Donna Rosa lives life four months at a time.
She knows that the melanoma that's ravaged her body on and off for the past 12 years could return at any time. After a cancer scan every four months, she learns whether she'll have four more.
Rosa also knows that being alive means she's beaten nearly insurmountable odds.
Bruce Thiers, chairman of the dermatology department at the Medical University of South Carolina, said that no matter how long a person has been free of melanoma, "out of the blue, it can knock at the door and be an unwelcome visitor."
Rosa understands that. And by accepting it, she said, she's been able to live with the disease.
Rosa, who is married to Citadel President Lt. Gen. John Rosa, will be the lead speaker Friday at the Colleges for Charleston Relay for Life. At the all-night event, teams from The Citadel, the College of Charleston and the Medical University of South Carolina will try to raise money and awareness about cancer.
Rosa said too many people dismiss melanoma as "a little skin cancer." But the disease, which starts on the skin, can quickly move through the body's lymphatic system and scatter malignant tumors in its organs.
According to the U.S. Centers for Disease Control and Prevention, more than 50,000 Americans were diagnosed with the disease and nearly 8,000 died from it in 2004, the most recent year for which statistics are available.
There was a time, after being free of the disease for a while, that Rosa thought she'd beaten melanoma for good. When it came back, she was devastated.
"Cancer is a mind game," she said. "It will take your body, but it will try to take your mind, too. I'll not let it catch me off guard again."
Now, she simply cherishes life in four-month increments, she said, praying she'll live to see life's next milestone.
Rosa said she's grateful to have seen her two sons graduate from high school and college, and one of them get married, as well as the birth of her first grandchild.
When her husband talks about what he might want to do after he retires, she thinks to herself, "I just want to be alive then," she said.
And she hopes for a medical breakthrough. "With melanoma, you just hope you can stay alive long enough for new research," she said.
Rosa was diagnosed with the disease in 1996 when after reading a news story of a woman who died from melanoma, she pushed a doctor to remove a mole on her back.
She's since been through four surgeries, including one in which doctors had to break one of her ribs and pull a lung outside her body so they could remove a tumor.
She's been treated twice with chemotherapy, which left her so sick at times that she could barely move. When her body couldn't take any more of that, she began an experimental drug meant to boost her immune system. She took that drug for three years until she developed an allergy to it.
"You have to be aggressive with melanoma," she said, "because it's such an aggressive disease."
At a low point in 1999, when she learned about the tumor in her lung, Rosa said doctors told her the disease had reached stage four, the worst it can possibly get.
They told her that the life expectancy for someone whose disease had reached stage four was nine months.
But she's alive. And remarkably, since doctors last removed a lymph node into which the cancer had spread from her hip in December 2001, she's been free of the disease.
Rosa lives a public life as the wife of a college president, and now she's taking advantage of that to help others prevent and deal with cancer. "I think the reason I got melanoma and lived is to get the word out about it," she said.
Rosa said she wants to tell people they should get regular skin screenings and follow up with a doctor about any moles that show the slightest sign of change, maybe even some that don't.
And she wants to encourage those with cancer to work closely with their doctors, but to also trust what their bodies are telling them. People really need to take control of their own treatment, she said.
John Rosa, who is retired from the Air Force, said "I flew planes for 30 years and they have checklists." But "there's no checklist for cancer."
He accompanies his wife at all of her appointments. The two talk to the doctor, take notes and decide which subsequent steps are right for them, he said.
Donna Rosa said it's her faith in God, and the love she receives from her husband, children, sister Tommye Priest, and her friends that have helped her endure.
John Rosa is a man used to being in charge. But he said his wife's cancer has driven home to him that "many things in life are not in your control."
The Rosas' sons, Jonathan, 31, and Brad, 28, said their mother is a strong woman with powerful faith who buoyed them up when they felt they were drowning under the weight of her disease.
Brad, a graduate of The Citadel, said he remembers clearly a time when his mother was undergoing chemotherapy. She was a woman who had always been full of life and energy, but she was just lying on the couch, drained from the chemicals raging through her system.
He just wanted to do something to help her, he said. He offered to bring her water or food but she couldn't stomach anything. "You just feel helpless," he said.
Waiting until the next all-clear sign from his mother's doctors is a way of life for the family.
Underneath, Brad said, "we're terrified." But in an odd way, waiting has become routine.
Today, Donna Rosa said, she doesn't miss a chance to talk about melanoma.
She makes sure Citadel staffers hand out sunscreen to people watching the school's parade. She stops cadets with sun tans and warns them about the dangers of too much sun. She also serves on the advisory council of MUSC's Hollings Cancer Center.
And to anyone suffering from cancer she says, "Don't give up no matter what your odds or what the doctor says to you. I'm living proof that you need to hang in there."