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00000178-5fb1-d100-a9fb-7fb9d77f0000Stories of Cancer. Scroll down to read our collection of personal essays about cancer. Watch: Cancer: The Emperor of All Maladies is a six-hour TV series directed by filmmaker Barak Goodman, aired March 30-April 1.Watch: Find videos of our live events in Indianapolis with medical researchers, caregivers, physicians, patients and clergy, here.

For A Young Cancer Patient, "Just Stay Positive" Wasn't The Advice She Needed

Tarlie Townsend

When I was diagnosed with Stage III melanoma at age 23, I faced an onslaught of emotions: frustration that it took two misdiagnoses and 10 valuable months to get the diagnosis; shock that this could happen to me, when I was young, healthy, and alert to the risks of skin cancer; and, of course, fear of what was to come.

Even in difficult times, though, I’ve always been a pretty upbeat, glass-half-full kind of gal. I think that may be why it would surprise friends and family when I’d bring up the less pleasant things that melanoma might mean for me down the road. Although we expected the upcoming surgeries to remove all detectable cancer, there was a significant chance of it reappearing as Stage IV. Only 20 percent of Stage IV patients survive five years, a steep drop from the (already discouraging) 60 percent rate I’ve been assigned at Stage III.

When I’d bring this up with friends or family, I was often met with an uncomfortable pause. Worried that thinking about the bad was only augmenting my suffering, they would steer the conversation in a new direction.

I now try to face [fear] head-on: Not to fight it off, but to accept and tend to it.

These conversations were hardest, understandably, for my mom.

“Oh, I don’t even want to think about that happening! We have to stay positive,” she’d say.

Of course she didn’t want to think about it, and of course she wanted to believe that no harm will come to me. I completely understand and deeply appreciate that.

But at the same time, it felt like I was being shut down in a conversation I desperately needed to have. I’d never had to seriously contemplate my mortality before, and suddenly I had only a 60 percent chance of being alive five years after my diagnosis. I needed to process that. And for me, processing it meant considering it a real possibility that I’d fall in that other 40 percent.

Conversely, “just staying positive” not only felt like burying my head in the sand, but also reinforced the power that ideas like severe illness and death had over me. Giving death a that-which-shall-not-be-named Voldemort quality made it seem all the more threatening.

And anyway, I couldn’t not think about it. In every doctor’s appointment there was discussion of what we wouldn’t be able to control. In every paper I read there was another grim statistic. I couldn’t delude myself into thinking those things didn’t apply to me, and I found it wasn’t helpful to simply numb myself to them.

Around this time I was reading The Art of Happiness by the Dalai Lama and Howard C. Cutler. I was struck by the Dalai Lama’s words on confronting suffering:

Trying to avoid our problems or simply not thinking about them may provide temporary relief, but I think that there is a better approach. If you directly confront your suffering, you will be in a better position to appreciate the depth and nature of the problem…

“For example, you might consider things like old age and death as negative, unwanted, and simply try to forget about them. But eventually these things will come anyway. And if you’ve avoided thinking about these things, when the day comes that any of these events occur, it will come as a shock causing an unbearable mental uneasiness.

He also shared insight into how to tolerate suffering:

“If we can transform our attitude toward suffering, adopt an attitude that allows us greater tolerance of it, then this can do much to help counteract feelings of mental unhappiness, dissatisfaction, and discontent.”

Reading this, I suddenly understood what was underlying those uncomfortable conversations with friends and family. They were worried that thinking about bad outcomes for me might mean overemphasizing or even assuming the worst, and cause me to suffer more. But my gut was telling me the opposite: that confronting those tough possibilities—stage IV metastasis, a failing body, long hospital stays, death—would help me come to terms with them, so that I’d actually suffer less from the fear. That is, in examining rather than avoiding the negative, I would become more, well, positive.

So I developed a few strategies. Now, I ask my mom and others directly if we can discuss these things, explaining why the conversation helps. That way, they’re less taken aback and resistant. And whereas a flash of fear used to envelop me, turning my stomach and driving me to Netflix for distraction, I now try to face it head-on—not to fight it off, but to accept and tend to it. When I do that, the fear suddenly shrinks.

Today, three months after diagnosis, I am feeling positive. Graduate admissions have just come in, and as I weigh the offers I’m brimming with excitement about graduate school and my career. Yet my positivity comes not from the good news or the big dreams, but rather from a calm acceptance of the uncertainty.

As before, I recognize that the melanoma might recur, perhaps derailing my career plans and more. That possibility still scares me. But now I’m much more comfortable confronting and sitting with that fear, able to feel excited about my future while acknowledging that Stage IV recurrence is a real possibility. And, thanks to understanding loved ones, I have much more opportunity to talk about it.

Tarlise (Tarlie) Townsend is interested in the intersection of psychology and policy, and will begin a Masters in Public Policy in the fall. So far her research has taken her to Vietnam and Germany, and she’s eager to see what’s next. Tarlie writes about her experience with cancer at:

Read more of our Stories of Cancer series here.