COLORADO SPRINGS, Colo.
Two weeks after doctors gave her the grim news, Joanne Pittz sat down at her word processor on Good Friday and composed the letter she would send to nearly 100 people.
"Dear Family, Friends, Caregivers, Co-workers," she began. "I have been blessed with your overwhelming support and prayers since my diagnosis with cancer . . . "
With that, Mrs. Pittz went on to outline her sickness in minute detail: how the source of the cancer was in the bile duct; that nodules were discovered on her liver and in her lungs, and that a primary concern now involved a large tumor in the liver -- a mass that couldn't be removed because it had surrounded a major vein.
The plan, she wrote, was for her to begin chemotherapy to shrink the tumor in hopes that it eventually could be removed.
Mrs. Pittz decided to write the letter because it seemed the easiest way to break the news.
But her letter served another purpose: to reinforce her relationship with those dear in her life, relationships that the cancer was affecting just as readily as it did her body.
Some of those relationships would be strengthened; others would be strained. But -- as often is the case when someone becomes seriously ill -- none of them would go unchanged.
Those who would be most deeply affected by her cancer were her husband and their five children. They would be with her from the beginning: when she started experiencing the symptoms in March -- tightness in her chest, swelling in her legs -- and when she underwent the tests that led to the awful diagnosis.
Her oldest, Thom, 25, says he has tried "to go through things like it's normal."
"Just treat her like Mom," he says. "Give her a hard time."
But he has found that on some days, that approach just won't do, such as when his mother is feeling low.
Son Will, 24, admits that sometimes he doesn't know how to act.
"It's hard to communicate," he says. "You don't know if you should dwell on the fact that she's sick or go on as if it's normal when it's not."
Her 22-year-old son, Dan, was living in Boulder and attending the University of Colorado when his mother was diagnosed with cancer. He decided he needed to move back home and finish his credits at the Colorado Springs campus. Though he got continual phone updates about his mother's progress when he lived in Boulder, he found it wasn't enough -- especially the time his mother had to go into the hospital and he didn't learn about it until days later.
Living at home also allowed him to draw on his family for support. "I've broken down a lot," he says. "It's good to be able to fall back on each other if we need to."
The two youngest children admit that they try not to think about the cancer.
"It doesn't really help to think about it a lot. Even though she has cancer . . . you forget she has it," says Steven, 17.
"It's kind of like she doesn't even have it," said daughter Doranne, 14. "It hasn't dawned on me yet. It still doesn't make sense."
Sometimes family members find their moods affected by the ordeal.
"I feel myself sometimes on edge," says her husband, Francis. "Little things upset me."
An avid reader, he'll often bury himself in a book. "Sometimes," he
says, "I use that as an escape."
Before her diagnosis, Mrs. Pittz was a caseworker for a drug prevention program. Since then, her associates have struggled on two levels: coping with the loss of a valued co-worker as well as the shocking illness of a dear friend. They decided to channel their effort toward filling in for her at work, making sure she didn't have to worry about anything on the job.
"In retrospect, it probably wasn't the best approach to take," a co-worker says. "By taking the work away, it was maybe saying she wasn't needed."
Mrs. Pittz knows that some people don't want to bother her, but she says that hasn't stopped friends from offering gestures of support.
"I have a card basket overflowing," she says. "People are praying for me all over the country."
Members of her parish, St. Paul Catholic Church, have shown their support in an organized effort. Meals are delivered to the Pittz household every other night. A collection was taken up to help with medical expenses not covered by insurance. People have volunteered with the little things: transporting her daughter to appointments and the like.
"Everyone was looking for a vehicle to express their concern -- a tactful vehicle," says a parish member. "It is a touchy situation. You do want to help, but you don't want to overstep your bounds."
Mrs. Pittz is aware that some people have drawn away from her since she's become ill.
"People do feel awkward," she says. "They don't know what to say sometimes. I guess a lot of people are hesitant to call. They don't want to bother me. They don't want it to be too much. They know I need my energy."
Mrs. Pittz has told them to call anyway; that if she's not feeling well, she'll simply let the answering machine pick up the calls.
"I want to know what's going on in their life," she says. "I don't want to dwell on my sickness."
Advice for visitors
If you're wary about approaching someone who is seriously ill, here's some advice from Sister Jane Grosheider, who leads a seminar called "I Was Sick and You Visited Me."
Listen to them to pick up on their feelings, concerns and hopes.
Don't be afraid if they express strong feelings -- try to be supportive.
Don't try to fix their hurt or take it away. Let them talk.
Trust yourself. The best gift you have to give is your caring presence.