The couple revealed that Elizabeth Edwards' breast cancer had spread to her bone during a news conference designed to reassure the public about the prognosis for her health and his candidacy.
"The bottom line is, her cancer is back," said John Edwards, the 2004 vice presidential nominee and former senator, at a news conference in their hometown of Chapel Hill, N.C. "We are very optimistic about this, because having been through some struggles together in the past, we know that the key is to keep your head up and keep moving and be strong."
The Edwardses suffered through the death of their teenage son, Wade, in 1996 and Mrs. Edwards' breast cancer diagnosis the day after John Kerry and John Edwards lost the 2004 election. She was treated with surgery and several months of radiation and chemotherapy.
The recurrence of the cancer presents a setback for the couple, both personally and politically.
"Getting these results was not a good day for us," John Edwards allowed.
Elizabeth Edwards' illness and treatment are certain to affect her husband's campaign schedule and may raise questions about the viability of his campaign, especially among financial donors wondering whether he will be in for the long haul. The first fund-raising deadline is fast approaching on March 31.
Edwards has been considered among the top-tier candidates although he trails front-runner Hillary Rodham Clinton and Barack Obama in public opinion polls. His forceful opposition to the Iraq war - and oft-repeated apology for his 2002 vote for it - as well as his plans on universal health care have improved his standing among the party's liberal base.
Both Edwardses said the cancer was treatable and that they would stick with their plans to campaign vigorously for the nomination.
"The campaign goes on. The campaign goes on strongly," said Edwards, who argued, "other than sitting around feeling sorry for ourselves, there was no reason to stop."
Wade E. Byrd, a Fayetteville, N.C. lawyer and one of Edwards' chief fundraisers, said the Edwardses sounded optimistic enough that he didn't think donors would be wary "right now" about him abandoning the campaign to be with his wife.
"I wouldn't have been shocked - although I would have been disappointed in a major way - if he had gotten out of the campaign," Byrd said. "I'm not surprised at all that Elizabeth was more than likely the one saying, â€˜You will not get out of this campaign.'"
New Hampshire state Sen. Lou D'Allesandro backed Edwards' 2004 campaign in large part because of his affection for the candidate's wife, but remains uncommitted for 2008. He said his heart broke for the Edwards family and he was a bit surprised that the campaign will continue.
"To some extent, yes, because she is such an integral part of the campaign," he said. "I couldn't envision the campaign without her."
Other candidates have faced cancer in their families and have not let it slow their campaign. Chicago Mayor Richard M. Daley ran for re-election this year despite his wife's diagnosis of metastatic breast cancer in 2002.
Republican presidential candidate John McCain has had repeat occurrences of skin cancer. McCain rival Rudy Giuliani is a prostate cancer survivor, as was 1996 Republican nominee Bob Dole and 2004 Democratic nominee John Kerry.
Democrat Paul Tsongas made his survival from cancer an issue in his 1992 campaign for the Democratic nomination. He lost the primary to Bill Clinton. Tsongas' cancer later returned and he died three years later.
The recurrence was discovered after Mrs. Edwards broke a left rib, likely moving a chest, and had X-rays that also found something suspicious on the right side.
Mrs. Edwards' doctor called her in for more testing, and her husband cut short a campaign visit to Iowa to accompany her to the hospital Wednesday. A biopsy confirmed that the cancer had returned, and the Edwardses are awaiting further testing to see if the cancer may have spread to her liver. "There were times yesterday that we thought it might be a lot worse than it is, and we wouldn't be having the same conference we're having right now with the same hopeful tone," Mrs. Edwards said. The Edwardses smiled and joked throughout their appearance, held in the same hotel garden where they had their wedding reception nearly 30 years ago. "I don't look sickly, I don't feel sickly," Mrs. Edwards said. John and Elizabeth Edwards hosted a barbecue for their top national fundraisers Wednesday night, but never mentioned the diagnosis. Instead, they both talked optimistically about his presidential prospects. "We're all sort of flabbergasted" to hear the news Thursday, said Richard Thaler, a vice chairman of Deutsche Bank Securities and a top Edwards fundraiser who attended. "It was a wonderful event last night, and everyone is very, very upbeat about his chances." After the news conference, the couple left on a two-day fundraising trip to New York and California that included a stop in Boston so Mrs. Edwards could visit their adult daughter, Cate. They also have an 8-year-old daughter and a 6-year-old son. The news about the cancer's return and the decision to keep the campaign going was a closely held secret, with family friends and senior campaign advisers unaware of the diagnosis. John Moylan, a senior adviser who runs Edwards' campaign in South Carolina, said he learned the news by watching it on television. "This was a very private decision about a very private matter," the attorney from Columbia, S.C., said. "It was the best way to handle it." Rival candidates were quick to offer words of encouragement. Obama and Clinton posted pictures of Mrs. Edwards on their campaign Web sites, and McCain spoke to her on the phone. She also got some warm words from the White House. "Good going, our prayers are with you," said presidential spokesman Tony Snow, who has battled cancer.