Steamboat Springs In the full and sonorous sound of an organ, the hymn "Amazing Grace" rings through the sanctuary of St. Paul's Episcopal Church when Marilyn Ramunno is asked to play her favorite song.
"It just kind of transports me," Ramunno said of playing music. "It's a good way to just lose yourself and have strength. I love it. I can play for a long time."
Ramunno, a widowed mother of five, has been playing the organ since 1957, but her musical pursuits took on fresh meaning just five years ago when she was diagnosed with breast cancer. In May - after two rounds of chemotherapy, radiation therapy, surgery and ultimately thinking she had beaten the "vicious" cancer - Ramunno learned it had spread to her spinal fluid. Episodes of illness have prevented her from filling her role as organist at St. Paul's for the past three weeks, but she looks forward to returning.
"I don't know what my outcome is going to be," Ramunno said. "It probably would take a miracle, I guess, to beat it. They're being honest that it's pretty serious, but I don't want to give up hope."
Painful twice-weekly injections into her spine and intense headaches that force her to lie down for fear of passing out are constant reminders of the cancer.
Transports, or escapes, from the cancer are welcome to Rammuno.
Ramunno and three other Steamboat organists have more in common than the large wind instrument. The lives of Ramunno, Lisa Wilderman, Cheryl Hardy-Moore and Jan Fritz are defined daily by cancer. Wilderman is being treated for ovarian cancer. Hardy-Moore has twice recovered from breast cancer. And Fritz works with cancer patients every day as the clinical nurse coordinator for the cancer program at Yampa Valley Medical Center.
Henry Wadsworth Longfellow said, "Music is the universal language of mankind." These four women's stories are different. But music has spoken to them in the same tongue.
"When people have cancer, they're in this cancer world," said Fritz, who is the organist at Concordia Lutheran Church.
"Music to people who are involved with music, it's therapy," Fritz said. "It's a form of distraction, it's a form of getting away."
Wilderman, the organist at the United Methodist Church of Steamboat Springs, is a retired Steamboat Springs High School English teacher. Her ovarian cancer has interrupted a retirement she intended to spend abroad teaching English. It's always hard for her to answer former students she sees who ask her how she's enjoying her retirement.
"How do you tell a 20-year-old that it takes hours a day to work through the mental part of cancer," said Wilderman, a widowed mother of two grown sons.
For Wilderman, who used to plan her life out months in advance, one of the hardest parts of dealing with cancer has been slowing down and living one day at a time.
"I think the hardest part is not knowing what tomorrow is going to bring," Wilderman said. "The hardest part is the mental part for me."
Music has been part of her pursuit to "quiet" herself.
"Music's always been important to me, but now it's taken on a deeper meaning," Wilderman said.
Wilderman's chemotherapy is supposed to affect her hands to the point that she shouldn't be able to play the organ, but she has been able to continue in 20- to 30-minute intervals.
Unlike Ramunno and Wilderman, Hardy-Moore had to give up playing the organ when she was diagnosed with breast cancer for the second time in 2005. The weakness that resulted from her chemotherapy forced her to cut out many of her hobbies so she could have the time and strength left to keep her law practice running.
Still, she counts other musical experiences, such as playing the guitar and the reformation of a singing group, as therapeutic during her treatment.
She has been cancer-free since October.
"Music's your soul," Hardy-Moore said. "It's the part of you that can relax and express emotions that maybe you can't say so well."
Fritz said playing music and exercising the mind in general can help battle one of the side effects of chemotherapy.
"One of the things that happens to people on chemotherapy is a cognitive dysfunction," Fritz said. "We call it chemobrain."
Symptoms of chemobrain include loss of concentration and impaired memory.
Wilderman said she has suffered from chemobrain and tests her brain each day with Sudoku puzzles.
"If I can't solve an easy one, I don't do my medical bills that day," Wilderman said.
For each woman, music is just one part of a larger pursuit to live well with cancer. Other ingredients include pets, family, friends, prayer, other hobbies and hope for the future.
"You just want to make their life better for that day," Fritz said. "That's the challenge."
Ramunno said it is sometimes difficult to balance her wish to live with the knowledge that she might not. She said her prayers and the prayers offered on her behalf at St. Paul's, have kept her strong.
"I don't dread death," Ramunno said. "I might dread the process. But I've got faith. I'm strong for that."
Ramunno said it also helps to look back and realize that she's had a wonderful life with no regrets.
"I really appreciate everything I have been blessed to do in my life with my family and my kids," Ramunno said. "And I've done lots of things I've loved to do. I feel like I've been very lucky."
Before her most recent occurrence of cancer, Hardy-Moore had been diagnosed with and overcame breast cancer in 1985.
"The first time I had it, I was so scared of dying," Hardy-Moore said. "You do all the bargains with God to stay alive. Emotionally, I feel like it was almost a wake-up call to appreciate life."
That experience allowed Hardy-Moore to take a different attitude the second time around. When she learned what day her hair would fall out from chemotherapy, she threw a party and had her hairdresser come over to shave her head while friends drank martinis and had a good time.
"At first, you can't imagine losing your hair," Hardy-Moore said. "But it's laughable. In the perspective of life, it's nothing."
Next week, Hardy-Moore will travel with her husband to Mongolia to visit their only son, who is in the Peace Corps. It's the sort of trip Wilderman has a passion for and only recently has been able to consider again.
In addition to music, she credits hobbies such as quilting and gardening with calming and relaxing her to a point where she can see her new life, a life with cancer, in perspective. She recently began writing poetry and essays to journal her way through the cancer.
"I think that, throughout my life, I've always valued beauty and creativity," Wilderman said. "Putting those things together quiets me. I think I've really created a calm in me."
Wilderman is looking for-
ward to her many travel plans, including a Newfoundland cruise and trips to countries such as Scotland, Norway, Russia and Nepal.
"I'm just learning to dream again," Wilderman said. "I'm realizing that cancer will never go away, and I have to live with it."
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