I spent decades pleasing everyone. Then cancer changed the equation.

The summer I turned 50, I was diagnosed with lymphoma.

While the type I have is considered to be very treatable, it’s also considered chronic. “You’ll likely die with it, not of it,” my oncologist told me.

The one-two punch of turning 50 and receiving a cancer diagnosis became a crash course on managing another chronic ailment that’s long plagued me, people pleasing.

As a firstborn daughter, disappointing people I love has always felt physically painful to me.

When my son was a toddler, and I’d leave to go to a yoga class, he’d sob as we watched me through the window, his face scrunched up like he was being tortured.

I’d try to override the ache in my chest as I backed the car out of the driveway, reminding myself that my son was safe in my husband’s care, and it was healthy for me to take a little time to nurture myself.

As my kids grew and I attended regular therapy, the silent, impossible expectations of myself that I hadn’t realized I’d been carrying started to appear, like invisible ink being revealed.

I started to see that the flood of guilt I felt when I put my kids in part-time childcare or hesitated to volunteer at their schools was neither necessary nor healthy.

Lymphoma occurs when the white blood cells responsible for fighting infections mutate and multiply.

People-pleasing, I’ve learned through the years, is, for women, a cultural norm and often a survival tactic.

It’s meant to keep us safe, but if unchecked, it gnaws at us, depleting us.

Cancer brought my people-pleasing into sharper contrast.

When someone asked me to do something I didn’t have the time, energy, or desire to do, I began to feel a “no” rising up.

I’d start to push it away, as I’d always done.

But a quiet voice said, “You have cancer.

You can say no.” Sometimes my nos were silent, like deleting the school emails looking for parent volunteers.

Other times, they were more challenging, like when my mom asked for a ride home from the ER late one night when she was sick.

To battle the tug of guilt, I summoned that quiet, wise voice, and I heard, “You need to rest.

Mom can get an Uber.” Sometimes the boundaries were just for me, like deciding to swap out our oversized SUV for a smaller car because I was tired of the anxiety that flooded me every time I pulled into our garage.

With practice, it became easier to set boundaries.

Boundaries, I began to see, are actually benevolent, because they communicate our needs and limits to others.

I began speaking up about things I wouldn’t have in the past.

No, I really don’t want Chinese food tonight, I’d say, gritting my teeth for a moment before realizing I could exhale.

I’d stated a preference, a need, or a limit — and the world had kept on spinning.

As women, the world will give us as much as we can carry, and then it will pile a few more blocks of concrete on for good measure.

We’re the only ones who can say, “That’s enough.” I’m now two years out from my initial diagnosis, and I still see my oncologist once a quarter.

As the doctors look over my bloodwork, I check in with myself.

Am I still setting boundaries when they’re called for?

Am I prioritizing my well-being and scheduling things to look forward to?

Like lymphoma, people-pleasing requires surveillance.

It’s a chronic condition, and one I’ll be working on for the long haul.

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