“Would you like to have a bone marrow biopsy today or tomorrow?” These are the only words I remember coming from the oncologist who I had just met in the emergency department (ED).
I was in my second year of medical school and just 24 years old when I was thrust into this unforeseen journey and diagnosed with cancer. When I walked into the ED, I had no idea the fever, nausea, and vomiting I had come in with wasn’t the “flu,” the bruises all over my legs weren’t just from my puppy, and the extreme fatigue I had been experiencing wasn’t from slogging my way through finals week. I had a bone marrow biopsy that very day, and suddenly my carefully charted path was derailed by the overwhelming reality of being diagnosed with acute promyelocytic leukemia (APL).
I spent the next several weeks fighting to survive and witnessing the profound impact my diagnosis had on my family. Their unwavering support became an integral part of my journey, opening my eyes to the reality that cancer doesn’t merely affect an individual; it transforms the entire family dynamic.
I was wholly unprepared for how to navigate a cancer diagnosis in my 20s. How was this going to impact my relationships? What impact would this have on my ability to accomplish all I had hoped to? Would we be able to pay all the medical bills as they added up? What would happen to my self-esteem and body-image? Were there other young people with cancer? If so, where were they? No one had all the answers.
Fortunately, the chemotherapy worked — I did “survive,” and I spent the next 2 years intermittently on treatment working my way back to the life I had before cancer that I so desperately hoped was still waiting. One year off medical school wasn’t that long, right? The “chemo brain” would go away eventually. It had to. I had rehabilitated major injuries as a collegiate gymnast. Recovery would be like that. Wouldn’t it? The grit, resiliency, and tenacity that got me a college scholarship for gymnastics pushed me to keep working to get my life back on track. I returned to school stubbornly committed to becoming an orthopedic surgeon just like I had planned since I was a kid. Back to the map and plan I knew.
Shifting My Path
During medical school rotations, my oncologist subtly nudged me towards a career in oncology, believing my experience as a survivor would bring invaluable empathy to patient care. At first, I hesitated, grappling with the notion of immersing myself daily in an environment that reminded me of my mortality.
However, encountering patients who mirrored my own struggles gradually shifted my perspective. I realized the potential to use my experience as a cancer patient as a source of education, healing, and inspiration for others battling cancer. Witnessing the resilience and dreams of fellow survivors sparked a realization: this was my purpose.
The transition from a young adult leukemia survivor to an aspiring oncologist was not a simple pivot; it was an evolution. My journey, from navigating the unknowns of cancer treatment to finding a newfound purpose in advocating for adolescent and young adult (AYA) patients embodies a transformation fueled by resilience and empathy. As a survivor for 17 years now, I vividly recall the challenges of feeling isolated, the fear of recurrence, and the struggle to navigate life after cancer. It is this firsthand understanding that fuels my commitment to providing compassionate care and support to my patients today.
Empathy in Action
My experience as a young adult cancer patient profoundly shapes how I approach caring for my patients today. It’s in the nuanced understanding of their lives beyond their illness that I find the keys to truly impactful care. Appreciating the significance of their support system, their commitments, and the obstacles they face in accessing treatment is integral to my approach.
Drawing from my own experience as a high-level competitive athlete, I empathize with the silent resilience ingrained in pushing physical limits, a trait I frequently encounter in other athletes, first responders, and military personnel. Recognizing the unique challenges of survivorship, especially for AYA patients — whether it be concerns about achieving life milestones, facing fertility issues, financial strain, or feeling isolated from their peers — guides my focus. It’s about seeing them as individuals beyond their cancer diagnosis, easing their worries, and instilling confidence in their medical team and plan.
Understanding the psychological impact of a cancer diagnosis and treatment is as crucial as addressing the medical aspect. Together we navigate the complexities of losing control, acknowledge the realities of PTSD (and possibility for post-traumatic growth), and address the often-overlooked burden of survivorship guilt. My aim is comprehensive care, not just the medical piece but holistic support that acknowledges the multifaceted layers of my patients’ experiences.
This commitment to compassionate care has motivated me to advocate for better support for young cancer patients. Recognizing the gaps I experienced firsthand, I have been granted the opportunity to spearhead the development of an AYA cancer program at Mayo Clinic. While there is no prescribed path for such an endeavor, my history of navigating uncharted territory and emerging stronger lends itself to this mission. My story of survival fuels the fire to ensure that every young adult facing cancer finds community, can navigate their way through the challenges, can emerge resilient, and can redefine what it means to thrive beyond illness.
Allison Rosenthal, DO, is a lymphoma specialist and medical director of the Adolescent and Young Adult (AYA) Cancer Program at Mayo Clinic in Phoenix.