The preceding week had been anything but normal. On Monday, Elizabeth had learned from her doctors that the cancer she’d beaten in 2005 might have returned. On Wednesday, in their hometown of Chapel Hill, N.C., the Edwardses sat together as Elizabeth underwent a series of tests. They revealed she did in fact have stage IV metastatic breast cancer that had spread to her bones and perhaps part of her lung and other tissue. Early in the evening, the couple told their inner circle that Elizabeth’s cancer was back. They also revealed that, at Elizabeth’s insistence, John’s campaign would continue as planned. That night, at a retreat with campaign fund-raisers, the couple smiled and kept their sad news to themselves.

But by the next morning, cable news channels were filled with speculation on the state of Elizabeth’s health. When CNN broadcast an erroneous report from the Web site politico.com that Edwards would suspend his campaign, some staffers at Edwards’s headquarters broke into tears. “Is it true?” they asked. It wasn’t. In a noon news conference, with his wife by his side, Edwards told the world of Elizabeth’s diagnosis. The couple (who lost their 16-year-old son in 1996) spoke optimistically of her future and used the coming struggle as a metaphor. “If you’re not able in a focused, thoughtful way to deal with this kind of pressure, you’re not ready to be president,” he said. “The campaign goes on strongly.”

Just how strongly could depend on Elizabeth. Edwards has vowed to be by his wife’s side as she undergoes treatment. In initial tests, her cancer levels appeared low in infected areas, but the extent of her illness, and the rapidity of its spread, were not yet known. Ruthless as it may seem, some donors may withhold their support until it’s clear Elizabeth’s illness will not overwhelm Edwards’s candidacy. A fund-raising deficit could make it impossible for Edwards to secure early endorsements from labor leaders who are wary of alienating Hillary Clinton and may only support a candidate with a decent shot at the nomination.

Another hard question for the Edwards team: how to weather a long campaign with the candidate’s wife on the sidelines? Elizabeth has always been a popular surrogate and peerless adviser for her husband. She helps select and manage personnel and shape campaign message and strategy. “She gave up her own career,” said one associate, who asked not to be identified analyzing the Edwardses’ ambitions, in an interview before the recurrence of Elizabeth’s cancer. “I’m sure some of her self-worth is tied to helping John.”

But those close to the Edwardses say Elizabeth can still help her husband, even if she’s more tied to home. “The challenge with this campaign was, unlike the last campaign [when they were free to travel], the kids are in school,” says one supporter, who, mindful of the campaign’s tight control of discussion of Elizabeth’s cancer, would speak only anonymously. “She was the queen of e-mail, queen of the conference call. We’re used to that with Elizabeth.” In the coming months, the Edwardses will have to simultaneously manage public image and private pain. Sadly, Elizabeth is used to that as well.