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Seasons of Life; Seasons of Cancer

Power of Words

Together with Sharon Bray – teacher and author of two books on writing and health – CKN welcomes you to our new Writing Series where Sharon helps readers tap into the healing power of writing during difficult times.  As Sharon puts it, “Your stories matter. You are your stories. Our stories shape us and act as the lens through which we see the world. It’s through story that we make sense of our lives, reclaim our voices, and learn our words can touch others’ hearts.”  Follow along with this bi-monthly series with Sharon and please send us your stories….they matter to us.



by Sharon Bray, Ed.D.

My dog and I make our usual stroll through our neighborhood park in the early morning.  Although she’s much more interested in chasing squirrels than the other dogs who arrive with their owners for a romp in the park’s off leash hours, we stop to greet the other dogs and adults for a few minutes.  Invariably, the introductions begin, human and canine, and when people find out we’ve returned to Toronto from California to live, they express surprise  “You mean you moved from California to Canada?”  How could you leave a place with such great weather?” 

My explanation is as familiar as the question I’m asked.  Sunshine is nice, but I’ve longed for the changes and colors of four distinct seasons.  The impact of year-round temperate weather and what I have called “relentless” sunshine, had the effect of leaving me feeling as arid and thirsty as the dry landscape we inhabited.  For some people, and I’m definitely one, our spirits and creativity are fed by the rhythm of Nature’s changing seasons. Now, as autumn begins to make her entrance, I am all the more aware of how much the seasons “feed” my spirit.

Perhaps it’s because I grew up in a place where all four seasons arrived on their designated calendar dates and a young girl a constant array of offered new discoveries in Nature: colors, smells, and childhood adventures. I feel more “at home” in a place where Nature’s colors and moods are more distinct, just as the little field mouse, Frederick, expressed when he recited his poem to his small companions during the long winter months:  “Aren’t we lucky the seasons are four?/Think of a year with one less…or one more!”(From:  Frederick, by Leo Lionni, 1967)

In their 1990 book (a reprise of their PBS television-radio series) The Seasons of Life:  Our Dramatic Journey from Birth to Death, John Kotre and Elizabeth Hall described how Nature’s seasons are not only metaphors for life’s journey, but how human life is intimately connected to the seasons. Using the biographical sketches of actual people at all life stages or “seasons,” they demonstrate how human lives are influenced by the times of day, circling of the planets, phases of the moon, or growth and harvesting of the crops.

The awareness of the interplay between Nature’s seasons and human life existed long before Kotre and Hall’s book.  The ancient Greeks used seasons as metaphors to define life’s stages: childhood was spring; youth became summer; autumn described adulthood, and winter was synonymous with old age.  Henry David Thoreau, famous for his book, Walden, also saw the seasons as symbolic of human life.   Just as plants go through stages such as bud, leaf, flower, and fruit, or seed, seedling, and tree, he observed that man, too,  experienced similar stages of life throughout the year. 

The cyclical nature of life and living reflects what we witness in nature.  Many years ago while attending the Toronto International Film Festival, I saw a beautiful French Canadian film which focused on the changes in the lives of a small group of friends.  One man was concerned about aging, but his friend challenged him to think of middle age as autumn, which she defined as “the other side of spring”–still colorful and vibrant.  It’s a metaphor I’ve thought of often as I age and see my life continue to change.  

Writing in The New England Journal of Medicine in 1985, Fitzhugh Mullan, MD, described his discovery of a malignant mass in his chest and from his personal experience, described the “seasons of  cancer survivorship:”  acute survivorship (diagnosis and treatment); extended survivorship (post-treatment); and permanent survivorship (long-term survivorship).  In a 2009 article in Cure Today, Kenneth Miller, MD expanded Mullan’s original seasons to four distinct phases or “seasons” of cancer survivorship, building from observations not only by his patients’ experiences but also his wife’s.  He compared her stages of cancer and recovery to the seasons of nature, writing:

I have learned just as much about cancer and the seasons of survivorship in my work as a medical oncologist as I have alongside my wife, Joan, who was treated 10 years ago for acute leukemia and more recently for breast cancer. Her diagnosis was certainly like the cold, bleak winter, and transition like the rebirth of spring. And while each season was different than the others, each was beautiful in its own way. (

Miller then defined what he termed as the four distinct phases or “seasons” of cancer survivorship. 

1.     Acute survivorship: when a person is diagnosed and treated.

2.     Transitional survivorship: when celebration is blended with worry and loss as a patient pulls away from the treatment team.

3.     Extended survivorship: includes those who are living with cancer as a chronic disease and individuals in remission because of ongoing treatment.

4.     Permanent survivorship: people who are in remission and asymptomatic, or,
cancer-free but not free of cancer because of chronic late and long-term health or psychosocial problems. Others may even develop secondary cancers related to cancer treatment, or develop second cancers not related to the first cancer or its treatment.      

Seasons, however, may be more than just metaphorical when it comes to the cancer journey.  In a 2007 study, researchers from Norway and Oregon found evidence suggesting that men diagnosed with prostate cancer in summer or autumn had better survival rates ( for more details).  Vitamin D—the sunshine vitamin–plays a part.  In other studies with early stage lung cancer patients, high concentrations of Vitamin D appeared to contribute to a better survival rate post-surgery.  Patients whose surgeries occurred in sunny months (May – August) had a 30% higher survival rate than those who had surgery in winter. “Season,” epidemiologist David Christiani noted, “had a pretty strong effect.”(

Whether diagnosed or treated with cancer in summer or winter, the seasons of an illness may dominate our lives and how we think of our experiences.   Marilyn Hacker’s 1994 collection of poetry, Winter Numbers, invokes the darkness and cold of winter as she details the loss of many of her friends to AIDS or cancer as she also struggled with breast cancer.  Dan Matthews, poet, chronicled the journey of his wife’s terminal breast cancer in a collection of poetry,  Rain, Heavy at Times: Life in the Cancer Months (2007). John Sokol wrote about his cancer in a poetry collection entitled In the Summer of Cancer (2001).  Barbara Crooker, in “For a Friend Lying in Intensive Care Waiting For Her White Blood Cells to Rejuvenate After a Bone Marrow Transplant,” used the season of springtime to signal her friend’s renewal and rejuvenation:

The jonquils. They come back. They split the earth with

their green swords, bearing cups of light. 

The forsythia comes back, spraying its thin whips with

blossom, one loud yellow shout.

The robins. They come back. They pull the sun on the

silver thread of their song.

The iris come back. They dance in the soft air in silken

gowns of midnight blue.

The lilacs come back. They trail their perfume like a scarf

of violet chiffon.

And the leaves come back, on every tree and bush, millions

and millions of small green hands applauding your return.

(From:  The Cancer Poetry Project, Volume 1, 2001)

Why not explore how seasons influence your life or cancer journey?  What seasonal metaphor best describes the stage of life or cancer survivorship you are experiencing? Here are some suggestions to get you writing:

·     Write about the different seasons in your life, whether the cancer journey, a marriage, loss and grief, adulthood– any of life’s seasons that have been important or significant to you in some way.

·     If you are a cancer survivor, explore how Miller’s “Seasons of Survivorship” apply (or not) to your journey.  Which “season” has been the most difficult to endure?  Why?

·     Explore cancer in a poem, using seasonal metaphors to describe your experience.  You might begin by “exploding” as many images of that season on the page before you begin to shape a poem.  Be as descriptive as possible.


Let us hear from you!  CKN will select and publish your responses to the suggested writing prompts from Sharon.  Send them to Karen Irwin.  500 word limit.



SharonBraySmallSharon Bray, Ed.D., is the author of two books on writing and health: A Healing Journey: Writing Together through Breast Cancer and When Words Heal: Writing Through Cancer. Her blog site,, features weekly reflective essays and writing prompts for anyone writing out of illness, pain or life struggle. She leads a number of expressive writing workshops for cancer survivors and teaches creative nonfiction and transformational writing for UCLA extension Writers’ Program. She earned her doctorate from the University of Toronto.



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