The Roller Coaster

A Reflection About Holding On

When I ask patients how they've been doing since our last appointment, they often answer with a small, tired laugh, "It's been a roller coaster." I've come to believe that is exactly the right description because it's true in ways that most metaphors aren't. The roller coaster doesn't just describe the ups and downs of your life after cancer enters it. It illuminates it.

Let's stay with the image for a moment.

A roller coaster has two essential elements: the car and the track. The car carries you and all you've brought with you. The track is everything else. It is the path laid out before you, designed by forces outside your control, visible only a little ways ahead before it disappears into the next curve or the next drop. You didn't choose the track. You can’t alter it. And you can’t get off.

When you’re living through cancer treatment, the track is relentless and unpredictable. There’s the fatigue — not ordinary tiredness, but the kind that sits in the body like heavy lead, occasionally lifting just long enough to offer hope between treatments, before settling back in. There is nausea that comes and goes on its own schedule. There is neuropathy, that painful tingling and numbness in the hands and feet, a side effect that reminds you, even on good days, that you’re fighting a serious illness. These are the physical turns of the track, the dips and climbs the body navigates, whether it is ready or not.

Then there are the scans.

Scan results are their own particular feature of the track. Sharp, defined moments that send the car soaring or plunging or, perhaps most disorienting of all, holding steady in a way that feels neither safe nor resolved. Stability is, objectively, good news. But it lands differently than people expect. It doesn't return you to the life before. It just gives you more track. It can feel like being held at the top of a loop, waiting to find out what comes next. And then there is the scan result that says: we see something small, we're not sure what it is, we're going to do more testing. That result doesn't give you bad news to process. It gives you uncertainty, which is harder. Uncertainty means the track ahead is not just unseen — it’s not yet built.

All of this is the track. The shifting symptoms, the scheduled scans, the results that clarify and the results that confuse. The disrupted rhythms of your body. The calendar reorganized around appointments and recovery windows. None of it is chosen. All of it must be ridden.

And through it all, through every plunge and climb and nauseating curve, there is the car.

The car is not just you. The car is your life, and it’s full. There’s a partner in the seat alongside, or a parent, or a child who doesn't entirely understand what’s happening but feels every lurch nonetheless. There are friendships that have drawn closer and some that have pulled away. There are roles you still hold — parent, spouse, worker, friend — that don't pause because treatment has begun. There are dreams and plans that have been set aside, with the hopes of returning to them later. All of this is in the car, along the ride with you.

And everyone in that car is holding on.

That’s what I think of when patients say, “It’s been a roller coaster.” Not the vague sense of ups and downs, but the specific image of hands gripping the bar — white-knuckled, determined, exhausted. You grip because the track demands it, because the people next to you are gripping too, and there is something in that shared effort that holds the car together. You grip out of the sheer effort of staying present on a ride you did not choose and cannot stop.

Holding on is not passive. It is an intentional choice that the track cannot take from you.

What strikes me, after years of sitting with people in the middle of this ride, is how rarely the roller coaster metaphor gets its due. It tends to be brushed past, as if it were a cliché rather than a genuine experience. Yet, it's reached for because it names something true about what you’re living: that the sensations — physical and emotional alike — come from the track twisting and rising beneath you. That the fear and the relief and the suspended feeling of stability are not signs of not coping well. They are appropriate responses to a track that keeps shifting.

While you’re on this ride, there is something validating about simply naming it. Cancer is a roller coaster ride. The track is hard, and you didn't choose to ride it. And here's the thing: you are holding on, the best you can, so as not to fall out of the car that holds everything that matters to you.

And that is everything.

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Reflections on the inner psychological experience of living alongside cancer.

Jae L. Ross, PsyD, is a clinical psychologist who works with individuals and families whose lives have been reshaped by cancer, helping them navigate the emotional challenges of diagnosis, treatment, and beyond.

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