Melanie Hernandez noticed the lump two weeks after delivering her fourth child.
But at 31, Hernandez was too busy to think about cancer. She had a husband, a newborn, three other kids and her own preschool. She didn't want to think that the ugly, uncomfortable growth could be cancer. "Even to associate that word with your name, it's devastating," she says.
By the time a doctor diagnosed Hernandez with melanoma -- nine months later -- the disease had spread to her lymph nodes, requiring three surgeries. Although she shared the grim news with her husband, it was a month before the couple confided in anyone else.
"Having to tell people, that's the hardest thing," says Hernandez, who was diagnosed in January.
Hernandez says she can sympathize with the lead character in the Showtime series The Big C, which premiered last week and continues tonight at 10:30 ET/PT. Cathy, played by Laura Linney, hides her diagnosis of advanced melanoma -- a deadly skin cancer with a 16% survival rate -- and refuses to consider treatment.
Though The Big C is drawing a wide audience and praise for its star, it has gotten a mixed reception from cancer survivors, who now number 12 million.
Some argue that the series reflects little of their experience and wastes its opportunity to educate viewers about preventing and treating a neglected disease. Others welcome the chance to bring attention -- as well as humor and warmth -- to a disease that mars so many lives.
Leah Lockhart, whose melanoma also has spread to her lymph nodes, says she doesn't want the series to get bogged down in medical details. Merely mentioning melanoma is enough to draw attention to the issue, says Lockhart, 30, of Palm Bay, Fla.
"Everything else can be Googled," she says.
Some survivors say the series shines light on, and dares to poke fun at, parts of the cancer experience that might surprise people who have never had to deal with the disease.
And Hernandez notes that people can react to cancer in unexpected ways.
"Laughter is healing," she says. "It's OK to laugh at our bad luck. ... Cancer leaves you deformed, in ways that no one else can tell. It's mentally not fun. You have to be able to make fun of yourself."
Shunning support
Hernandez endured three surgeries to remove the melanoma, and she found herself turning away friends who wanted to help. Although many melanomas are related to sun exposure, hers was not. It developed on her vulva, and the surgeries were painful.
Hernandez, who lives in Willits, Calif., knew her friends meant well, but she wasn't eager for guests while recovering from a difficult procedure in a private area.
"I finally had to get a little rude and say, 'I don't want anyone at my house,' " Hernandez says. "People were taking it on themselves to volunteer for things that I didn't want. I don't like to be taken care of. I just wanted my husband, my kids, and to sit on our couch and watch movies."
Jenny Bicks, a writer on The Big C who survived early-stage breast cancer, says she wants to portray the messy mixture of emotions people feel when confronted by their own mortality, and the dilemma of deciding how to spend their remaining time.
In the opening episode, Cathy kicks her husband out of the house, flirts with her oncologist and sneaks a cigarette.
"Cathy is going to be frustratingly real," Bicks says. "She is not going to do what she is supposed to do at any point in time." In many of her decisions, "she is probably wrong, but she needs to learn that, and that is going to be part of her battle."
Some cancer survivors say they recognize Cathy's refusal to share her diagnosis with her family as a form of denial.
Bicks plans for each season to revolve around a different stage of grief: denial, anger, bargaining, depression and acceptance. Cathy isn't meant to be typical or admirable, she says.
"It takes a lot of energy to tell people you are sick," Bicks says. "Every time you tell someone, you have to deal with their reaction," she says. "We'll see that in the show, where she tells someone and then suddenly is lying and telling people everything is going to be fine."
Anne Hellmann, a mother of four with advanced colorectal cancer, says she also understands Cathy's dilemma.
"When I first got my diagnosis, I was very private," says Hellmann, 50, of Kingsville, Md. "When you tell someone you are stage IV, you don't want them to give up on you. I don't consider myself terminal."
Yet Hellmann found she needed help explaining her diagnosis to her family.
"My husband and my sister kept saying, 'You're going to be cured,' " Hellmann says. "I kept saying to them, 'I'm not going to be cured.' I said to my doctor, 'You have to set something straight. I'm not going to be cured.' And he looked at them and said, 'There is no cure. That doesn't mean there is no treatment or there isn't a plan. But there is no cure."
Turning away treatment
Some cancer survivors say they understand why Cathy is unimpressed with available melanoma treatments.
Hernandez also has rejected doctors' advice. After her surgery, three doctors urged her to consider interferon, a grueling immune therapy.
The year-long treatment would have left her extremely sick, often bedridden, and would have required that she spend a month in San Francisco, 2 1/2 hours away. At a time when she was unsure how much time she had left, Hernandez clung to her children, unable to imagine the thought of trying to find someone else to take care of them.
"If it was interferon or nothing," Hernandez says, "I would choose nothing."
She told her doctors no.
She also pulled out of a clinical trial of a new experimental drug, ipilimumab, because she would have had to stop breast-feeding her 14-month-old daughter. Her daughter cried whenever Hernandez couldn't nurse. She felt like she was pushing her child away, Hernandez says, at a time when she never wanted to let go.
"I was angry, mourning for what was, angry that this was a choice that I had to make, or that I didn't have a choice," Hernandez says. "You just find yourself grasping onto these little things, in order not to change anything. This was one more thing I was going to have to give up, and I clung to it so hard."
Hernandez says her husband of 15 years -- her childhood sweetheart -- never questioned her decisions. But she eventually changed her mind. She now travels to San Francisco every three weeks for treatment, although she doesn't know if she's receiving the drug or a placebo.
"I began to think I was being selfish," she says, "if I didn't do everything I possibly could."
Laughing through pain
Some cancer survivors say they recognize the absurd situations in which The Big C's heroine finds herself, such as when her oncologist -- at a loss for what to say -- hands her brochures instead. And Hellmann says she can sympathize when, in an upcoming episode, Cathy confronts an overzealous support group bearing an enormous casserole.
"I got a lot of bad casseroles," Hellmann says. "I said, " 'Somebody should try it,' but we just couldn't eat it."
Hellmann says she understands Cathy's pain at realizing how little time she has left. In the show's first episode, Cathy decides to build a pool in her yard and announces her plans to skip dinner in favor of liquor and desserts. Hellmann says she's trying to make better use of her time, too. When her husband didn't take a hint to buy her a new ring, she bought it for herself.
Like Cathy, many survivors says they're making time to spend with their children.
"I want to soak up every single thing around me," Hellmann says. "If my kids start talking, I just sit back and let them roll. You just want to savor every moment."
Hernandez is also making changes in her life, such as working fewer hours at her preschool to spend more time with her children.
Her new schedule will give her more time to cook a family dinner and help the kids with their homework, she says. "I want to enjoy my baby while she's still a baby," says Hernandez, whose youngest is now 18 months old.
But Hernandez acknowledges that watching The Big C may eventually prove too painful.
She notes that if The Big C succeeds and continues for several more seasons, it will only bring suffering to its heroine. And she's not sure she wants to tune in for that.
"You can only find so much comedy in someone's demise."
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