After a diagnosis of cancer, a person's perspective toward life changes.

"My first reactions were fear, confusion, shame and complete out-of-control panic."

Confronted with mortality, one may be frightened about not completing life's goals, seeing children to adulthood and beyond or seeing grandchildren grow. These hopeful futures are threatened in a heartbeat with the word "cancer."

During the acute phase, when a patient receives the diagnosis and makes plans with medical providers, people may respond differently.

"Once I made the decision on what I was going to do, I set a goal. I got mad and decided that cancer was not going to rule my life."

At this time, life revolves around treating the cancer, but at the same time, hanging on to everything that is important in one's life. This is a challenging time, as we are all creatures of habit. When those habits are shaken up, it's hard to focus on "new" habits. But survival dictates we must, and adapt we do.

One never forgets one had cancer. It is always lurking in the back of the mind. Every time we hear that someone is diagnosed, it brings back all the memories of when we received the news we had cancer.

"I wanted the look of it, the feel of it, the smell of it and all reference to cancer out of my life forever! It seemed like it took forever for my hair to grow back. I resented medical staff putting 'cancer' on my diagnosis. I didn't have cancer anymore, it was completely removed, but that diagnosis stays with me today."

We live with it every day. We may not dwell on it, but it's never very far from the surface.

Some aspects of cancer only turn up later, sometimes years later. This can be really challenging. Lymphedema is one such side effect that has no cure, but it can be treated. Scar tissue can form after surgery, and it may manifest as a problem years later. Radiation can change the appearance of a body part, thereby making it a constant reminder. We are never the same as before, but we are healthy and whole.

"I still worry, each time that I go for my checkups, if any test appears slightly out of the norm, I get anxious, but I also know that with God's will and the love of my family and friends that it will be all right."

After the cancer has been treated, it is time to move on to a new normal in life. After a major event like cancer, we may look at life differently. We often begin to appreciate everything more. Birthdays have a new special meaning. We do not look at them as "getting older," but as another wonderful year of life. We all know life is precious, but cancer patients know this precious life can change on a dime.

"I realized how very blessed I was and that cancer was a part of my life. Yes, blessed. Don't misunderstand me, I would never want it to come back, but because of the cancer a lot of wonderful things happened that I would not trade for the world. I found that I could rely on my family; I didn't always have to be the strong one. It pulled us closer together. My husband, children and grandchildren took care of me. My special friends and my 'second family' at work learned and walked the steps with me. All of them were there with smiles, encouragement and humor."

Survivorship is more than having no more cancer. It is evolving through the experience and taking forward the lessons learned and strengths gained, and grieving through the losses, too. It has the potential to enrich ones life and deepen relationships.

"Cancer gave me the strength to step out and try something new, to change my life and go in a different direction. It also gave me the sense to really appreciate all that I have and not be envious of others. It also taught me not to feel sorry for myself. I met, became friends with, and will never forget the memory of all of those special people that touched my life."

Char Houska is an oncology certified nurse, certified breast care

nurse, breast care coordinator and ovarian cancer survivor at St. Patrick Hospital and Health Sciences Center. Mary Kramer is conference coordinator at St. Patrick and a breast cancer survivor who shared her thoughts, in italics.