Toni was diagnosed with breast cancer in her right breast when she was 51 and in her left breast when she was 53. She had worked as a government attorney for nearly 30 years and had planned to work until she was 65, even though she found her job unfulfilling. Now she did not know whether she would live until she was 65.

Marissa was shocked by her diagnosis of breast cancer at age 29. While her friends were planning their weddings and having children, she was undergoing a bone marrow transplant. She knew she would never be able to bear children, and she believed that marriage, too, was unlikely. She had been in a long relationship with a man whose values were very different from hers and who had given her little support during her cancer treatments. His use of drugs and alcohol were particularly troubling to her. With few friends and leisure activities, she did not know how she would cope.

Jill was married with three children when she was diagnosed with cancer, and she had a mastectomy at age 42. Her children had been the focus of her life since she had her first child 18 years ago. Her husband worked long hours to support the family and had little time for Jill or the children. Now that she was diagnosed with cancer, she could not imagine how her family would deal with the crisis they faced.

I counseled these four women shortly after their diagnosis with cancer. They were all terrified, and they believed they would probably die from cancer. Despite their difficulties, all of these women had many strengths. All were willing to undergo surgery and other challenging and debilitating treatments in an effort to save their lives. And although they were not initially aware of it, all had a vision of how their lives could be improved. Cancer was the catalyst that made that happen.

Although the diagnosis of breast cancer is terrifying and shocking, most women with that diagnosis will not die of breast cancer. Even those who eventually have a recurrence will typically have some healthy years after their diagnosis. Even after their recurrence, they can make significant changes in their lives. What is it about cancer that makes it a catalyst for change? In helping people cope with cancer, I have found many answers to that question.

Cancer victims describe cancer as a wake-up call. Although we all know that we will die at some time, that eventuality typically feels unreal until a person is confronted with a life-threatening illness. No longer can we deny the finiteness of our lives. We know emotionally as well as intellectually that our lives will end. Despite the sadness and pain associated with that thought, it can also impel us toward action.

Many people who have survived breast cancer are no longer willing to endure unrewarding jobs and destructive relationships. Before, our hopes for the future—perhaps a fulfilling retirement or eventual improvement in a relationship—may have kept us stagnant and reluctant to seek change. After cancer, however, we are aware that living for the future and suffering in the present is probably a poor choice. We live more in the present and want that present to be rewarding.

Cancer seems to sharpen our perceptions, as though a bright spotlight had been focused on all aspects of our lives. We see our lives more clearly. The greys of our lives are transformed into blacks and whites, the goods and the bads, the strengths and the weaknesses. Our priorities typically become clearer, and we have a better sense of what we value and what is no longer important to us.

Having had one close call, we often seek to change our lifestyles so that we avoid another one. In learning about our disease, we have learned about those qualities and behaviors that can impair our immune system. We know that depression and unremitting stress can take a toll on our system and leave us vulnerable to disease. We also know that healthy eating, regular exercise, and certain foods—such as soy products and cruciferous vegetables—may well improve our likelihood of staying healthy. Some of us also feel guilty because we feel we neglected our bodies in the past, and this made it easier for cancer to gain a foothold. All of these beliefs and attitudes may lead us to take more control of our lives and to pursue a lifestyle that contributes to health and stress-management.

Cancer also leaves us with a sense of time urgency. We are no longer willing to bide our time—we want to move forward more rapidly. As a result, the rate of changes in our lives often accelerates. Relationships hasten along the trajectory that they had been following; good relationships usually improve, while bad relationships deteriorate and may end.

In addition, cancer has probably changed our capacities. In some ways we may be more limited than we were. We may be coping with physical discomfort, hot flashes, sexual difficulties, and changes in appearance; however, positive changes in our capacities are also present. Having successfully gone through the ordeals of diagnosis, surgery, chemotherapy, and radiation, we feel powerful and proud of ourselves for having persevered. This new-found strength is yet another force that propels us forward in our lives.

What did the women described at the beginning of this article do to cope with their difficulties? What choices did they make in the face of cancer? Mary joined a support group that made an enormous difference in her life. Although she continued to admire her mother’s fortitude in dealing with cancer, Mary learned that talking about her diagnosis and fears made her feel better and seemed to help others talk more easily about their feelings. Mary has also become an activist. She lobbies the government for breast cancer funding, she is active in the Race for the Cure, she plans fund raisers, and she has made a difference in the lives of many diagnosed with breast cancer.

Toni left her government job, took some of the money she had set aside for her retirement, and pursued training as a special-education teacher. Three years after her diagnosis, she completed her masters degree and was employed as a special education teacher.

Marissa, too, made important changes in her life. She realized she could no longer continue her primary relationship. At the same time, she built up her support systems. She reached out to old friends and sought to strengthen new friendships. She moved closer to and spent more time with her parents, and she volunteered as a peer counselor.

Jill and her husband sought marital counseling. Through that process, they learned to talk with each other more effectively, and they found a renewed interest in each other’s company. Their roles at home became more flexible, and they were more able to share interests. Although Jill’s husband continued to work a great deal, he tried to get home earlier to have dinner with Jill and the children.

All of these women made positive changes in their lives despite their diagnosis with breast cancer. I encourage you to look at your own lives, priorities, values, and strengths, and seek to make your own life more rewarding too.

Linda Seligman is a licensed psychologist who specializes in counseling cancer patients, survivors, and their families in Fairfax, Virginia. Dr. Seligman also has considerable personal experience with cancer. She is an eight-year breast cancer survivor and both of her parents were diagnosed with cancer. She has written seven books and over 50 articles and book chapters.