By her own account, Ruth Aloni had a good life. She worked 12- to 14-hour days as a regional manager for American Standard Plumbing, a job that required frequent travel. She had good relationships with her two grown children. She spent weekends entertaining friends at her home.

"Work was all-consuming, but I loved what I did," said Aloni, who will be honored at the upcoming American Cancer Society Hawai'i Pacific Boots on the Beach event. "I was very active and very fulfilled."

From the outside, it would be difficult to regard what happened next as anything but tragic, but Aloni, who moved from Melbourne, Australia, to Hawai'i 30 years ago, understands the greater truth. She knows what cancer has taken from her — and what it has given.

The initial symptoms — bleeding, a loss of nearly 30 pounds — began in 1999, and they seemed to point at the obvious. But, as Aloni generously allows, many conditions manifest in similar ways. The bleeding was attributed to hemorrhoids, the weight-loss to the stress of her ongoing divorce.

It would take two years of persistent inquiry before Aloni would receive the answer she dreaded most: Stage 4 colon cancer.

It wasn't Aloni's first health crisis — she had suffered a heart attack in 1987 — but the enormity of what she was to face was devastating.

"It's like the center of your universe stops," Aloni said. "You're never going to be the same again. You don't know if you're going to have a life.

At the same time, Aloni was concerned about how her children — particularly her daughter Lara, who had struggled with her throughout those two long years of uncertainty — were coping with the news.

"It's so hard to begin to know how it affects someone else," Aloni said. "I think sometimes the people around you are more affected than you are yourself."

Doctors estimated Aloni's chances of living beyond five years at just 5 percent. Aloni understood what this meant: There was still a chance.

"I made up my mind very early that I was going to survive, that I wasn't going to be defined by the illness," she said. "When they gave me poor odds, I just said, 'Well, someone has got to be in that survivor percentage, and you and I are going to work to make sure it's me.' "

STARTING TREATMENT

Aloni underwent an intensive regimen of chemotherapy and joined a clinical trial. At one point, Aloni wore an auxiliary pump that infused chemotherapy medication into her body, meaning that she was on chemotherapy 24 hours a day for four months.

Despite the odds, Aloni responded well to the treatment and seemed to be on the path to a brighter, more hopeful prognosis. It wouldn't last.

In 2003, doctors found a cancerous growth in Aloni's liver. She would have to do it all again.

"It takes quite a transition to go from long-term patient to a normal, integrated life," Aloni said. "It was an absolute shock to the system because I knew what I had to face."

Again Aloni fought. Again she beat the odds.

To be sure, the progress was always tenuous. Once, while on vacation in Seattle, Aloni suffered a second re-infection due to the weakened state of her immune system from the chemotherapy. She spent two weeks in intensive care, during which time doctors there told her that they would honor her living will.

"At that point, your survival instinct kicks in," Aloni said. "I overrode it. I told them to do whatever was necessary to keep me alive."

'THEY WERE MY ROCK'

Aloni says it is difficult to reflect on her struggle with cancer. But what she keeps with her, what she refuses to let fade, is the memory of those who reached out to her.

Lara flew back and forth from her home in Seattle to help Aloni through her chemotherapy. A close-knit group of neighbors from her Kane'ohe complex also rallied their support.

"Every single neighbor helped me — with food, with moral support," she said. "They were my rock."

Like other cancer patients, Aloni said her disease made her acutely aware of the interior-exterior nature of her existence. There was the face she presented to the world, and the world behind the face, which churned with fear and uncertainty.

Aloni also found that there were lessons to be learned from her experience if she were willing to recognize them.

"It gave me a chance to get my life together and evaluate my priorities," Aloni said. "Cancer is like a volcano: it's either dormant or active. It doesn't go away. What I learned is to make every day count because none of us are promised a tomorrow."

LIVING IN THE PRESENT

With an immediate past she'd prefer to leave in the past and a future that comes with no assurances, Aloni finds herself with a unique sort of liberty, a freedom to live wholly in the present.

During her treatment, Aloni found comfort in simple art projects such as drawing, knitting and decoupage. (What, after all, is a better response to the presence of death than an act of creation?) In the process, she discovered a creative self she hardly knew existed.

In art, Aloni found not just a personal release, but a means of giving back.

Working with the American Cancer Society's Hawai'i Pacific section, Aloni started the Hands On Healing program, which provides classes in a wide variety of art media to hundreds of people with cancer and their caregivers.

"I missed a lot of life and living because I was so focused on work," Aloni said. "I had to ask myself, 'How do you simplify your life and find balance?' Now I try to enrich my life by helping others."

That, in Aloni's final accounting, is a very good life.

Reach Michael Tsai at mtsai@honoluluadvertiser.com.