Sometimes the end of cancer treatment doesn’t mean the end of cancer.  Sometimes the treatment takes years. And sometimes, it’s the mystery of what’s yet to come that makes life magical, even when the unknown seems unwelcomed.

Carole Pepe knows this. She was diagnosed shortly before Christmas 2003 with multiple myleloma, a rare cancer that affects the plasma cells in the bone marrow and once considered terminal, now considered incurable.

Treatment took a good four years and involved two stem cell transplants, heavy duty (read: toxic) chemotherapy and steroids, each of which had its own set of side effects and complications – things like weight gain, fuzzy thinking, listlessness and a suppressed immune system that allowed illnesses such as pneumonia and bronchitis to fester.

Even now as she reclaims her good health, she’s susceptible to bone fractures, sleep apnea and respiratory infections.

“I’m not ever really done,” she said. “I have to be monitored closely and regularly. The farther away I am from (active cancer) the odds are less in my favor and the more fearful I get (about recurrence) But I’ve beat the odds so far.”

To undergo treatment, Carole had to quit her job and spends months at a time in Little Rock, Arkansas where her specialist and treatment center was located.

“I was really weak. I gained 30 to 40 pounds due to treatment. I had a lot of fuzzy chemo brain and would be very frustrated. I couldn’t be part of conversations, couldn’t retrieve words.  They don’t tell you ever little side effect. And I was angry at the loss of my whole identity.”

Getting to her “new normal” took time and change was gradual.

“I didn’t have to go back to work, but it took a while for me to have a sense of worth,” she said. “My job now was to get better and that’s still how I look at it. Not to have any stresses in my life.”

An athlete, Carole intensified her physical efforts with yoga, specifically Structural Yoga Therapy, taught by Mukunda Stiles which focuses more on energy flow, muscle and joint imbalances than physical poses.

“I became very disciplined about exercise. I incorporated it into my life in a different way. I realized how much the yoga helped me through all parts of treatment, so I started to focus on that.

Carole had always been active, running marathons, skiing, biking long distances. But treatment put an end to some of that, limiting her endurance or putting her at risk for breaking now fragile bones.

“It became clear that yoga would be something I would take with me for years and years,” she said.

Now Carole teaches yoga, focusing on a practice for those in cancer treatment or survivorship.

There have been other changes too. “I wasn’t going to waste time with things that aren’t healthy in terms of people or activities. It’s made it easier for me to say ‘no’ when before I would be hesitant.”

She said she’s also learned to be more relaxed and have more fun doing the things she enjoys, such as skiing.

“I really just think we need to look to each day with gratitude and awareness at the specialness of it and make choices that are conscious and mindful

We need to be aware of our place in the universe, which isn’t always something that we can control. When all that stuff happened to me, I was angry and couldn’t find any answers. But now I realize we’re only a small speck. I can’t expect to know all the answers and have everything turn out the way I want it to be. There are mysteries that are unsolved, and the mystery of every day is fun.”

3 Steps to take

• Make a gratitude list, writing down all the things you’re grateful for in this day. Try making the list a daily habit.
• Try a yoga class. Many hospitals and cancer centers offer free classes to patients, caregivers and survivors. Carole teaches such a class at Yoga Loka, 34 Bridge Street, Frenchtown, NJ every second and fourth Tuesday from 9 a.m. to 10 a.m.
• Just say No! Don’t waste time on people or activities that don’t bring you joy or that aren’t healthy. Instead, take in the grandness of nature with a walk or hike outdoors.

Recommended books

Comfortable with Uncertainty: 108 Teachings on Cultivating Fearlessness and Compassionby Pema Chodron

Fear: Essential Wisdom for Getting Through the Storm by Thich Nhat Hanh

Or any other books by these two authors