September 08, 2014 12:00 PM

As she battled ovarian cancer twice in the past nine years, Diem Brown always held on firmly, and hopefully, to her longtime dream of experiencing pregnancy and childbirth. In 2012, just before having her remaining ovary removed, the MTV reality star even underwent a controversial procedure to freeze her eggs. “I know the risks,” she told People at the time. “But for my own sanity, I just want to have something ‘normal’ before going through this cancer journey once again. For me something normal is having my eggs in a freezer somewhere or knowing in my heart I have exhausted every fertility preservation option possible.”

Heartbreakingly, Brown, 32, is now facing her third cancer fight—and in emergency surgery on Aug. 17 doctors had to perform a hysterectomy. “When I came to, they told me that they couldn’t save my uterus,” she tells PEOPLE from the ICU at a New York City hospital. “That was a blow. We’d fought so hard to keep it. Might sound silly to most, but it’s what made me still feel like a woman and gave me hope for a future. I felt empty … gutted.”

It’s a devastating turn for the Roswell, Ga., native, who was first diagnosed with ovarian cancer at age 23. Brown was shocked to learn the disease had returned seven years later, but she came out cancer-free after surgery and chemo, a journey she candidly blogged about on People.com. “I’ve only got this one life,” she said last month. “I need to live every day to the fullest.”

She was doing just that when she suddenly collapsed with crippling stomach pain while filming a new TV reality competition in August. Doctors promptly operated to remove a tumor blocking her colon, but complications from that surgery led to a second operation within three days. The outlook was grim: The cancer had spread to her stomach lining, and she was left with a colostomy bag. “I was completely defeated, honestly,” admits Brown. “Trying to figure out ‘Why?’ puts me into that dark place.”

But when her doctors explained how “touch and go” her second surgery had been, “it put things into perspective,” she says. “I might not have the ability to ever carry a child, and I have this damn bag for the time being—but I’m alive.”

Expected to remain hospitalized for several weeks, she has slowly been regaining some strength. “They’ve been bribing her to walk with Jell-O cups,” says her sister Megan. Most encouraging has been the support she has received from fans on MedGift—a gift registry she started to help those suffering from illness—and from fellow cancer patients. Facing the prospect of chemotherapy and a tough road ahead, she plans to document her struggle once again. “She needs a purpose, and her purpose is to be that voice for others,” says Megan. For now, she’s taking things day by day. “I’m trying not to think about the entire war,” she says, “but each battle at a time.”

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