My chemotherapy ended unexpectedly because my bone marrow simply couldn’t keep up anymore. Last time, I admitted that I wasn’t taking it very well, but I didn’t tell you the main reason why.

I’ve been through two major surgeries. During the first one, they removed my right ovary, the largest tumour, and took a good look around inside. That was at the beginning of November. The second surgery took place on March 25th this year. By then, they took everything they could. My remaining ovary, fallopian tubes, uterus, appendix, and they did a bit of “scraping around” inside as well. Recovery was, of course, much harder than after the first operation. On top of that came chemotherapy every 21 days, assuming my blood tests were good enough. I had my routine. I knew roughly what to expect, I had my medications, and most importantly, I felt like we were actively fighting the shadow growing inside me. We were on a clearly defined mission.

It’s not that targeted maintenance therapy is nothing. In many ways, it’s like a small chemotherapy in tablet form. The difference is that, if tomorrow’s CT scan goes well, we move into the next chapter of my treatment: maintenance therapy. The goal is to keep any microscopic cancer cells that may still be hiding in my body from growing again for as long as possible.

In my case, the BRCA1 mutation plays an important role. Under normal circumstances, this gene helps repair damaged DNA inside our cells. When it doesn’t work properly, cells lose one of their main repair mechanisms. Olaparib takes advantage of exactly this weakness. It blocks another repair pathway that cancer cells rely on to survive. While healthy cells can usually find alternative ways to repair themselves, cancer cells carrying a BRCA1 mutation have far fewer options. Errors gradually build up inside them until they eventually die. That’s why Olaparib is considered a targeted therapy. Unlike traditional chemotherapy, which attacks all rapidly dividing cells, it focuses on a specific weakness in cancer cells.

Of course, this doesn’t mean the cancer will never come back. Unfortunately, medicine can’t offer guarantees like that. The goal is to significantly reduce the risk of recurrence and extend the amount of time a person remains free of detectable disease. My type of cancer is considered one of the more aggressive forms and, unfortunately, it also has a higher tendency to return than some other cancers. That’s why, after successful surgery and chemotherapy, it’s important to do everything possible to reduce the risk of recurrence.

And that brings me to the real reason.

Until now, my focus was simple: recover from surgery, survive chemotherapy, remember my medication, eat enough protein, show up for blood tests. Most importantly, I held on to the belief that if I could just get through all of this, it would be over. My doctor even said that after everything, I could potentially be “healthy.”

I follow fellow patients from all over the world. Some have just been diagnosed. Others are going through treatment like I am, or have already finished it. Some have gone through it more than once. They call themselves cancer survivors. People who have beaten cancer. People living life after cancer.

But the truth is that for many of us, there is never really a life after cancer.

There is only life with cancer.

For some, it comes back again and again. For others, it hasn’t — at least not yet. And some of the people I used to follow are no longer here. To most people, they might just be strangers on the internet. To us, they’re not. Even if we’ve never met and never exchanged a single word, they’re one of us. Someone walking the same road.

Many of you tell me that hope is important, and you’re right. You can’t do this without hope. But every time someone loses their battle, a little piece of that hope disappears with them.

What if next time it’s us?

When I tell people my chemotherapy has ended, most react exactly as you’d expect: “Finally, it’s over!” “You’ll be healthy now!”

I used to think that too.

But now, whenever I hear those words, the smile I put on is a fake one. It’s the smile people expect in a moment like that.

I’ve tried explaining that chemotherapy ended because my bone marrow simply couldn’t handle any more, and that the targeted treatment will put its own strain on my body as well. We don’t know yet how well I’ll tolerate it. My cancer is estrogen-sensitive, which means I most likely won’t be able to take estrogen replacement therapy. At not even forty years old, I may end up with the body of an old woman long before my time.

There’s still a double mastectomy ahead of me, hopefully reconstruction afterwards, and the long recovery that comes with it. My head still spins. My joints are stiff. I get out of breath easily. Most days, I still need a nap just to make it through the afternoon.

My type of cancer is aggressive, and it likes to come back.

Nobody knows when. Nobody knows how extensive it will be. Nobody knows whether I’ll handle it. Or how many times I’ll be able to handle it.

And it’s not just me.

My son has a mother who can’t always do everything a little boy deserves. Because of treatment, our family ended up split between two continents. The people around me have had to adapt to my pace, my limitations, and my needs.

While everyone else seems to keep moving forward with their lives — having more children, building careers, building homes, travelling, going on dates — I’m sitting here in my kitchen, not knowing what comes next.

I don’t know whether I’ll ever meet someone willing to sit beside me and hold my hand when I’m sick again.

And I don’t even know if that would be fair to ask of them.

Cancer will always be part of my life now. What role it ends up playing is not something I get to decide.

That’s something I still have to come to terms with.

And that will take time…