When Time Runs Thin

Living well with metastatic breast cancer

Being diagnosed with metastatic breast cancer, also known as stage 4 or advanced breast cancer, when I was 47 years old, was one of the most terrifying moments I’ve ever experienced. It brought my life to a crashing halt, smacking mortality right in my face.  

Seeing large metastatic lesions eroding my hip on x-ray and CT films, lesions that would require an emergency hip replacement, sent my distraught brain scrambling for alternative explanations. ‘They’ve put the wrong patient details on the films; it can’t be my hip.’  

Since then, my brain and I have come a long way on this journey with metastatic breast cancer thanks to supportive family and friends, specialised cancer counsellors, skilled psychologists, mindfulness meditation, being in nature and creating things I love: music, photography and writing.  

What does ‘living well with metastatic breast cancer’ mean to me?  

To be honest, at times it doesn’t feel like living well at all.  

When I was first diagnosed, I was in hospital for two weeks during COVID restrictions which meant I could nominate only two visitors for my entire stay. When I was discharged from hospital, still dependent on a wheelie walker for my new hip and soon to start radiation treatment, I wasn’t allowed to drive and couldn’t physically manage in my two storey house. Family arrived from interstate and temporarily rented an accessible unit where they cared for me: driving me to daily radiation treatment along with endless medical appointments and the odd midnight trip to the emergency department, arranging medications and physical aids, cooking meals and attending to all the daily tasks of living.  

Some months after my diagnosis with metastatic breast cancer, living again in my own home and trying to make sense this new and unexpected reality of having an incurable and life-limiting advanced cancer, I became extremely depressed and was diagnosed with and treated for clinical depression.  

There have been times when cancer treatment side effects have caused my feet to be so painful I could barely walk to my letterbox and my fingers so stiff and sore I couldn’t turn the door handles or taps in my home or manage standard cutlery without adding large easy-hold handles.  

And a big one. Wrestling with the anguishing and unanswerable question of ‘why me?’ and trying to reconcile myself to this new reality of having metastatic breast cancer. Thanks to insightful and skilled psychologists, I now understand this journey of continual adjustments as an intertwined process of doing the necessary work of dealing with loss – grieving current and future losses, alongside the equally necessary work of restoration – finding meaning and purpose in life, my new life that is, transformed as it is by metastatic breast cancer.  

So, can I actually ‘live well’ with metastatic breast cancer?  

A friend from my new tribe of people living with metastatic breast cancer talks about ‘living as well as you can with metastatic breast cancer’. This resonates with me.  

While I can no longer enjoy throwing a heavy pack on my back to relish the blissful quietude of hiking in the remote mountains of lutruwita / Tasmania, I can savour, and now with a wider lens of wonder, the intricacies of nature all around me: the wavy-lined patterns on the smoothly curved exterior of shells washed up on the beach, the gradual unfolding of tightly compressed buds in early spring, the sleek duck-dive of a platypus in the creek, the laughter-inducing sounds of forest ravens trying to out-caw each other like the amiable arguing of old men sitting around rough-hewn wooden tables in the late afternoon sun with their shots of ouzo or coffee in the small Greek villages I once visited as a back-packer in my twenties.  

Life is not the same, cannot be the same, will never be the same as it was before my diagnosis of metastatic breast cancer. And there are many more challenges to come. My cancer is not curable, it will progress, and I will die an earlier death because of it.  

But as I grieve and let go of all that I’ve lost, I find I become strangely free to discover all that my life now is. Each day is a gift: precious time to be lived in ways that are meaningful and purposeful to me, and to be loved and cherished for the transient moments they truly are. There is no time for the trivial; there is only urgency and poignancy for the things that really matter.  

Decades ago, I came up with my own epitaph: As music be my beating heart, words be air I breathe.  

Through Dreams2Live4, an organisation that helps make ‘dreams’ come true for adults with metastatic cancer, two pieces I composed for piano, Piano Sonata No.1 and Un Piccolo Momento (A Little Moment), were recorded by accomplished Australian concert pianist Tamara-Anna Cislowska and broadcast on ABC Classic radio along with an interview with me. That gave me the courage to pursue another of my dreams and I arranged for a piece I composed for violin, Reminiscence, to be professionally recorded. Recently, this was also broadcast on ABC Classic radio along with an interview with me. I have also created a music video for Reminiscence which is on my YouTube channel. These projects are available via my website: miekatabart.com.  

Not long ago, I heard a quote that went something like this: The purpose of life is finding your gift; the meaning of life is sharing it.  

So, while I wouldn’t wish metastatic breast cancer on anyone, which is why we need urgent and additional funding into metastatic breast cancer research and treatment trials, and equitable access to and outcomes from highly specialised breast cancer treatment for all people with metastatic breast cancer across Australia, I’m certainly using this time-bomb of a diagnosis to hurry along progress with the things that really matter to me and that I can offer to others. This, for me, is living (as) well (as I can) with metastatic breast cancer.

Dr Mieka Tabart (2023)