Not everyone is familiar with the concept of a 12-step program, so you might wonder: What is a 12-step fellowship? What are the 12 steps?
In 1935, Alcoholics Anonymous (AA) was founded, establishing the essential principles of what would become the first 12-Step fellowship. The 12 Traditions were later developed to help AA maintain its purpose and structure as it grew. This 12-Step approach to recovery, with its structured yet flexible framework, contributed to AA’s growth and the rise of many other fellowships addressing a wide range of issues.
A 12-step fellowship is a group of individuals who support each other in recovery by working through 12 guiding principles, one day at a time. It provides a framework for personal growth, accountability, and community support. The core involves acknowledging the problem, seeking help, making amends, and committing to a life free from destructive behaviors. This is achieved through self-reflection, accountability, and spiritual growth.
Members share experiences, offer support, and reduce isolation. These fellowships encourage each person to define their own understanding of a Higher Power. They also protect anonymity to keep the focus on recovery. A sponsor provides guidance throughout the journey. The only requirement for joining is a desire to stop unhealthy patterns. Programs are free, supported by member contributions.
I first joined a 12-step fellowship at age 15. Even at that young age, I sensed a deep need for a safe space—somewhere I could speak honestly and be met with understanding. I longed for connection and began to understand the value of taking responsibility, developing emotional awareness, and seeking a purposeful life.
One of the most transformative parts was discovering my own understanding of a Higher Power. That relationship became a cornerstone of healing—offering hope, resilience, and strength through the hardest times. The 12 steps provided me with tools to reclaim my life and achieve lasting change. My ongoing work and service in fellowships has spanned a lifetime and has enriched my life in ways I couldn’t have imagined.
More than 50 years later, I was diagnosed with stage IV metastatic breast cancer (MBC). This incurable disease tries to take my life every day, yet I must still find a way to live. After that diagnosis, I realized I had spent decades preparing for this moment. The serenity and strength I had built through my Higher Power and the 12 steps would now carry me through my greatest challenge.
Two weeks after my diagnosis, I joined a support group for others living with stage IV MBC. I immersed myself in the cancer community—taking classes on MBC, hospice, palliative care, emotional resilience, nutrition, and meditation. I also participated in a Legacy Project, deeply aligned with 12-step principles, which helped me reflect on my life and continue living with purpose—one day at a time.
When people hear my diagnosis, they often say, “You’re so upbeat,” or “You’re an inspiration.” The truth is, I owe that to the same program that gave me a life worth living 50 years ago. Working a 12-step program is still my “secret sauce” to living fully. The same tools I first found in recovery now help me navigate cancer—and whatever else life brings. With deepest respect for the original 12 Steps of AA, I’ve adapted them to guide me through life with cancer. Here are those originals and my personal interpretations:
- We admitted we were powerless over our disease—that our lives had become unmanageable. I accept the reality of living with a terminal illness and that resisting it brings suffering. Surrendering is not giving up—it’s making space for peace.
- Came to believe that a Power greater than ourselves could restore us to sanity. My Higher Power brings hope and peace, guiding me through this with grace and clarity.
- Made a decision to turn our will and our lives over to the care of God as we understood God. I am not in control. I trust in a higher purpose, acceptance, and my care team. I choose to live each day fully.
- Made a searching and fearless moral inventory of ourselves. I ask: What regrets do I have? What relationships need mending? What fears am I holding? How can I take part in my treatment and end-of-life choices?
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. With honesty and vulnerability, I share my fears, regrets, and feelings with my Higher Power and a trusted person.
- Were entirely ready to have God remove all these defects of character. I let go of patterns that no longer serve me—resentment, fear, anger, and the need for control.
- Humbly asked God to remove our shortcomings. I shed these burdens, finding gratitude, presence, and mindfulness.
- Made a list of all persons we had harmed, and became willing to make amends to them all. I reflect on relationships that need peace or closure.
- Made direct amends wherever possible, except when to do so would injure them or others. I take action when appropriate—through conversation, apology, or kindness—fostering peace.
- Continued to take personal inventory and when we were wrong promptly admitted it. I practice ongoing self-awareness, addressing feelings with honesty and compassion.
- Sought through prayer and meditation to improve our conscious contact with God. I connect spiritually through prayer, meditation, and nature, seeking peace and guidance rather than a different outcome.
- Having had a spiritual awakening, we tried to carry this message to others and practice these principles in all areas of life. I share my journey with others—through words, writing, or example—serving with a loving heart.
This adaptation of AA’s 12 Steps has given me a framework for living—even while facing a terminal illness. It keeps me grounded, honest, and open to healing not just physically, but emotionally and spiritually.
I don’t walk this path alone. My Higher Power, recovery community, cancer community, care team, and loved ones walk it with me. I may not know how many days lie ahead, but I do know how I want to spend them: with courage, compassion, and connection. These principles continue to guide me, as they have for decades, one day at a time.
If my experience offers someone hope, comfort, or direction, I am grateful. May you, too, find peace, strength, and purpose in your challenges. Even in uncertainty, there is always a way to love, to serve, to grow, and to live well—one day at a time and by practicing 12 meaningful steps.
