Living with Uncertainty, Embracing Possibility

December 5, 2023

On May 31, 2023, I had my final round of Herceptin and Perjeta infusions, an immunotherapy I received to help destroy the ER+, HER2+ metastatic breast cancer I was diagnosed with in March 2022. 

The nursing staff at the chemo clinic made an exception and allowed my 5-year-old daughter, Moxie, to witness me ring that final bell. I held Moxie in my arms and invited her to hold the rope with me. She got bashful and in a whisper she said, “No momma, you do it.” 

I rang the bell so loud that afternoon you could hear it two counties over. Like so many meaningful moments with our young children, Moxie might not remember that day when she’s older, but it’s one I’ll never forget. 

The next month I had a CT scan and an MRI scheduled to determine whether five months of chemo, a total left mastectomy and sentinel lymph node surgery and 28 rounds of radiation were enough to kill the cancer and stop it from spreading any further. 

The day before my CT scan, in my weekly writing circle, I wrote a poem, something of a dream, to my future self—a happy, vibrant, healthy woman who was cancer free and living a long life. 

My words were a prayer. I imagined opening the results of the scan the following day and finding out that everything was normal and clear. I would receive confirmation of something I already knew to be true: The cancer was gone and it wasn’t coming back. 

My prayers were answered. The CT scan came back normal and so did the MRI–a cancer patient’s dream come true.  

I celebrated with my husband, mom, brother, and sister. I shared the fantastic news publicly in every way possible. “The results are in!,” I posted on FB and IG, “No signs of cancer. No further metastasis. My medical oncologist called to say my CT results were ‘pristine’!”

I wouldn’t be alive today were it not for the unwavering curiosity, hope, and brilliance of the scientists and doctors who have committed their lives to creating treatments and to finding a cure. I wouldn’t be alive today were it not for the hundreds of thousands of women who have already passed on, their cancer experiences laying the foundation and path for my eventual healing. 

I’ll never forget the “life expectancy” conversation I had with my oncologist last December. I’d finished chemo and surgery and was getting ready to begin radiation. At the very end of our appointment I bravely but hesitantly asked her to help me understand the average life expectancy of three years for metastatic breast cancer. I’d seen that number published by reputable sources, and like many cancer patients, I refused to accept it as truth.

She confirmed that three years was “probably a true average,” but went on to explain quite thoroughly that “there’s quite a bit of variability” depending on whether the cancer was “de novo metastatic disease, whether it’s recurrent, whether it’s in the bone, whether it’s in the organs, whether it’s HER2+ or HER2-.”

I sat there with open ears, but the weight of her words started to press on my heart, and I felt myself go numb. I remember mumbling, “So that means more likely than not… I will …” She picked up where my voice trailed off.

“More likely than not, statistically speaking, your life will end because of this breast cancer, but,” she emphasized, “You have a real and meaningful chance of being cured of your disease by treating the spot on your sternum.” 

Tears started pouring down my cheeks, wetting the mask that prevented us from seeing each other’s full faces. She let me cry and then added, “The hard part is going to be living with the vulnerability of not being able to answer your question.”

We sat in silence, alone in that sterile room, then she handed me a few tissues. I wanted to run away, but instead I had to wipe up and then head upstairs for an immunotherapy infusion.

This is the reality for so many of us impacted by metastatic breast cancer. The balancing act of the space between light and dark, hope and despair. It takes courage to embrace a cancer-free attitude after staring down the dark tunnel of a stage IV diagnosis. 

The uncertainty can feel unnerving, the statistics impossible to bear. But like other harrowing experiences in my life, cancer is only one part of the story. The disease does not define me. 

I am not a statistic and I refuse to become one. I have accepted this diagnosis, but I will not succumb to it. And while finding peace with the uncertainty is my everyday prayer, I’ve never given up on the possibility that this cancer was yet another opportunity for my spiritual evolution. 

We are walking miracles and life is such a gift. Breast cancer has given me more than it’s taken away. With every tear I shed and every breath I take, I am drawn closer to my humanity– fallible, vulnerable, mortal. I believe we always have a choice and I choose to see abundance. Each day I nourish joy, find gratitude, and embrace the chance to continue participating in this beautiful and mysterious thing we call life.

Katie Joy Duke is an author, mindset coach for women and mothers, and a stillbirth and stage IV breast cancer survivor. Her memoir Still Breathing: My Journey with Love, Loss, and Reinvention was a #1 Amazon best seller in ‘Family Health’ and ‘Pregnancy and Childbirth’ and is available in paperback, ebook, and on Audible. She will be touring late winter/early spring 2024 in Seattle, Portland, Denver, and New York City. Learn more about her coaching services and speaking tour on her website . 

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