The beaded ivory gown is precisely how Erika Heller had envisioned it. The aisle at Blessed Sacrament, one of Toronto's longest, means she can savour the walk today with her father, George Heller, on her arm.
A gaggle of young girls waving fairy wands of flowers will also walk down that aisle, as relatives from the Czech Republic take their place in the pews to watch Ms. Heller marry Ryan Cornell and see them head off for a Mediterranean cruise.
But her blissful vision was challenged as recently as four days ago, during her latest visit to her oncologist. Dr. Monika Krzyzanowska told the 30-year-old twice during that visit to consider postponing the honeymoon.
Morphine has not seemed to ease Ms. Heller's pain complaints lately. Chemotherapy, the doctor said, would help.
"Out of the question," she responded. "I'm going."
A cancer patient for more than three years but a daughter of high society all her life, Ms. Heller looked starkly out of place as she made her way down to the lobby of Princess Margaret Hospital among the greying grannies and granddads who make up the overwhelming majority of cancer patients.
She studied her prescription, which would provide her higher doses of morphine to control the pain on her Mediterranean trip and beyond.
And unlike many new wives, Ms. Heller knows just when the honeymoon will be over - at 9:30 a.m. on July 2, when she is scheduled to have an magnetic resonance imaging scan of her tumour. On July 10, she will start one more cycle of chemotherapy, having already completed more rounds - 32 - than her age.
But today, her wedding day, she doesn't want to think about cancer. The only thing that separates her from other brides is a quarter-sized bump on the right of her chest, where a port was surgically placed to provide access for chemotherapy drugs.
That and the knowledge that her fiancé is willing - no, eager - to become her husband despite the very real possibility that their union will be cut short in a few years and include more than its share of suffering.
"I absolutely love her and I think the world of her," said Mr. Cornell, 31, a manager of space planning at Hudson's Bay Company (HBC), where the man who is about to become his father-in-law was not long ago the chief executive officer.
"I don't know what tomorrow holds. I could get hit by a bus tomorrow. But I've got today and I'm going to enjoy it."
Long day's journey
Ms. Heller was only 9 when she experienced her first bouts of abdominal pain intense enough to curl her into a fetal position. Despite visits to emergency wards and family doctors, no cause was found.
It wasn't until the severe symptoms of blood loss, diarrhea and anemia that a colonoscopy was ordered 14 years later, in 2000. Doctors discovered a startling 500 polyps - growths that produce mucous membranes - lining her colon. Without treatment, cancer was all but guaranteed.
Genetic testing would reveal that Ms. Heller had familial adenomatous polyposis (FAP), usually a hereditary illness, although neither of Ms. Heller's parents has the gene. Like 20 to 30 per cent of patients, Ms. Heller had a spontaneously occurring mutation. Most of her colon, rectum and some of her small bowel were removed at a Toronto-area hospital that summer.
There were severe complications. Her family was told that she might not make it. When she awoke from a second surgery, just after her 23rd birthday, she was wearing an external pouch to collect her solid wastes. A different colorectal surgeon, Zane Cohen, replaced it the following year with an internal pelvic pouch built out of the small intestine, which gave her control of her stools.
For the next few years, life was similar to that of other people her age, save for her bland diet of chicken, white rice and white bread.
In the spring of 2003, Ryan Cornell was in the management-trainee program at HBC when he spotted a high-spirited young woman working in the company's Brampton offices - slender with long brown hair, strong shoulders and exotic cat-shaped blue eyes.
"When I saw her in the halls at work … she was just incredible," Mr. Cornell said in an interview. "She was very beautiful, confident and easy to talk to."
Ms. Heller was working in HBC community investments at the time. She noticed Mr. Cornell too. Tall, with deep brown eyes and thick, shiny black hair, he could easily be mistaken for brooding on looks alone. But he is what many in-laws hope for: elegant, polite and clever.
If she was going to date anyone in the office, she confided in a friend, it would be him.
Their first outing was casual - a bite to eat after work - but the connection was immediate. It seemed a case of opposites attracting: Whereas he was reserved and followed the rule book, Ms. Heller was gregarious and followed her own map.
They dated for a few months, but they parted ways at the end of that summer for the usual reasons people in their mid-20s do: timing and careers. Mr. Cornell moved on to other HBC jobs in Milton and Brockville.
A few cells?
In 2005, Ms. Heller became a junior buyer for HBC. Months before, in March that year, a sharp pain in her midback caused her to contact her family physician, Howard Seiden, an affable, chatty man with closely cropped salt-and-pepper curls whom the family has called their "go-to guy" since he became her doctor eight years ago. Knowing his patient wasn't one to complain, he arranged tests for her at St. Michael's Hospital in downtown Toronto.
An X-ray showed nothing abnormal. An ultrasound revealed a blood clot in her portal vein, which carries blood to the liver from several other organs, and a CT scan suggested a mass nearby it. But given her repeat operations, doctors hypothesized that it could be scar tissue or a benign tumour. Just to be certain, a needle biopsy was done.
Ms. Heller returned to her parents' red-brick Georgian home in the tony north Toronto neighbourhood of Lytton Park to convalesce. She was cared for by her mother, Linda, a former elementary-school teacher, and her father, George, then still HBC's CEO.
One day, Dr. Seiden called to say he was coming over. No one in the Heller family thought much of the visit - he was a family friend. Ms. Heller had all but forgotten the biopsy. They gathered in the kitchen. Mr. Heller was sitting at a table across from his daughter; her mother was cleaning the last few dishes.
The biopsy had come back, Dr. Seiden said, and a few cancer cells had been found.
"I remember thinking, 'What's the difference between you've got cancer and you've got a few cancer cells?' " Mr. Heller said. He answered his own question: "Nothing."
Moments later, Ms. Heller looked at her father - his face was as white as a sheet. She hugged him, then her mother, who kept saying: "You deserve a break."
As Dr. Seiden closed the door that night, he heard Ms. Heller's always poised and composed mother begin to cry.
The tumour was the size of a golf ball and lodged in an area near vital structures, where no surgeon felt it could be safely removed. Chemotherapy was the treatment of choice for Ms. Heller, who knew that drugs alone could never cure her.
Her cancer was deemed a stage IV (there is no stage V) of unknown primary origin. One doctor even told her around the time of her March, 2005, diagnosis that she had six months to live. A further biopsy at the Dana Farber Cancer Institute in Boston in December, 2005, revealed that she most likely had colorectal cancer.
"They actually took a piece of tumour out, tested it and were quite certain that it was colon cancer - even though she had no colon," Dr. Seiden said. "So why do you have colon cancer when you have no colon?"
Dr. Zane Cohen, now the chairman of general surgery at the University of Toronto, said what probably happened is that a small cancer in the colon went undiagnosed after Ms. Heller's first surgery (performed by another doctor). It would be impossible to analyze every one of 500 polyps, though none of the ones sent to pathology revealed cancer.
The prognosis, with an inoperable tumour that had spread beyond the colon, was grim. Not long ago, the median survival time was just over 12 months; now, with newer, better drugs, people were living two years or more, some four years or so.
Those numbers did not add up to a bright future for a woman of 27.
"I believe there is nothing I can't fix," said Mr. Heller, now retired but a senior director for HBC. "I see a problem and I immediately go for the resolution. I never worry about the problem - I worry about fixing it. But this is tough. This is the first thing in my life that I couldn't fix."
It was the summer of 2006 and Mr. Cornell, then living in Newmarket, north of Toronto, was taking part in a wedding that he heard Ms. Heller was going to attend. Eager to reconnect, he sent her an e-mail. He had heard that she had cancer, but that did not stop him.
And Ms. Heller did not let nausea from chemotherapy keep her from getting reacquainted with her old flame via online messaging into the wee hours of the night.
The cyber-courtship continued until she was feeling well enough to go out to dinner in late August. Soon, she had him watching her favourite TV shows, which he would never normally view, such as American Idol and Dancing with the Stars.
"The thought was definitely there, that she was the one" Mr. Cornell said. "It's very natural."
Ms. Heller was in love, but she felt that she needed to be explicit about her health problems: "If something happens to me in five years, you are going to be a widower at 36," she told Mr. Cornell.
"He said he'd rather be with somebody that he really loves for a short amount of time than somebody that he likes for a lifetime," she recalled.
But those were not the only barriers. With her body battered by seven operations and chemotherapy, conceiving a child would be virtually impossible, she told him. Even adopting would pose enormous obstacles, given her diagnosis.
"I'm aware of it. I know what the challenges will be. I accept that," Mr. Cornell said later. "It's part of who she is. I love everything about her" - most of all, he said, her golden heart.
Coming from a wealthy family, Ms. Heller could easily do nothing but focus on herself and her illness and select the world's best specialists for her care. Instead, she volunteers her time. She is a spokeswoman for Look Good Feel Better, a national non-profit program committed to helping women manage the appearance-related effects of cancer and its treatment. And she does charity work for Colon Cancer Canada.
Among all the terrifying things cancer is, it is also a societal leveller. No amount of wealth or social standing can change a diagnosis.
In June last year, Mr. Cornell was on a boat with Ms. Heller's father, touring around Lake Simcoe, saying he wanted to show him his family's cottage in Orillia.
"I could see he was kind of looking for an opening," Mr. Heller recalled. "He said: 'I want to ask your permission to marry your daughter.' "
Mr. Heller began to laugh - as if his daughter would do anything other than what she wanted. "You're a fine young man," he said. "And my daughter would be lucky to have you. But my daughter is not my possession. You have my permission so long as she accepts."
There was only one hitch: If Ms. Heller required costly treatment anywhere in the world, she was going to get it - and her father was going to pay.
"When it comes to medical, it can't be a question of availability of funds," Mr. Heller recalled saying to Mr. Cornell. "That is my cost. I want that out of the way before you get married."
The best-laid plans
Mr. Cornell gave Ms. Heller only one hint about when he would propose: It would not be on a holiday. His plan? To propose on Canada Day, which is also Ms. Heller's birthday, but do it in the United States, where it's not a holiday.
The pair crossed the U.S. border to Niagara Falls on June 30, 2007, supposedly on a pre-birthday shopping trip. Mr. Cornell had made reservations for the evening at a highly recommended restaurant, but Ms. Heller finished her shopping early and wanted to go back to their hotel on the Canadian side of the border.
He persuaded her to return to the U.S. side for dinner, but as they headed for the restaurant, they became nervous. "It was a seedy neighbourhood," Mr. Cornell recalled. "When we got to the restaurant, it looked like something out of The Sopranos."
Neither felt comfortable even parking the car. As they drove back toward the border, Ms. Heller pointed out a McDonald's as a quick alternative. "For the love of God," Mr. Cornell thought. "I'm not going to propose at McDonald's."
Finally they went to a steak house on the Canadian side. Just before midnight, Mr. Cornell told her that he had something for her.
"You're the first woman I've ever given a diamond to," he told her of the single diamond dangling on a white-gold chain, a present for her birthday. "I wanted to give it to you just before your birthday so your first 30 years ended up a good note, and I hope the next 30 years are even better."
And then he topped it off, with a 1.5-carat diamond ring, and a proposal on bended knee.
"I'm engaged," Ms. Heller said to her mother when she returned to Toronto. "Now what do we do?"
The pair grabbed every bridal magazine they could lay their hands on.
"If anybody deserves a fairy-tale wedding, it's Erika," Linda Heller said. "She's been in pain for eight years."
They hired wedding planner Rose Tenuta, who helped to pick the location, Toronto's Park Hyatt hotel. Most of Ms. Tenuta's clients spend about $80,000, including the cost of wedding bands; she estimated that today's wedding, with 186 guests, will cost $100,000 to $125,000.
Ms. Heller will have one matron of honour, five bridesmaids, a junior bridesmaid, four flower girls and a ring bearer. There are five groomsmen. And Ms. Tenuta promised a veritable matrimonial SWAT team armed with walkie-talkies to herd guests and have on hand a bridal emergency kit of headache reliever, breath freshener and spare thread for popped buttons .
Less than a month before her wedding, Ms. Heller had the first of three fittings for her ivory-coloured dress with beads and a French bustle.
Lucinda Carmona, wearing a navy blue polo shirt, blue runners, dark pleated skirt and dozens of pins sticking out of a wrist cushion, immediately began puckering fabric to create an hourglass silhouette. "You learn the personality of the bride," Ms. Carmona explained as she took in the sides of the bodice. "She's a modern bride."
By the last fitting, Ms. Heller had lost weight from running around before the wedding. The dress had to be taken in.
Worries and options
At Ms. Heller's oncologist appointment this week, besides suggesting she postpone the honeymoon, Dr. Krzyzanowska (who specializes in gastrointestinal malignancies) mentioned that perhaps she would like to see a palliative-care doctor to help her manage her symptoms, particularly her pain.
Ms. Heller didn't like the word "palliative," but said she would consider it. She planned to investigate several options once the wedding was over, including whether the operation that wasn't possible three years ago could be done today, likely in the United States. If not, there would be other drugs to try.
Ms. Heller keeps things upbeat, especially for her parents' sake. "They're very good at hiding how scared they are," she said.
She added, "I'm good at hiding how scared I am too."
Walking with her
As for Mr. Cornell's family, they are very supportive of their son's marriage. "We're just ecstatic, we're so excited," said his father, Don Cornell, an entrepreneur based in Newmarket. "We're so glad for them, they're so in love. Every time they look at each other, they smile. It's so nice to see your child so happy."
Three weeks ago, the couple had a pre-wedding appointment with Rev. Larry Marcille. Taped to his office door at Blessed Sacrament was a mock photograph of a Toronto Maple Leafs team with bags over their heads - the Montreal Canadiens puck that sits near his desk required no further explanation. A photo of Father Marcille meeting Pope John Paul hung on the wall.
A baptism certificate showed that Mr. Cornell was Catholic; another sheet of paper proved that the couple had completed their marriage course.
Though Ms. Heller was not baptized, she had a Catholic connection: Her mother and paternal grandmother were Catholic and there was a story that even her father's father - who was Jewish - served as a Catholic altar boy.
Any children they had, she assured the priest, would be raised Catholic.
After a few minutes of conversation, Father Marcille held private talks with each partner. He had it down to an art: Each interview lasted precisely 12 minutes.
He could not reveal much about their conversations, but he would say that "Ryan is very much in love with her, and not once did he say this was a burden for him."
The priest described Ms. Heller as the most positive woman he has ever met. "He's with her and walking with her. … I see the great love of this couple, for sure."
He told Ms. Heller that he would pray for her, and that he believes in miracles.
"How many days God gives to them, they're going to accept that with graciousness," Father Marcille said. "We hope it will be many days together, and years."
Lisa Priest is a reporter specializing in health issues for The Globe and Mail.