of perspective protects you from neuropathy after a few cycles of chemo. No positive outlook changes the fact that you might need to mainline poison while your friends plan weddings, trips abroad, or futures unsullied by life or death care let alone decision making. No number of doctor visits, research papers, or third opinions protects you from the looming possibilities–or statistically likely events–waiting around the corner.

Which is why I find sharing cancer updates with loved ones fascinating. Maybe it’s because I’ve been told by cancer muggles to “have hope” or “it will get better” or “things could be worse.” Maybe it’s because cancer patients are seen as overly negative. But the bargaining I see people do when I tell them – trying to find a silver lining, trying to see if the data could be interpreted differently, asking questions I already an oncologist asked two-and-a-half years ago – shows they still live innocence (and love for me).

The sadness in their eyes shows me their real time confrontation with a truth I already know: no amount of love, support, follow-up visits, or positive thinking stops tumors from doing their thing.

I wish life worked like that, but it doesn’t. It’s a reality my loved ones want for me that no longer exists.

The truth is – I’m terrified of chemo. And just like 2 years ago, it’s an option again. That’s the main reason I (ironically) went the hormone therapy route. Terrified to lose my memory. Terrified that my wit will be drowned out by chemicals. Terrified I’ll want to die even more than I did on Zoladex or Tamoxifen. Terrified it’s goodbye to everything forever, and that life will be a constant push and pull of sickness and frail stability. Terrified that symptoms are unique to the individual and there’s no “preparing” for chemo.

To cope with it, and all the uncertainty, I limit dreaming about the future. This is more adaptive than fatalistic, I promise.

In just four months (April - present), I was told to pause medicines making me miserable, wait on results, got a good lower ctDNA result, enjoyed a few more clear headed, libido-existent weeks and then –boom– a MyChart update shifts the course, yet again.

That’s survivorship. My survivorship today.

It’s the ground shifting under your feet in ways healthy people take fully for granted. It’s knowing, not fearing, that cancer will be in my life forever. I just don’t know quite how yet, at least not long term.

It’s hand-wringing over each decision made that could’ve caused this increase in PPM. Was it all those extra cocktails in June? I should have said no? Should I have just listened to that second oncologist — one who said you should do chemo back in 2023? Is it too late?

Fuck.

It’s not knowing where your story ends or what kind of cancer patient you'll be. Are you the one who returns to a cancer retreat 22 years later to give the newly diagnosed hope? Or the one someone met at a survivor’s retreat, who months or years later, passed because the cancer was just too aggressive?

It’s a laundry list of what ifs and what’s coming.

I accept that no day is promised, that no one knows exactly where they’ll end up. But in addition to the unknown, it’s the brutal reality that you do know what came and what is to come: the scans, scars, trauma, testing, scares, etc. Those inevitabilities are weight on the shoulders like boulders.

Simply put: how do you accept a life where suffering is not just possible, but guaranteed? And how when it’s suffering you didn’t ask for no less?

If I find out, you’ll be the first to know.

I thought, “How cool! Was this a tradition passed down from Ancient Greece?”

I didn’t realize this it wasn’t special. It was normal – just not in America.

In America, you don’t realize how much being chronically ill (or, if we’re being honest, having a human body) can cost you – and by the time you find out, it’s already too late.

Here you have to manage logistics, navigate bureaucracy, and self advocate – just to have a chance at accessing care. Because here in America, healthcare is a commodity not a human right.

I am a policy nerd, so I knew this intellectually. But entering cancer-land taught me what it feels like to live within a broken system.

Being Believed is a Luxury

A co-worker recently asked me about the hardest parts of being a young cancer survivor (AYA).

Without thinking, I giggled and blurted out “Honestly? The gaslighting!”

When she asked for an example, I laughed harder. Not at her – but at the absurdity of it all. Gaslighting is usually how you are initiated into the cancer community.

Like many AYAs (before me and those to come), I noticed my cancer before my doctor did.

January 2023 I felt a random sharp pain in my breast and immediately scheduled a OneMedical appointment. My grandmother was a two-time cancer survivor and I was certain this wasn’t (as my doctor suggested) exercise related, so, to quell my fear, she gave me a breast exam. Then she gave me her sharpest medical opinion.

“It’s nothing. You just have lumpy breasts.”

It wasn’t until a month later – after a Valentine’s Day dinner with my best friend – that I noticed bloody discharge from my right breast.

Most people diagnosed with cancer under the age of 39 are either misdiagnosed or dismissed entirely. Many suspect their own cancer and are turned away because they were told they were “too young.” Then weeks, months, or years later they return – with something more advanced.

And this is not limited to cancer.

People with endometriosis – mostly women – wait an average of 7-11 years from the onset of their symptoms (which doctors often refer to as “just bad period cramps”) to get a diagnosis.

Even when we know our bodies more than anyone, being believed is a luxury.

Illness is a Full Time Job

Once you become sick, you are now the CFO | COO of your own survival.

As the COO, you spend a ridiculous amount of time showing up and waiting around.

At the onset of diagnosis time is filled by MRIs, surgical consults, first opinion, second opinions, thirds opinions. Appointments made and rescheduled. You learn your mastectomy was moved six hours earlier — less than a day before said surgery. Your calendar is constantly in flux, and you structure your life around their availability, not the other way around.

You also need to know how to interrupt a doctor when they speed pass all the life altering drugs and treatments you just learned about.

You have to roll with the punches and stay nimble – your life depends on it.

Needless to say, I developed a strange appreciation for weekends – not for friends, drinks, or dates, but because the hospitals were closed. There were no appointments to schedule, no bill collector harassing my line, and no test result bad (or worse), to get.

As your CFO, you also have to figure out how to pay for your life.

Depending on how you look at it, I was fortunate enough to leave my job right before symptoms started. [On the one hand, the deep panic of a diagnosis while worrying about securing contract work is a whole thing, on the other, no full-time job meant I could just focus on healing]. But, no full-time job means no employer insurance. When I left my job pre-diagnosis, I picked the “good enough” Bronze HMO plan via Obamacare. But when I was suddenly staring down the barrel of at least Stage 0 cancer and a mastectomy, I had to take the L on higher premiums for a lower deductible.

Between my mammogram, MRI, genetic counseling, surgery consult, I spent many mornings recalculating different insurance plans. What was the annual cost of paying a $300 Bronze monthly premium with sky high out of pocket maximum versus a $660 Platinum plan with lower co-pays?

The Indignity of America Care

Once you’re this deep in the medical system, you realize that in addition to your bills, being a patient in America costs you your dignity.

I know that sounds dramatic, but I struggle for any way else to describe being mid-biopsy – breasts fully exposed, alert, bleeding – while my radiologist waited on hold for CareFirst to approve a second incision to search for cancer. I was literally bleeding out after a biopsy incision waiting on another – but that didn’t matter, we had paper work to sort out!

Again this is not rare. It’s called having an HMO.

Meaning: even if your doctor believes something is medically necessary, they still need permission from a desk worker (living who-knows-where) who answers to entirely other desk worker (in who-knows-where) – to proceed. Mid-procedure.

This is how much friction the system allows between you and care.

Don’t Forget What Matters

This just scratches the surface. I was driven to write this because of Venus Williams.

First – congratulations to her on the comeback win and engagement. Second – I am sick to my stomach about her (half) joke about needing to return to tennis to afford healthcare.

I hate this moment. I really fucking do.

Because as funny as her answer to why she returned, I am reminded that access to care in this country is a luxury – and to do so without having your dignity skewered, is even rarer.

Especially, if you are chronically ill and especially if you rely on doctors to stay alive.

So: who is this system for?

People who thrive in escape rooms? James Bond types who can sneak between international waters?

It certainly isn’t for the vulnerable, the scared, or the already sick.

What are we doing when we ask sick people to prove they’re sick and that they deserve care?

What does it mean about us that our system assumes that dignity is optional – and then send you a bill for it anyway?

I still don’t know, but I know it doesn’t feel right.

Medical 101

AYA (Adolescent and Young Adult): A cancer diagnosis between the ages of 15 and 39. AYAs often face delayed diagnoses, fewer research studies, and unique mental, sexual, and financial stressors — while still being expected to “bounce back” faster than other age groups.

Delayed and Misdiagnosis: When a condition (often serious, like cancer) is either diagnosed late or misidentified entirely. Common in patients under 40, women, people of color, and those with chronic or invisible symptoms. Often caused by systemic bias, rushed visits, or overconfidence in pattern-based medicine.

HMO (Health Maintenance Organization): A type of health insurance that typically only covers care from doctors who work for or contract with the HMO. Translation: you need a referral for everything, and even mid-biopsy, a stranger may have to “approve” the next step.

EOB (Explanation of Benefits): A document sent by insurance that outlines what they covered and what you may owe. Usually comes with zero explanation and intense anxiety. I procrastinate opening bills for this reason.

Deductible: The amount you have to pay out of your own pocket each year before your insurance kicks in for most non-preventive care. Ex. If your deductible is $3,000, you pay 100% of those first ($3,000 in bills) — even with insurance.

Out-of-Pocket Maximum: The maximum amount you’ll pay in a year for covered services — including your deductible, co-pays, and co-insurance. Once you hit this number, your insurance covers everything at 100%. Spoiler Alert: It’s usually a big number.

She told me good news.

Good news.

But what do we do with good news?

Tuesday, at my 3-month follow-up, my oncologist (Dr. C) said I still get to continue living without being on anti-estrogen medication – a continuation from April. I’m happy! I’m happy?

I can’t seem to smile when I try to write how I feel. So an “I’m happy!” is not believable even to me (okay that realization did make me smile).

Dr. C said we were still waiting on results and of my ctDNA test. If the score was higher than it was in April, we’d consider 3-months of chemo or chemo pill. If it was lower, we’d continue monitoring every 8 weeks.

Straightforward right? My quality of life would hinge on whatever MyChart said.

So when I opened MyChart to see a lower score – thank goodness – I didn’t really have a feeling. Or not an obvious one. A homeless woman assaulted my mother on Independence Day. I still haven’t processed that, let alone the follow-up appointment with Dr. C. Let alone the weight of the possibility of putting poison in my body to save it.

So what do we do with good news? I don’t have a feeling yet. But I have plenty of memories that make this moment feel less like a sigh of relief and more like…an allowance to breathe.

I remember the unprompted text from a former boss saying “YAY!!! I heard it's only stage 0”.

I remember my third stereotactic breast biopsy.

I remember the Maydan dinner with my mom a week later, when they called to say they found no invasive cancer, only DCIS. I remember crying that day, the deep exhale that followed, and me - the - lapsed Catholic thanking God.

I remember days after my mastectomy getting the call to say that, yes, they had found microinvasions. That my cancer was actually Stage 1 not 0. That back to surgery I must go. I remember the day of that second surgery – paralyzed in the passenger seat, not wanting to open the car door. My then boyfriend holding me as I cried, because I wasn’t prepared for the twisty road cancer actually follows.

I remember seeing three different doctors to decide on a treatment plan based on the stage bump.

I remember the Zoladex injections and Tamoxifen that sent me into a deep deep depression. That killed my libido. That included a monthly hole-punch to the abdomen.

I remember realizing how differently – and painfully – I experienced the world on that medication, even though it was the thing that was supposed to keep me alive.

So when I hear good news, what do I feel?

I’m scared and probably still numb.

Because when you can only see your future 8 weeks at a time, you can’t really get comfortable. (If that doesn’t land, imagine being a parent and you can only picture yourself as you are now, 8 weeks at a time).

Every finding has a treatment option. Every treatment option has a risk. And every risk is either underestimated – or very underestimated – by the medical system.

I’d say each path has pros and cons, but sometimes there is no “good” choice between a bilateral or a unilateral mastectomy – either way, a part of you goes missing.

So despite what a muggle might think, it’s not the curtain call of celebration when you hear “good news.” It surprises me too. Just ~72 hours ago, Dr. C said if the ctDNA is higher, we can consider chemo, if it’s lower we’ll keep monitoring. So in one day, I held – but didn’t really sit with – the potential that I might have to:

• Ask a million new questions

• Make arrangements for medical leave

• Endure chemo and its aftermath

• Return to very tough meds

Or, that I might continue surveillance — which still means:

• Watching numbers dance on a graph

• Scans on scans on scans

• Waiting on results

• Dealing with insurance (in this country? LOL)

• Navigating unprocessed trauma

Even now, questions remain: Should I go back on Tamoxifen like Dr. P (my OG third opinion) recommended? She agreed with Dr. C that I needed a break — even before Dr. C pushed me to take it — but she also said to stay on Tamoxifen for 10 years. Is this “good news” safe? And if so, how long?

How long are you NED until you’re not NED? And what does that mean?

This doesn’t mean I’m fine forever. That’s not how cancer works. If you’re familiar with this world. You know it’s every day, sometimes an hour at a time. If you’re not you’ll say “I look great” and celebrate my news, and I love that for you. I do. It’s an innocence I miss – and one you can only have in the absence of chronic illness.

But as for me? I’m looking forward to processing what’s already happened. And – for as long as I can, or as my blood tests allow – nothing new.

Cancer 101

• ctDNA (circulating tumor DNA): A blood test that looks for tiny fragments of tumor DNA floating in your bloodstream. Think high-tech cancer radar: if cancer cells are active somewhere in the body, this test might pick them up — sometimes even before a scan would. Not perfect, but a big deal in cancer monitoring.

• Tamoxifen: A medication often used to lower the risk of breast cancer coming back. It blocks estrogen receptors (many breast cancers use estrogen to grow), which can help prevent recurrence. Side effects can include hot flashes, mood changes, low libido, and in some cases, depression.

• Zoladex: A monthly injection that temporarily shuts down your ovaries. It drops your estrogen levels to mimic menopause, often used in hormone-sensitive cancers. Translation: medically induced menopause with all the physical and emotional symptoms to match, plus a literal hole-punch in the belly each month.

• NED (No Evidence of Disease): A phrase meaning nothing is currently showing up on scans or bloodwork. Not the same as “cancer-free,” which implies permanence. It’s more like: “We don’t see anything now — but we’ll keep checking.”

• DCIS (Ductal Carcinoma in Situ): A non-invasive form of breast cancer that occurs when abnormal cells develop in the lining of the milk ducts in the breast.

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At the request of a dear friend, I’m sharing the ins and outs of navigating life with after my breast cancer diagnosis at 31. The “new normal”, the medical menopause, the broken healthcare system, the heartbreak, the love, the continuous struggle of answering ‘am I having a mood swing, or am I (rightfully) upset’?, and the darkly funny observations you can’t unsee in the absurdity.

A lot of what I, and those around me, anticipated about cancer and survivorship was(is) wrong. You don’t know what you don’t know, and the way we discuss (or avoid) illness doesn’t set patients or their support systems up for success.

To that end, I hope this can be a space where I (and other survivors) can share freely. I’ll explain in later posts, but the discomfort with everything that comes with cancer makes that challenging.

So here’s to an unfiltered and honest corner about my cancer experience. Whether your a cancer muggle, or taking it a day at a time like me, thanks for coming.