Like you, my worst nightmare is turning from the caregiver into the dependent. I don't receive help well because it is completely out of character for me, and my role as a caregiver is precisely what has shaped my adversity to receiving care from the people I love. I experience guilt about being a burden and fear about having any expectations of my family--expectations I fully expect them not to meet. Neither my husband nor my children would do well in that role--and honestly I would hate to see them in it.

I won't tell you that "you're going to be alright" when you know as well as anyone that contralateral breast cancer has worse outcomes, but I would like to point out a few things I believe are reasons to keep fighting and have hope:

*I'm pretty sure your age group has the best survival rates--very young women and very old women have the worst rates.

*The interval between recurrence matters. If it's over three years (and I think it has been), survival rates are much better.

*Because you hate receiving care so much--you are more likely (and stubborn enough) to fight particularly hard in order to be as self-sufficient and healthy as possible to avoid it. You have the kind of will that is indicative of survivors.

*Your tremendous effort to beat this disease before, is a good future indication of how strong you can be (even if you don't feel strong right now).

*You have access to some of the most outstanding hospitals, doctors and research available.

I am not trying to talk you out of your fear, anger or sadness. I am only trying to find the silver lining in this very dark cloud and to let you know that no matter what--you are precious and deserving of all of the help and care that I hope will come your way. I also live close to MD Anderson, and will help as much as you will allow.

I know you hate people to feel sorry for you--but I feel sorry for the difficult journey you have had to endure despite the fact that I believe you are warrior enough to survive it.

"Yes, I'll have the love combo, open faced with a side of respect and large a glass of forgiveness, easy on the ice please--my brother