We’ve made such great strides when it comes to breast cancer:  We have better treatments with fewer side effects. We have much-needed funding and dozens upon dozens of organizations dedicated to helping find a cure. And, of course, we have awareness: The entire month of October is bathed in pink; support groups abound; thousands walk in solidarity with signs on their backs proudly exclaiming, “I’m a Survivor!” or “I’m a Previvor!”

But what about those women who are neither?  While we try  to focus on the positive when it comes to breast cancer, the truth is that far too many women do succumb to the disease. In fact, 40,000 people die from the illness each year. So what do we call women who are facing metastatic disease? They are neither survivors nor previvors. And, according to a report in The New York Times by Roni Caryn Rabin, they sometimes feel “invisible” within the advocacy community.

This excellent article explains that the average life expectancy for a person with metastatic breast cancer (meaning it has spread to distant organs from the original tumor site) is slightly over two years. Of course, a person with stage 4 cancer can still enjoy her life, but she often jumps from one medical cocktail to another, constantly seeking the treatment that will help prolong it. Often it’s not a question of if the cancer will kill them. It’s a question of when.

Certainly, awareness is crucial, but while the pink ribbon campaign is typically about “hope and empowerment” as Ms. Rabin writers, those with more dire diagnoses don’t feel like they are a part of it. They, too, are battling breast cancer. They, too, are courageous. But in their cases, it’s sadly a matter of the disease having the upper hand.

Shortly after the release of my book, Previvors, I wrote an op-ed piece for The Huffington Post that somewhat addressed these “us versus them” type of issues. For instance, some breast cancer patients take issue with the words “previvors”  and “survivors” because they feel those words demean their own battle. And the article in The New York Times helps to explain why they might feel that way.

I believe that survivors and previvors deserve their own identity, but maybe we need a different word to describe those who are losing their fight with breast cancer. I don’t know what the answer is. But I do know that we’re all in this together: previvors, survivors, those who are facing metastatic cancer, and those who have lost loved ones to the disease. We need to be sensitive to the fact that we all have different battles to face. And we need to support each other, regardless of what those battles might be.