The one constant thing that gives people fighting cancer hope is the continued support of friends and family. Phone calls, emails, a surprise or planned visit at the door that has a big hug on the other side, a held hand over coffee or tea, or sitting patiently by their side as they go in for treatments. When that support falls by the wayside, it makes the determination to fight this disease or any other less worth the effort. In my humble opinion as someone fighting cancer, we sometimes fight harder to overcome disease for others more than ourselves. Because it is in their caring and the will in their eyes that gives us a much brighter hope than we find in ourselves. It is the lack of support or caring that sets off an internal depression that makes it ten times harder to find the will to fight. People seem to find it easier to hug a tree than a human. Try to imagine if you will sitting in a house alone and thinking about a disease that can run rampant through your body. It is hard to imagine and something that we do not want to think about. Yet many many people face that struggle every day of their lives.

So if you haven't reached out to someone you know, a neighbor, a friend, someone in your church or where you work, or even a family member that is struggling with cancer or any other disease, then find it in your heart to do so. It will make a difference. And if you have reached out to someone once or even twice, know that once is not enough and twice is not enough. No matter how much you think you are being a nuisance, that constant reminder of love and support is 95 percent of your friend's battle. The old saying "You never know who your true friends are until you go through a crisis and see who stands by our side" is very very true. So go stand by someone's side today, tomorrow, and for many days to come to offer support and encourage strength until their fight is successful. Even a phone call goes a long long way.

For those of you who stay in touch with me by phone and emails and that come knocking on my door in this time of need, I thank you very much for giving me the strength and will to survive.

Every time I hear about someone who has died from cancer, it knocks me down a notch. It makes me sad for the person, for the family, for the friends, for me -- because I know I am not guaranteed survival from cancer and while I mostly live each day as if I am immune to this tragic outcome, the knowledge that people do really die from this disease that I am trying to beat is overwhelmingly sobering. And what shakes me most is the fact that these people who die from cancer must have had the same outlook as me at some point in their journey -- the outlook of promise and hope and continued survival. And then something happens that jolts this hope from their grasp. It could happen to me -- and my family and my friends. And that scares me.

Sometime last year, my husband told me about a woman in one of his graduate classes whose husband was fighting melanoma that had spread to his brain. He was in year number eight of constant treatment -- both traditional and alternative -- and with each day, his hope for survival was fading. His wife and my husband talked at times about his journey -- and they talked about my journey with breast cancer. And after the class ended, both spouses periodically checked on each other. Today, my husband asked this woman in an e-mail about her husband. She replied and shared that he died last October. She wrote that he could not fight any longer -- that the last chemotherapy he tried to endure was too hard on him. He died with dignity. And she is proud of him. And I can't stop crying.

My tears will dry. And sadness will drift from my every thought. And I will return to my usual enthusiastic approach to surviving my own dreaded disease. But in the back of my mind, where I have saved every sad story about cancer and death, my sorrow will linger. And I suppose it should. So I can keep my sights on the possibility that surrounds me -- death -- and so I can continue living with every fiber of my being. Because living is not a guarantee. Ever.

The topic of my hair is often the subject of conversation -- and is a constant reminder that this brown curly hair I have covering my head is nothing like the straight blond hair I was born with, grew up with, was known for. Because my little boys have white blond hair, I am consistently asked by strangers, "Where did your boys get that blond hair?" "From me," is what I want to say because it's the truth -- but that would make no sense to anyone who does not know me, anyone who does not know that my hair -- that once looked much like my boys' hair -- was lost to chemotherapy and returned shockingly different. So sometimes I just chuckle in wonder with these strangers who may not expect an answer anyway. Or I tell them the story -- if they seem to really want in on the details of the mystery. Most people are surprised that my hair grew back like it did. I am not surprised -- I was warned that it might happen -- although it is still a startling discovery each time I look in the mirror, each time I look back at photos, each time I see gray hairs emerging through my dark hair -- gray that only slightly showed up in the midst of my blond locks.

The memory of my blond hair keeps popping up. My husband told me the other day that he had a dream about me -- I was in a restaurant, at a table, by myself. He was walking toward me. And I had blond hair. The rest of the dream is insignificant. The blond hair is significant. And the other day, I pulled my brush out of my purse. It hasn't been used in more than a year -- because I don't brush my curls at all -- and at the base of the brush, wound around the bristles, were long blond strands of hair. My blond hair. My old hair. The same hair I showed my friend who visited from Ohio last week -- the hair that was once on my head, was cut off in preparation of the great fallout, and is now kept in a ziplock bag.

I like my brown hair. I like my curls. But I miss my blond hair. I am sad that I no longer match my children, that I don't look like the bride in my wedding photo, that I will attend my 20-year high school reunion in two years and will wear a photo name tag that looks nothing like me. I like the familiar -- which is why I never wanted to show my bald head, why I covered my head with blond wigs and hats to keep my appearance as close to normal as possible. And then in a strange turn of events, my hair grew back in an unfamiliar fashion -- and somehow the question, "I see where your boys get that blond hair" flip-flopped into "Where did your boys get that blond hair?" It is all still new to me. I know one day it will become familiar and normal and not such a big deal. Some day. I hope.

When I first started going to counseling, I was told I would need eight to 10 sessions of cognitive behavioral therapy to help me deal with my anxiety, my panic, my fear of breast cancer recurrence. My first session was in May 2005 -- and I am still going. Those initial sessions are possibly all I really needed -- and perhaps I could have stopped the therapy long ago. But stopping never came up and no one told me I had to call it quits so I kept on marching into territory I had never before traveled. I have a degree in counseling -- but I'd never been counseled. I know how to listen to others and share empathy and ask open-ended questions -- but I'd never been the one talking and sharing and venting and crying and answering questions. Until last May -- when I discovered the appeal and the comfort of the counseling chair.

I marched into one of my sessions yesterday and plopped into a brown faux leather recliner. I talked about my recent graduation from Herceptin therapy and about how I might manage in life now that treatment is over. I talked about my jobs -- as a writer and a preschool teacher -- and how they fit into my world. I talked about the level of stress in my days and about how my once constant fear that cancer was trailing me has largely diminished. I talked about how breast cancer is no longer my constant companion -- about how it is now just an acquaintance. And I talked about how counseling was once so necessary and about how it is now just a luxury that helps me maintain peace as I live forward.

I am not sure when I will stop going to counseling. But I'm not completely sure of much anymore. And I've learned from counseling to not really question the future -- to just live in the moment and to give thought primarily to the here and now. And right here, right now, I'm sticking with my sessions, my one hour every month, my comforting counseling chair.

It's about time. More than 50 percent of all cancer patients and survivors and more than 75 percent of those cancer patients in an advanced stage of cancer suffer unrelenting, sometimes debilitating, and always quality of life-limiting chronic pain. For various reasons, cancer patients and survivors are left on their own to find a solution to the pain that never leaves them. I have been fairly vocal about my position regarding chronic pain and the sheer and absolute lack of very many physicians in the medical community willing to do what they have the ability to do, but won't, when it comes to providing pain relief.

There are more issues to being alive than being alive if you cannot enjoy the life you are living because you are in some way profoundly diminished by pain. The American Cancer Society, the Susan G. Komen Breast Cancer Foundation and the Lance Armstrong Foundation have come together to form a coalition to provide funding of a three-year grant that allows the University of Wisconsin Comprehensive Cancer Center Pain & Policy Studies Group to evaluate federal and state laws, regulations and agency guidelines that can impact patient access for effective pain relief. With a keen interest in how well this evolves, I will keep you updated on the progress the group makes in changing the current and sad state of patient care in this country when it comes to pain management.