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Cancer must have hired a hell of a PR team in the last decade. this year, but most public awareness campaigns and the media paint a rather rosy picture of the ordeal. Fictional cancer sufferers can expect baldness and some puking, but they also generally get better. It’s easy to forget that once cancer reaches a certain stage, death is not a matter of if, but when.

Cracked spoke with three young women Susanne Kraus Dahlgren, Jo Evelyn Ivey, and Christina Shaw who all have Stage IV metastatic cancer, meaning the disease which originally crashed in their breasts or lungs has set up camp all over their bodies and shows no signs of leaving. They told us .

It wasn’t necessarily an insult; 97 percent of lung cancer patients are 40 or older, and the average age at diagnosis is 70. Yet there’s been a significant uptick in lung cancer diagnoses among young nonsmoking women, thanks to a mutated gene that’s begun working its way down through the population, in the most unwelcome trend since Uggs. It can take a long time to diagnose these women, largely because active teens and 20somethings don’t tend to get body scans for every little thing and few doctors entertain the possibility of lung cancer. By the time it’s detected, it’s a Breaking Bad situation. Christina had a persistent cough for two years, but she didn’t think much of it until she started getting pain in her hip so severe that she sometimes had to walk with a cane.

“The doctor told me I had a large mass in my lung the size of my fist and it was most likely cancerous, since there were other lesions throughout my body,” she says. “The cancer had spread to my lumbar spine, my right hip, my liver, my lymph nodes, and my brain, which unfortunately meant it wasn’t curable, and I would only receive palliative treatment.”

It was like rolling snake eyes on 100 sided dice: Only 2 3 percent of people who get lung cancer are under 40. The odds are slightly higher for breast cancer, accounting for about 5 percent of all cases. Susanne just squeaked into that exclusive club when she found what she thought was a cyst when she was 39, and Jo Evelyn was only 31. “I thought it was funny,” Jo Evelyn says, “‘I’m having a really bad week, and now I’ve got this lump.'”Kinda puts that lady at work swiping your lunch in perspective, though.

Susanne likens having a metastatic diagnosis to being “stuck in the middle of the road with a bus barreling down on you, but you can’t tell how close it is or when it’s going to hit you.” Metastatic breast cancer has a five year survival rate of 22 percent, which is a grim prognosis, to be sure, but it’s also wildly variable. Susanne and Jo Evelyn have been told by their doctors that they’ll never be rid of the cancer. “To stop treatment would mean I’m going into hospice,” Susanne says. In all likelihood, it’s simply a matter of when, but it’s always in the back of your mind that you could be one of those miracle cases, so you have to make two entirely separate plans for your life: Plan A and Plan Dead. “I have to make long term decisions factoring in the possibility of dying, while acknowledging I could very well still be around for a while,” Susanne says.”Yeah, I’d love to come to your New Year’s party. If, you know .”

For Susanne, that meant getting married and co founding a metastatic breast cancer activist group called MET UP,
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while Jo Evelyn’s life kindly took the planning out of her hands. Against all odds, she went and got herself pregnant. Not everyone was happy. One of her oncologists read her the riot act for failing to have her tubes tied when she first went through chemo, then he doubled down and guilt tripped her about bringing a child into the world who wouldn’t have a mother for long. “But I figured, I’m dying anyway,” she says, “Why not bring this life into the world?” So she went off treatment for eight months, had her baby at 37 weeks, and went right back into treatment the next day.

The stats on metastatic lung cancer are even worse, with a five year survival rate of a mere 4 percent and a median survival time of six months, but Christina remains “cautiously optimistic.” She passed the two year mark last April, possibly because of a rare genetic mutation she has which is known to add longevity to lung cancer patients. It was the least her genes could do. Still, to be safe, she decided that if she was going to die young, she’d live a bit faster which meant moving across the country and buying a single wide trailer in Nashville so she could be rinkside for every home game her beloved Predators play.

Using sudden death overtime to deal with the possibility of actual sudden death seems like as good of a way to cope as any.

By the way, the team was just eliminated from the playoffs in a close seven game series. For the rest of the fans, that means no more hockey until next year. Imagine how much more, uh, final that last game had to have seemed to Christina. Air Force

“Sorry, but these ribbons and gel bracelets aren’t going to sell themselves.”

Instead, most of the money is earmarked for prevention and early detection, which are still humanity’s best weapons against cancer, but little comfort to those who, you know, already have it. An estimated 30 percent of breast cancers will become metastatic, including some that have been caught early and treated. Although current screening procedures have greatly reduced the odds of death for Stage I patients, they haven’t done a damn thing to reduce the number of patients who are already too far along by the time they get diagnosed. Those patients get little more than a “Tough shit, have a ribbon.” Many cancer charities have determined that, dollar for dollar, this is the most effective way to focus their efforts, but screening will never catch everyone, and as Jo Evelyn points out, “They don’t even know what causes cancer to metastasize .”

And then there’s the fact that when it comes to the big charities, research of any kind often takes a backseat to outreach, informational campaigns, and those colored ribbons. Last year, nonprofit juggernaut Susan G. donated only 16.5 percent of the $250 million it raised to research. Keep in mind that this is the group which supposedly works “for the cure.” They’re also notorious for not letting late stage breast cancer sufferers speak at feel good fundraising events (and if they do, you can count on them to downplay the seriousness of their condition).”She’s currently under treatment for owies caused by a Stage IV boo boo .”

Susanne also resents that in mainstream culture, cancer has mutated into a kind of mystical, spiritually cleansing experience a personality level up which gives you valuable “perspective” rather than a rapidly ticking clock. “I get monthly injections in my abdomen with a pretty large needle, and I take it without complaint because it’s keeping me alive,” she says. “I’m not stronger or braver for it. I’m just trying to live.””Wow, Mrs. Lynn. You did amazing with that pap smear.”
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