Portraits in courage 2

To be diagnosed with best cancer at the age of 25 must be one of the most difficult things a human can go through and endure. At twenty five people still feels invincible, with their whole life ahead of them. A patient of mine went through this almost five years ago. Chemotherapy, radiation therapy and nearly 5 years of antiestrogen therapy put many of her dreams on hold.  She had wanted a family with her new husband and looked forward to the possibility of having a child after her 5 years of antiestrogen therapy was completed. Over the last 5 years she has become one of my closest patients. I looked forward to her visits, as did all my staff. She is kind and always smiling.

Tragedy struck this week. After being only ill with the “flu” for one week she went to her home town doctor and was found to have a white blood cell count of 150 thousand (100 times normal).  The work up included a bone marrow biopsy which revealed the diagnosis of acute leukemia.  She is now in the second fight of her life. This leukemia is almost certainly related to her previous treatment for her breast cancer. How can this happen? It is a known complication of certain kinds of chemotherapy. The chemotherapy damages the bone marrow in some way that eventually allows the development of this kind of “secondary” cancer. This is a very rare but feared complication of the treatment of many kinds of cancers.

Treatment of her leukemia will require aggressive chemotherapy and eventually possible a bone marrow transplant. If she survives the first couple weeks of her treatment, which is in no way certain, she will face years of potential treatments and side effects. Her ability to have children has been lost. The amazing thing is her attitude has not changed. Despite the pain, fatigue, difficulty breathing, and the prospect of a long hospitalization her spirit and smile hasn’t dimmed. These are the characteristics that give her a fighting chance….. Everyone’s payers would help also.