Clare Runacres faced her then-boyfriend and told him the grim news: Her cancer had returned, and it had spread.
"I had an advanced, aggressive cancer, and the chances of survival were low," said Runacres, who lives in London.
Mike Ramsden - whom she had been dating for several years - decided to propose.
"I just knew I wanted to be with her, no matter the circumstances," Ramsden said. "That's what you do when you're in love with somebody and you're committed."
When the couple was on vacation together in Croatia about a month after they got the news, he popped the question. Runacres did not expect it.
"I was blown away," recalled Runacres, a journalist at BBC Radio 2.
"I also felt very sorry for him that he wanted to tie his life to mine, which I felt might be a very short and painful journey," she added.
Runacres was first diagnosed with cancer as a 20-year-old college student. She had surgery to remove a tumor, though her doctors told her there was not a treatment to prevent the cancer from spreading.
"Chemo and radiotherapy doesn't work on the cancer," she said. "You just have to hope it doesn't spread, which for most people, it does."
Nine years later, when she was 29, the cancer came back. Her doctors told her that the majority of patients with her diagnosis would die within six months.
"Basically, I was planning my funeral when I was planning my wedding," she said.
Runacres requested that The Washington Post not publicly share the specifics of her diagnosis or type of cancer, saying she believes comparing cancer cases can sometimes cause more harm than good, since each case is unique.
"I - like everyone diagnosed - have hunted out advice and looked at all sorts of alternative treatments. Most are a quick way for people to make money off sick people's pain and offer dangerously false hope. I don't want to lead people down any paths," she said.
"I'm often asked what I 'did.' I don't have the answer to how I have survived so long with my cancer," she continued. "My diagnosis is intensely personal. I don't want it or the actions I took afterwards or since to be scrutinized. I don't want to be responsible for what actions people with my cancer take."
After Runacres and Ramsden got engaged in April 2003, they set a wedding date for September that year.
"We didn't think she had long," said Ramsden. "Life sped up."
"When you are in an environment of cancer, you think that tomorrow is often out of reach, so you just live with the today," Runacres said. "Mike decided that he just wanted to live with my today, and that was enough."
On a sunny September day, they tied the knot in Sussex. While the celebration was joyous for both Ramsden and Runacres, it was punctuated by the pain that they likely wouldn't have much more time together.
"The emotions were absolutely raw," said Ramsdem, who works in communications. "I don't quite know how Clare did it. I am in awe of her strength. Clare is a force of nature; a force of life."
Runacres said there were a lot of tears that day, along with laughter.
"It was a very bittersweet day," she said. "Weddings are all about setting your course for the future and having a family and committing to grow old together. When you enter into that and you don't have those expectations, it's difficult."
Before their wedding day, Runacres had a second surgery to remove the new cancerous mass. Although the operation was successful, she worried it would spread again, as it had the first time.
"For many years, we didn't plan longer than maybe three months ahead," Runacres said.
Then, after a few years went by and Runacres's health remained stable, they began to discuss starting a family - something the couple once thought was unfathomable.
"Before I got pregnant, the focus was just on me staying alive," Runacres said. "When you have a child, there's somebody else's future to consider."
"Are you sure you want to do this?" Runacres recalled repeatedly asking her husband.
He replied: "We have to invest in our future. We have to believe that you're well and not sick."
After lengthy consideration, "we agreed that we both wanted children and a family, and it was a risk worth taking," Runacres said.
They ended up having two girls, now 13 and 15.
"From then on, I measured out my wellness on milestones that my children made," Runacres said. "The milestones I've seen have been magical."
On Sept. 13, the couple marked a particularly poignant milestone in their lives: their 20th wedding anniversary.
"It's something that on that day 20 years ago, I could only have dreamt would have happened," said Runacres. "It's truly extraordinary."
She knows how rare her story is.
"I'm aware that other people don't always make it that far, which is sad and difficult," she said. "I still live in the shadow of that cancer. I don't think that once something like that is embedded in your life, you ever leave it behind you."
Ramsden said it is woven into their story.
"We do this together. We try and we struggle and we work at it," he said. "That's just the way it has to be."
Runacres said they have been to some very dark places emotionally, and because of that, it's important to recognize the beauty in their lives as well. With that in mind, she decided to share a small slice of her cancer story on social media, in celebration of their 20th wedding anniversary.
"We didn't think I'd make our 1st anniversary. Today is our 20th," she wrote in a tweet, which has been viewed nearly 3 million times. "It was a beautiful day. Full of love and tears. Surrounded by our closest friends and family, we put our fears aside and danced til dawn. Even now I can't look at the photos without feeling that raw emotion. To reach 20 years feels like a miracle."
Runacres concluded the thread of tweets with: "Mikey, thank you for taking a chance on me. You're the best person I know. You are my miracle. For those living with cancer - keep hoping, believing, dreaming."
The thread, which got attention in the British press, is flooded with comments.
"I didn't know you had cancer. I have it too. I am in my first year with no evidence of disease," someone replied. "Yours is an inspiring story. Happy anniversary."
Runacres is touched to know her post had an impact.
"I was surprised and a little overwhelmed, but also grateful that people wanted to share their experiences with me, and that our experience could help others who are in a difficult place," Ruancres said.
The couple celebrated their anniversary with a small soiree at Runacres's mother's house, with their original wedding party in attendance. They had dinner and danced and shared tearful speeches.
"We're very, very lucky," Ramsden said. "I'm delighted she is still here, and long may we continue."