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The surgeon delivered the verdict without looking me in the eye. I was holding my right arm aloft, hardly breathing as he bent forward to study the strange swelling in my armpit. He straightened. “This is malignant.” His tone brisk and impatient, as if I should have known.

That trouble was afoot, I knew; a “suspicious mass” and clouds of insidious white dots were scattered across my mammogram from the previous week, in March last year.

But after the biopsy, I expected to have a few more days of blissful ignorance. Instead, my diagnosis was immediately obvious to a cancer surgeon — an aggressive strain of breast cancer that had visibly invaded lymph nodes in my right armpit. My fate was to die young and leave my four beautiful children motherless, like a tragic character in a movie. Not real life. Not my life.

Until I was diagnosed by one, I had never understood that an oncologist was a cancer doctor. No one in my family or circle of friends had ever struggled with the disease. For 39 years, I was in exceptional health and took for granted I always would be.

With the diagnosis, my world view was turned upside down. Nothing I knew to be true — not relative youth or physical fitness or organic food or never smoking or nursing four babies — had spared me from the disease all women dread. I was in its grip, helpless to stop it.

Or so I thought. This story is about how wrong I was.

The next morning, I told my news to a neighbour who had breast cancer a few years before I knew her. Her response startled me: I should run, not walk, from the downtown hospital where I was and schedule a second opinion at one of Toronto's cancer hospitals.

I had been booked for surgery in four weeks, the earliest slot on the surgeon's busy calendar. But when I consulted a second oncologist, he sharply disagreed, insisting that an aggressively spreading disease like mine should first be poisoned with chemotherapy to defeat any cancer cells marauding in distant and incurable parts of my body.

I turned to a third doctor, and it was he who would become my oncologist.

“This is locally advanced,” medical oncologist Mark Clemons said within seconds of walking into the examination room at the Toronto Sunnybrook Regional Cancer Centre. He seemed to recognize my type of cancer like an old foe, and I later learned that his clinic was busy with younger women like me whose breast cancer tends to be more aggressive and deadly.

The cancer had leached into lymph nodes beneath my clavicle, a sign it was spreading fast. Not only did I need chemotherapy first, I needed it now — he urged me to join a clinical trial the next week — followed by a mastectomy and many doses of radiation.

“When it's here,” Dr. Clemons told me gently, tapping his own clavicle, “the prognosis is not good.”

Second opinion was not second nature to me. At first, there was guilt in asking another doctor to second-guess the first. But I remain grateful every day for whatever good grace allowed me to take charge of my own treatment.

If I am to survive, it will be the work of an intuitive oncologist pushing state-of-the-art drugs, a deft surgeon, the high-tech wonders of radiation therapy and one of the latest triumphs of medical science, the breakthrough breast-cancer drug Herceptin.

But not entirely. What began as a strictly medical search would evolve into a pursuit of health outside the confines of the hospital. A week after my first chemotherapy infusion, a friend handed me a flyer advertising a conference being held a few days later by a group of registered nurses advocating a place for alternative therapies in cancer treatment.

I did not want to chase after miracle cures. But none was on offer. At this conference, I would learn about meditation and therapeutic touch. A naturopath would speak so persuasively about food as medicine that my diet changed immediately. And I would meet Alastair Cunningham, an elegant, silver-haired scientist at Toronto's Princess Margaret Hospital who runs an intriguing program working with the psychological side of cancer.

Cancer is a disease of the body, a wholesale corruption of healthy cells turned to mutants multiplying out of control. But more and more scientists are thinking that it is also a disease linked to the mind.

Our psychological state, the chronic stress in our lives and even aspects of our personality could play a role in the progression of cancer and the prospect of recovery.

It is fledgling science and its findings are hotly debated. But in recent years, a promising new science with the mouthful name of psychoneuroimmunology — PNI for short — has discovered some of the biological mechanics to explain the mind's influence on the body's health.

In studies of laboratory mice and humans under stress, researchers are tracking the two-way conversations between the endocrine, immune and central nervous systems, noting changes in levels of stress hormones, disease-fighting immune cells and the chemicals produced by the brain and immune cells. Others have studied what has been dubbed the “Type-C” personality — emotional characteristics that seem to be more common among those who develop cancer.

Many oncologists, trained to treat cells rather than people, remain unconvinced. Canadian hospitals spend twice the money on janitors that they do on psychologists and social workers. But the promise of mind-body medicine has spurred the largest cancer hospitals in the United States over the past few years to open integrative medicine departments, where patients mix massage, meditation and music therapy with chemo and radiation.

With studies showing that at least two-thirds of people diagnosed with cancer pursue alternative treatments — usually leaving their doctor in the dark — calls are growing louder from oncologists and psychologists convinced that change in the delivery of treatment is overdue.

“The pieces of the jigsaw puzzle are coming together,” says Stephen Sagar, a radiation oncologist at the Juravinski Cancer Centre in Hamilton and associate professor at McMaster University's medical school. “I've really battled to have integrated care brought into cancer for the last 10 years now and it's been like hitting a brick wall the whole time.”

The jury on the research is split. Half of the studies show a link between psychological interventions and prolonged life. Half refute any connection.

The controversy started 15 years ago when a study conducted by researchers at Stanford University's medical school found — quite to their astonishment — that in a decade-long assessment, women with metastatic breast cancer assigned to support groups had survived an average of 18 months longer than those receiving no psychological support. Scientists have been bickering ever since.

A study by researchers at Toronto's Mount Sinai Hospital a few years back, published in the New England Journal of Medicine, was touted as the nail in the coffin of the theory that the mind can influence disease. An attempt to replicate the Stanford study, it divided 235 women with metastatic breast cancer at random between those attending support groups where they could share their thoughts and fears with other patients and those left to their own devices. It found no difference in survival. What the research did show, however, is a huge improvement in the women's moods and perceptions of their pain.

“We were also able to achieve significant improvement with depression, anxiety, psychosocial adaptation,” says Molyn Leszcz, head of psychiatry at Mount Sinai and the study's principal co-investigator. “We didn't hit a home run. A home run would have been to show a survival effect. But we had evidence we were doing something right.”

A recent study from the University of Texas that is turning heads injected mice with ovarian-cancer tumour cells. When the animals were tightly confined in plastic chambers for several hours at a time — causing a surge in their stress hormones — the tumours multiplied in size and number and were far more likely to metastasize. But blocking the stress hormones stalled the spread of the cancer. Moreover, the cancer grew more slowly in mice restrained in groups.

And just last month, a study published in the medical journal Cancer Research by prominent PNI researcher Ronald Glaser showed that stress hormones increased the growth and spread of an incurable head-and-neck cancer called nasopharyngeal carcinoma. The hormone, norepinephrine, stimulated the tumour cell to produce two chemicals, one that spurs the growth of new blood vessels nourishing the cancer and another that breaks down healthy tissue allowing the tumour to spread more easily.

These studies are the first to draw a direct arrow between stress itself and the growth of cancer.

“I would not be surprised if we find out that a majority of cancer cells have those [stress-hormone] receptors, that those stress hormones could influence a lot of different kinds of cancers,” said Dr. Glaser, director for Behavioural Medicine Research at Ohio State University. “This opens up another way of looking at how we can treat patients.”

Many doctors and patients aren't waiting for scientific confirmation. They have begun applying these lessons to improve and possibly save lives.

A few months after my diagnosis, I slipped into a narrow seat in an auditorium at Princess Margaret Hospital, the low brim of my striped sunhat not quite concealing my baldness, to begin the first class of The Healing Journey, the program run by Alastair Cunningham, whom I met at the nurses' conference.

Dr. Cunningham is an immunologist turned psychologist with a thick New Zealand accent. He is a University of Toronto biophysics and psychiatry professor distinguished by an Order of Canada. He started running these classes out of the basement of his Toronto home 25 years ago, posting flyers on bulletin boards around the hospital to recruit the handful of cancer patients willing to see if yoga and relaxation exercises might ease their anxieties and the nasty side effects of treatment.

The Healing Journey now enrolls about 500 people with cancer every year, and sometimes their family members as well, taking the more open-minded among them to a place of peace and introspection that few people visit in a lifetime.

I paid $100 to be there — the program is not publicly funded — with about 30 other freshly diagnosed cancer patients and a few of their spouses. Dr. Cunningham showed us a projector slide with an image of balance that remains with me still — an imposing lump of cancer stacked on one side and smaller weights, representing the steps cancer patients can take to aid their own recovery, mounted together on the other.

I left the auditorium with no illusions that my mind can halt the freight train of my cancer. But I felt hope. Over the coming months, I enrolled myself in each of the five levels of the program, delving ever deeper into my own psychology and spiritual ambivalence.

When I return to visit, months after my last course, David Kellendonk is chanting. In his early fifties, a committed Anglican, dressed primly in a blue-and-white striped button-down shirt and navy-blue slacks, he would not normally dabble in this sort of Eastern spiritual mysticism.

But after his pancreatic-cancer diagnosis in April, he quickly became open to alternative approaches to his daily radiation dose. Here, East and West are blurred in a program that looks hard at the human condition and borrows equally from Buddhist monks and Catholic saints.

Now, Mr. Kellendonk sits beside his wife, absorbed in an emotional discourse on the existence of a divine power with people who were strangers only months ago. Churchgoers sit next to people who bristle at the mention of God. They have come to class with their homework — written musings on the difference between worldly and unconditional love — but their talk almost inevitably turns to the thorny ground of God.

At the front of the room, Claire Edmonds guides the discussion. A psychologist by training, she has worked with Dr. Cunningham for nearly two decades, both as a researcher and group leader. Soft-spoken but forthright, she expertly navigates the spiritual divide.

“There are people in my life who call themselves atheists and they're the most spiritual people I know,” she offers. “You make it real for you. And you make it real in your relationships with others and your behaviour in life.”

Mr. Kellendonk listens. Once, he would have self-righteously judged the people in this room who disavow God. “I talk to God every day,” he says.

But he has come to accept their spirituality as simply different than his. “With my Western faith, you tend to live in the past or live in the future. You regret the past or you are looking to what's going to happen in the future. With the Eastern faith, you live more for the moment, for the present, for what's happening now. I've learned to blend more of the Western beliefs with the Eastern beliefs. It's not an easy thing to do. I've just been placed on a path.”

After the meeting, Mr. Kellendonk tells me: “You don't have an opportunity to have these kinds of discussions normally. But the people in this group are in life-and-death situations. There's a whole lot less time for pleasantry and grandstanding. We have to get down to the nitty-gritty much more quickly. I'm hoping this can bring back my health, but I can't prove it will.”

It's a question that has consumed Dr. Cunningham for the past decade. After running programs with thousands of cancer patients, he has no doubt that some of those who plunged into the healing work lived longer. In a few remarkable cases, he has seen people with metastatic disease, doomed under a doctor's prognosis, slip into remissions that have lasted years.

But as a medical scientist, he has worked for most of the past decade to prove it with research, the first of its kind in Canada. The results, again, are mixed. But the study he stands behind most firmly found a clear link between psychological change and cancer survival.

Dr. Cunningham and his researchers looked at 22 people with incurable cancer who enrolled in The Healing Journey. Their psychological states were analyzed in intensive interviews over the course of a year and through the written homework and notes made during the course. At the same time, a panel of 14 oncologists reviewed each patient's full medical files and delivered a prognosis.

They found that the people who were faithful to their practices of meditation, prayer, journal writing or mental imaging — conjuring healing fantasies in their minds, such as images of armed warriors spearing their cancer — survived longer than those who were skeptical. The ones who lived longest, with few exceptions, were the patients who devoted the most energy to these healing techniques.

Dr. Cunningham says many scientific trials disguise the mind-body link by lumping all patients who use alternative therapies together in statistical averages, when those surviving longer than predicted tend to be the exceptional patients working harder at psychological change.

“Only a few people make much use of the therapy,” he observes. “Most others come along for the ride.”

Most recently, Dr. Cunningham has been pinpointing the qualities that set longer-term survivors apart. He is building on research that describes a “Type-C personality” — people who are particularly predisposed to cancer. Studies have shown that people were more vulnerable to the disease if they were too nice — prone to repressing their feelings and stoically appeasing others at the expense of their own needs. They have been described as unassertive, unable to express emotions and feeling hopeless, helpless and unloved. In some cases, they had also suffered the loss of a close relationship within a few years before their diagnosis.

A recently published study found that while many patients who beat the odds betray classic Type-C traits, the difference is that after their diagnosis, they make a psychological shift that diminishes those qualities. This matches earlier research showing that longer-term survivors tend to cultivate a fighting spirit and refuse to accept that their cancer will kill them.

In his own study, Dr. Cunningham found that the long survivors all shared a clear sense of what was important in their lives, felt the freedom to shape their lives according to those priorities and were more accepting of themselves, others and their lot in life. For these people, cancer was perceived as a motivation for change rather than a life-destroying illness.

“I've no doubt there's an effect here,” he says.

Judy Milley, 61, is one of two cancer patients from Dr. Cunningham's studies still unaccountably alive years after being handed a death sentence. When her breast cancer metastasized to her lungs in 1992, her high-pressure life ground to a halt. She dived into a routine of meditation, visualization, journal writing and long, contemplative walks. She started visiting a naturopath for herbs and vitamins, and feasted on fruits and vegetables.

“My whole life was given over to this,” she says now. “I realized there was no magic bullet for me. If anything is going to make a difference, it's going to have to come from within me.”

On the day Ms. Milley was to start chemotherapy, her bewildered oncologist revealed the stunning news that her X-ray showed no cancer.

“I coyly smiled at him and said, ‘To what do you attribute this?' ” As she tells it, the doctor mumbled lamely about a drug he had earlier instructed her to stop taking because it wasn't working.

“You believe what you believe,” she told him, “and I'll believe what I believe. And I'm phoning Dr. Cunningham.”

After she was diagnosed, the oncologists' consensus had been that she had less than two years to live. It has now been more than 12.

Andrea Palmer's story stretches belief even further. She was diagnosed at 25, while still a University of Toronto undergraduate, with a sarcoma between two fingers. Two years later, it had spread to her lymph nodes and lungs. She was told that she had less than a 5-per-cent chance of survival.

Ms. Palmer started working with a psychotherapist every week. She meditated for a half-hour every day, ate fruits and vegetables, stocked up on supplements. She began praying again, even purchasing rosary beads, after turning her back for years on her Catholic upbringing. And as a radical departure for a modern, bright and instinctively skeptical young woman, she even visited a healer her mother met at her church in Kingston who performed a laying-on of hands.

When she landed in the hospital after her first chemotherapy treatment, with a high-grade fever and no white blood cells left to fight the infection, she even had what she thinks was a vision of Jesus. “I was not at all religious before,” she says. “For me to see something like that is pretty crazy, because I really didn't believe or necessarily want to see that, or even think of seeing that.”

Ms. Palmer was slated for chest surgery when her chemotherapy ended. But when the day came to talk to the surgeon, he announced there was no cancer detectable on either her CT scan or X-ray and no longer any need for surgery. She sat stunned, her mind racing to her vision, and the healer who had prayed for precisely this outcome.

Four years later, a hale 31-year-old working as a fundraiser for the Calgary Health Region, she believes that the mysterious power of the mind cured her cancer.

“I kind of had a different outlook on everything. I was just completely, 100 per cent, open. It had to work. These things just had to all add up to work to fix me. For me, the doctors were going to do everything medically and scientifically possible, but the rest was up to me.”

One of Ms. Palmer's surgeons, Robert Bell, has since become president of the University Health Network in Toronto. While he acknowledges that doctors seldom see a recovery from so advanced a sarcoma, it has happened. Much as he'd like to believe that her drive and spirituality played a role, his grounding in science prevents him.

“Whatever the particular genetic pattern of that tumour is, it's highly, highly, highly responsive to the drugs we were using,” he says. “That's usually not the case with sarcoma, but occasionally it is, and that's what I think we saw in Andrea.

“But who am I to say [spirituality] doesn't work? There's obviously not the same degree of scientific rigour in an article . . . related to the psychosocial impact of religious belief or social support. But it's very hard to prove something is definitely not true. If somebody's belief system is such that they want to believe that, who am I to say they shouldn't believe it?”

These stories seem to have the makings of fairy tales. Both women stoutly believe their mental experiences were pivotal. But the science only teases us with the possibility.

“I've met people who have had remarkable recoveries you can't explain medically, and there's a real consistency in what they say that I have found to be persuasive,” says Joanne Stephen, a psychologist and researcher at the B.C. Cancer Agency. “But that anecdotal evidence doesn't meet the scientific criteria. So that's why we can't 100 per cent believe it. But I go, ‘Wow.' We shouldn't just let this go by the wayside.”

Véronique Benk would have wholeheartedly agreed. A respected radiation oncologist and researcher at Sunnybrook's cancer centre with a fascination for technology, she nonetheless missed detecting a large cancerous mass in her own breast, which had invaded nine lymph nodes before being diagnosed in 2001.

She died a year ago, at the age of 47, from complications of leukemia — a second and even more deadly cancer that may have resulted from treatment for her first. And although alternative therapies did not save her life, her legacy may turn out to be a major contribution to bringing them closer to the mainstream.

On the day of her first biopsy result, Dr. Benk dragged her husband to Wellspring, a non-profit cancer support agency in Toronto, funded mostly by donations, which provides a lifeline of social and emotional support and an array of mind-body programs for cancer patients and their families.

She had an intuitive sense from the hundreds of breast-cancer patients she had treated over the years that those who addressed the psychological and emotional side of their disease seemed better poised for recovery.

Her husband, Paul Fortin, a rheumatologist, did not share those instincts. But Dr. Benk had an unusually open mind. She was a dedicated researcher of technological advances in her field, and would sometimes play social worker to her patients.

“She decided she would do it all,” says Dr. Fortin, the tabletops and bulletin board in his office at Toronto Western Hospital filled with pictures of Dr. Benk and their two young children.

Even before her surgery, she had started to see a psychotherapist. At Wellspring, she sampled everything from support groups to Qi Gong breathing techniques and reiki touch therapy. She insisted that Dr. Fortin unburden his fears and anxieties to a trained volunteer.

Before long, she started classes with The Healing Journey. She became involved with a community-kitchen program she adored, where women with breast cancer cook meals and swap stories, and deliver boxes of organic fruits and vegetables to other women stricken with the disease. And she began taking vitamins and herbs prescribed by a naturopath and underwent acupuncture to treat her nausea during chemotherapy.

“She thought they might cure her,” her husband says, “but she wasn't counting on them. She thought, ‘I'm going to do things that are safe' and she felt better. She wanted the longest life and the best quality of life.”

Back at work before her second bout of cancer, she took a course in the U.S. on integrative medicine and became interested in conducting research in psycho-oncology.

She was painfully aware of her privilege as a doctor, with her medical connections and unlimited access to any research in the world. Even then, battling cancer was a full-time job. It troubled her that those without her background were lost in a system where psychological and social support depended on patients' own wherewithal.

“We knew the system. We understood the system, and even with that — wow, what a challenge,” Dr. Fortin says. “We received the best of care. But the best of care does not meet all the patient's needs and all the family's needs. And Véronique intrinsically knew that. There are a lot of surveys and we know what the unmet needs are. But why are the surveys just staying surveys? They have to become action items and they haven't for 10 years. So what's missing here?”

After Dr. Benk died, never recovering from a last-ditch bone-marrow transplant, Dr. Fortin resolved that he would carry on the work she began in mixing mainstream and alternative medicine.

Through Wellspring, he collected nearly $40,000 in her name and has called together a committee of cancer experts from all disciplines to review the psychosocial research. Next year, he plans to bring together a think tank of cancer specialists and administrators to draft a proposal for bringing evidence-based complementary and spiritual medicine out from the shadows.

“It almost needs a culture change, and that's difficult,” Dr. Fortin acknowledges. “This is so difficult to say, but as awful an experience as [cancer] was, both Véronique and I gained something out of it. We've grown. So there is something of value there. And it's not everyone who has that experience. Having been in the medical system, I can see many people missing that.”

In the end, the prospect that these approaches can lead to physical healing in some cases may matter less than their power to bring greater peace, happiness and well-being to almost all patients.

The M.D. Anderson Cancer Center at the University of Texas started its integrative medicine department after conducting research that found 69 per cent of its cancer patients had pursued at least one complementary therapy other than psychotherapy, with the appetite for it strongest among younger patients.

Few confessed to their oncologists, usually because the doctors never asked.

“Everything that we offer is available out there, but what's unique by having it part of the cancer centre is there is a co-ordination of the care,” says Lorenzo Cohen, the head of the department, who was raised in Toronto and started his career studying stress and prostate cancer in Canada before richer research funding lured him south.

“So the acupuncturist actually knows what the patient's white-blood cell count is and what the platelet levels are to determine whether it's safe to acupuncture. Or if it's not safe to puncture the skin, then they can do acupressure or work with beads that you put in specific pressures points of the ear.”

Aside from the classes and counselling, the department has plunged into clinical trials studying the impact of mind-body practices such as music therapy, yoga and journal keeping, as well as the anti-cancer potential of natural compounds such as green tea, fish oil and mushrooms. The centre provides a website for doctors and the public (www.mdanderson.org/cimer) with briefs of the latest research on more than 80 complementary therapies.

“Sixty-five-plus per cent of the most commonly used chemotherapeutic agents today for treating cancer were derived from plants or other natural products,” Dr. Cohen says, “so there's no question that there's going to be other plants and other natural products that in time will become conventional medicines.”

The closest Canadian version is a small cancer clinic in Vancouver called the Centre for Integrated Healing. Supported by the B.C. government, it is a health-care anomaly: On staff are four medical doctors, a naturopath and a doctor of traditional Chinese medicine, the only physicians publicly funded to provide integrated care in Canada. Here, about 450 cancer patients a year learn about mind-body techniques, spiritual exploration, natural health products, exercise and nutrition.

The centre has conducted research on the longevity of 360 of its patients diagnosed with incurable breast, colon and lung cancers, compared with the standard survival times reflected in a major U.S. cancer database.

The B.C. patients lived longer than would be expected and were less likely to be treated with last-ditch chemotherapy, suggesting mind-body medicine might help to preserve both life and money.

“It's really incorporating very low-tech, common-sense ideas into medicine,” says Hal Gunn, the centre's director. “I think we can provide substantial benefit by incorporating some of these simple ideas into health and healing that don't cost a lot of money.”

There are signs of a shift in the medical establishment to treat patients as more than their diseases. At the Canadian Institute of Health Research, the largest funder of medical science in Canada, 2 per cent of a $118.3-million cancer budget last year was devoted to psychosocial research.

The Canadian Cancer Society's research arm, the National Cancer Institute of Canada, invested a record $1.2-million on psychosocial and behavioural research. And under the Canadian Strategy on Cancer Control, one of eight working groups is devoted exclusively to psychosocial and supportive care.

Still, the idea continues to receive only passing notice in most hospitals, with less than 3 per cent of their budgets allocated to the psychosocial departments.

“There is a long history of surgical interventions, radiation interventions, chemotherapy interventions having first priority. And if cuts need to be made in finances and budgets, it's often the supportive-care elements that go,” laments Margaret Fitch, head of oncology nursing and supportive care at Sunnybrook, who chairs a working group on the issue.

“If you're around the table fighting for social workers and psychologists, it's a much harder sell than if you're trying to advocate for the latest X-ray machine.”

In a cash-strapped health-care system, it's easy to see psychology as a frill. But research shows that when patients' emotional needs are ignored, they are far more likely to run to the family doctor or the hospital emergency department. One study concluded that psychosocial services shaved 20 per cent from patients' overall health-care expenditure.

“Patients have needs, and unless they're met, they'll attempt to have their needs met in some other way,” says Barry Bultz, the author of some of this research. He is director of psychosocial oncology at the Tom Baker Cancer Centre in Calgary and chair of the Psychosocial Oncology Policy Advisory Committee of the Canadian Association of Provincial Cancer Agencies.

Dr. Bultz wants Canadian medicine to take more seriously the severe emotional distress that studies show afflicts at least 35 per cent of cancer patients left alone to face the threats of pain, disfigurement and death.

For the past two years, he has campaigned tirelessly for cancer hospitals to formally adopt emotional distress — anxiety, depression, sleeplessness — as a sixth vital sign that doctors and nurses would check automatically, in addition to temperature, blood pressure, pulse, heart rate and pain, as patients walk through the door. So far, the Canadian Strategy for Cancer Control has adopted distress as the sixth vital sign, as has Dr. Bultz's own hospital.

“From the patient's point of view, it isn't only about cure,” Dr. Bultz says. “It's about the life we live with this disease. It's a profoundly challenging illness, not only physically, but emotionally. That's why we say it can't be purely a biomedical disease. We have to incorporate the biopsychosocial.”

I finished my Herceptin infusions in early September, the final poke of the needle after six rounds of chemotherapy, surgical removal of a breast and every lymph node to be found in my armpit, 25 doses of radiation and a year of Herceptin treatment.

Life has returned to normal, but it can never be as it was. It is possible my breast cancer is gone. It is equally possible that cancer cells immune to treatment are working their mischief in my vital organs or bones. When people kindly ask me how I am, as they often do, I fumble with the reply: Today, I feel healthy, and my gratitude is inexpressible. But tomorrow, who knows?

While the future is a blank slate for everyone, those with cancer know the enemy that stalks us.

Some insist that the alluring promise of a cure with a mind-body approach strikes false hope in cancer patients with advanced disease. Others, Dr. Fortin among them, warn that the prospect can be subtly twisted to make people feel guilty that if their cancer comes back, it will be because they didn't work hard enough at healing.

But all I can do is what I can do. My life is joyfully consumed by the busyness of four children, their homework and school lunches, hockey games, swimming lessons, piano practising and Christmas parties, never mind my job at The Globe and Mail.

I am fastidious about diet and exercise. I faithfully visit a naturopath. But between bedtime stories and dinner dishes, I find little spare time to plunk down on the floor in a lotus position to meditate.

I do feel a little remiss at times for the healing work I'm not doing. And yet I am mindful of my abundant blessings in a way I never was before cancer. Not a day passes that I don't thrill at being alive to be a mother to my children. And maybe this is a healing meditation all its own.

Margaret Philp is a feature writer for The Globe and Mail.