[Editor’s Note: October is Breast Cancer Awareness month. Although there have been many advances in treatment and early detection for breast cancer, about 40,000 Americans die from breast cancer each year, and an additional 155,000 Americans are living with a terminal diagnosis.]

Anyone who has an understanding of mindfulness knows that the practice has to do with being present: present with the moment, present with your physical sensations and present with your thoughts. When we practice mindfulness, we train our brains to stay in the here and now.

But what does mindfulness look like when you are living with a terminal illness? How do you remain present, when your present reality is full of physical and emotional pain? How does one embrace calmness and meditation when you are fighting for your life?

Heather LoRe has been living with terminal cancer for eight years. When she was initially diagnosed with breast cancer she treated it aggressively, having a mastectomy and undergoing chemotherapy and radiation. However, that was not enough. Four years later her cancer came back, and this time, it was terminal.

When I first met LoRe, she said that living with terminal cancer is a mental marathon. Nearly three years later, LoRe is still running that marathon, but like any endurance athlete, she is discovering that she is nearing her limit.

“To be honest, I’m getting very tired at this point,” LoRe told me recently. “I’ve had eight good years that I’m incredibly grateful for, but some of the long-term effects of being sick can wear you out.”

The biggest challenge that LoRe faces each day is dealing with the pain and fatigue that accompany cancer. Those real physical sensations are even harder to deal with than the mental stress of knowing that, in the not-too-distant future, she will die, leaving behind her husband of 25 years and her 27-year-old daughter.

“I find every day that the world is still a good place, and that gives me hope.”

It seems cliché to say that a calamity puts things in perspective, but that’s just what happened to LoRe. Her husband and daughter became her main focus, while her job as a nurse, something that she was passionate about, became secondary.

“I started seeing life much differently, and wanting to fit in as much as possible with the people I cared about,” she said. “My priorities continue to be downsizing my life so that it more closely matches what I enjoy most, thereby increasing the time I’m with my family and friends, doing the things that keep me going in the most helpful way.”

Over the years, LoRe has identified tools that help her feel her best, including massage, reiki, and meditation.

“I personally think it helps the immune system,” she said of meditation. “For me, it clears my mind and helps me get focused on my priorities at this stage, with this condition. It helps me show myself that my priorities are important enough.”

Surrounding herself with positive people is also essential to LoRe.

“I’ve definitely thinned my crowd to those who are the most interested in being helpful,” she said.

At the same time, LoRe has learned how to deal with well-intentioned people who may unknowingly make hurtful or unhelpful comments.

“People will say, ‘I hope you feel better,’ but I’ve been hoping that for years and I don’t feel better,” she said. “Or they’ll say, ‘I hope you beat the cancer.’ I already know that the cancer is terminal, so that’s not helpful.”

In order to speak with people who understand what it is like to live with terminal cancer, LoRe began Hope and Friendship Metastatic Breast Cancer Foundation. The foundation hosts a support group in northern Massachusetts, where LoRe lives.

“[Other patients] have an acute understanding of what I’m going through on a much deeper level,” she explained.

In the group, men and women with a terminal breast cancer diagnosis can share tips, resources, and, most importantly, stories.

Meanwhile, LoRe is looking forward to celebrating her 51st birthday in February, a milestone that seemed impossible eight years ago.

“We’re the only people on the planet who look forward to getting old,” she said with a laugh.

When LoRe is exhausted or having a bad day, she looks at the big picture, beyond herself, to find hope.

“If I have hope for the human condition then I have hope,” she said. “I find every day that the world is still a good place, and that gives me hope.”

The author of this post is an editorial contributor to Headspace. These are their views, experiences and results and theirs alone. This contributor was paid for their writing.