“I think we were all trying to be very brave,” she said. “But it was like walking into a coffin.”

Ms. Lanoux, a small blond English teacher, lives in San Antonio with her husband, also a teacher, a 19-month-old daughter, an 8-year-old daughter and a 12-year-old son. The day she arrived at Anderson, Feb. 9, was the beginning of a difficult journey at the cancer center. She has been coming about every three weeks since, staying for a week at a time.

Her problems began in August 2008 on the way to a beach vacation. She started coughing. Her doctor was not concerned, telling her he thought she had acid reflux because she had had it when she was pregnant. He gave her Nexium. She returned in November at a friend’s urging, and her doctor prescribed cough drops and steroids. But she kept coughing.

Finally, in January, when she still could not catch her breath, her doctor ordered a chest X-ray to see if she had bronchitis. The next week, she returned to learn the result. Her husband wanted to go with her, but she told him not to bother, it was probably just bronchitis.

The doctor “came in and said, ‘This is the part I hate most about being a doctor,’ ” Ms. Lanoux recalled. There was a spot on her lung. A CT scan also revealed spots on her liver. And a biopsy of the spots on her liver revealed what it was. Melanoma. It had spread from an initial lesion  no one could ever find where it started  and was now threatening her life.

Ms. Lanoux’s doctor in San Antonio told her to go to Anderson. “She very honestly told me, ‘I don’t want to try treating you,’ ” Ms. Lanoux said.

“I think I was in denial until last month,” she said. “I had a 10 percent chance to survive five years, and I was going to do it.”

She has tried everything. Immunological therapy with side effects so severe it has to be administered in the intensive care unit. It did not work. Then she started biochemotherapy  a combination of three chemotherapy drugs and two immune system hormones to stimulate her body to attack her tumors. It is a controversial treatment, said her doctor, Patrick Hwu, but some patients had lasting remissions.