Clearly, the strong religious faith that many of the people I interviewed share affirms that spirituality plays a vital role in coping with metastatic breast cancer. In their view, there is a place for human suffering, dignity and transcendence in God's plan. There is order and purpose in the universe. This belief plays an important part in helping them to endure and transform their pain and loss into something deeply meaningful. A firm belief in the afterlife offers a further sense of hope and enlargement. For those who share beliefs with a spiritual community, a church or temple congregation, being cared for by this extended community supports the family and the patient at a time when isolation is more the rule than the exception.

Faith is not a given, however, and the struggle to achieve peace and acceptance is often hard-won, as Caren Buffum writes:

The most basic premise of my faith is that there is more to human life than a physical body--that we have a spirit that can and will exist apart from that which is now earthbound. Well, that sounds all well and good until one has to deal with the very real possibility that earth may not exist much longer for this one individual (or to put it the other way, the individual may not be long for this earth). So that has been the greatest challenge of all to my faith, and one that truly would not be able to be answered on an intellectual level. I don't know how it has happened, but somewhere along the way, my brain was able to let go of its need to understand eternal life and the spiritual side of existence. I firmly believe it has been an act of God's grace that I now experience a greater peace in my life than I had before I encountered cancer. I don't mean that life is easier--Lord knows it is not easier. But I live day to day without that underlying fear of what lies "beyond."

PJ reports how her faith has helped her to let go of her bitterness:

My spirituality has seen me through the pain and anger at breast cancer. I fight to keep my spirit up and my energy levels up and to not get too discouraged, which happens to all of us at times. My Michael has given me all that I need to wake up each day and pick up where I left off the day before. We have just celebrated our 27th anniversary last Friday, and for 13 years of that 27 we have lived with the fact that I have breast cancer. We changed our priorities and decided what was really important in life to us and then realized that this journey, while not what we planned, was a journey we could take together and still love every minute of every day. I have tried, and will continue to try everything that comes out there to continue to live. I try to keep the pain under control and my state of mind high among the stars and my spirit at peace. I have good days, super days and bad days, but I have been given another day and another part of the woods to explore with the one I love.

Some may think this is an unrealistic view but I have discovered to continue with the anger and the feeling of fighting against something brings me down. This is just the way I have found I can live with cancer and not rave about how much I have been cheated out of, or rant about what I might be missing. Things in life just happen and how we handle them is what can make or break our spirit. I'm honestly not always 100 percent positive but I do try to be and I feel better about everything if I turn it over to God when things get rough. God, Mike and a sense of humor are the three magic ingredients in my life that make it all worth living.

I have great faith, that is my first source of comfort. I believe I will only be given what I can handle. Sometimes I feel as if I'm at the limit of what I can handle. I get scared and I cry and pray for strength. If I need help at home, I have a wonderful church family that will provide meals, cook and clean or do just about whatever else I need.

Gerry Wirth reflected on the ways in which the faith he and Cindy shared sustained them during her illness, and after.

We believed that there is a God who is loving and good. We also believed that there is life with Him after death. With those two beliefs firmly rooted in our hearts, facing Cindy's illness and death was not overpowering. I know Cindy is with God right now. I know there is a reason that she was taken from us and some good shall come of it. Knowing these things has not made the experience painless. But it has allowed me to know all the suffering is not in vain. I do not understand the reason, but I know there is one. Our parish pastor said that Cindy was more well-prepared to meet death, one of the most prepared he had seen. Cindy also often told me not to let her sickness weaken my faith. It has not weakened it. It has tested it.

Pam Hiebert discovered a new sense of spirit through her illness.

Am I dying? Of course I am. And I have simply found a higher consciousness of this fact. Yet I also find, in this state of greater awareness, that for the first time in all of my life, I have such a keen appreciation for the small and endearing things about life. I wake with joy in my heart. I smile more deeply at the sight of a young baby. I am much more aware of the suffering of others and the frailty of existence in our world.

Somehow in this profound and devastating experience of the last three years, I have actually begun to identify myself as a person of faith. It is that faith that will continue to be an influencing factor in my cancer journey. It is this faith that will bring me home. I believe each one of us follows our own path to wholeness, yet the ability to pool our discoveries enriches the sacredness of our experience.

Certainly our resources and our connections with others provide the consciousness of living in community. Our friend Barbara wrote this: "A community is where a warrior returns to lay off her armor and let in the light and warmth of the sun. A place where wounds can heal and scars be displayed. A place that makes it all worth fighting for."

And Jenilu Schoolman wrote:

I have been asked how I could achieve such calm while facing death. What is the alternative? This is not a glib reply. The only other choice I can think of is to cry, to scream and yell, and just give up--but all that would be a waste of this precious gift of time. For me, the only way I can conceive of living is the way I am living.

Where does my strength comes from? Nature: trees and hills, snow and flowers, the little animals. All these have been a source of solace for as long as there has been a me. As a kid, I often found peace and comfort in the city park. Once I confided to my amused schoolmates that the trees and lake were my friends. And it is still true. Whenever I have turned to the natural world for guidance, I have not been disappointed.

In this crisis, I watch the cycle of the seasons. The trees do not mourn their autumn as the leaves fall at the appointed time. New ones are ready to replace them. Death and regeneration exist together everywhere I look in nature. Why should I be different?