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Finding Light Amidst Darkness

My name is Micaela, and on December of 2016, I received my first cancer diagnosis of sarcoma botryoides, a rare type of soft tissue tumor typically found in children under the age of 8-10. I was 14. 

This was beyond a shock. I remember the moment when I saw the ultrasound technician returning for repeat scans, while I noticed a large, black mass on the monitor. I remember crying all the way home that evening, thinking to myself, “What if it’s cancer?” But, when I heard the word, “oncologist,” in reference to a referral made by my physician, I went numb. Absolutely numb. I hadn’t processed it yet. And, to this day, I still haven’t. I don’t know if I ever will.

After being referred to three different oncologists, I found myself at the Children’s Hospital of Philadelphia. I underwent surgery in March of 2017, where my surgical oncologists removed a mass about the size of a baseball. They thought they had got it all. I began weekly chemotherapy as a precautionary measure on April 5th. 

The morning of April 5th, I awoke by 6am, but not because of the long-awaited (and dreaded) two-hour ride down to Philly that would be followed by my first chemotherapy infusion. The morning of April 5th was the middle-school performance of “Heal the World.” And I couldn’t miss it for anything. I wouldn’t miss it for anything. Two hours later, I walked up to the microphone and introduced the performance during an all-school morning meeting. Less than twelve hours later, my port had been placed, and I was receiving my first chemotherapy infusion as an inpatient on the oncology floor at CHOP. 

By the next week, I had returned to school and participated in activities as usual: completing homework and assessments, having lunch with my friends, and going to classes. By the fourth round of chemotherapy, I developed back pain, unlike anything I had ever experienced before. Immediately prior to what would have been my infusion on April 26th, my physicians ordered a renal ultrasound. “Large amount of abnormal soft tissue within the pelvis causing mass effect worrisome for malignancy.” They had discovered a larger tumor growing in my abdomen. The same day, I received my fourth and final cancer diagnosis of metastatic non-HPV cervical cancer. I was hospitalized and would begin radiation immediately, once a day, every weekday, for about a month. About halfway into my radiation regimen, I was discharged with instructions to continue going to radiation until the end of May. I had hopes of finishing in time to go on the annual 8th grade trip to Washington, DC at the beginning of June. 

On June 6th, I returned to the hospital: I was underweight (83 lbs), nauseated, and in pain. Another scan was performed. “…Overall picture favors progressing metastatic disease.” My cancer had returned. This time, in my lungs and liver. 

I was again hospitalized and given two options: gemcitabine (chemotherapy) or nivolumab (immunotherapy). Choosing between one or the other would, likely, ultimately decide my fate: Immunotherapy would take a while to work, and if it didn’t work, we wouldn’t know it for a while. Chemotherapy hadn’t worked for me before, and if that didn’t work, I would have to wait to start immunotherapy because my immune system would need time to recover from chemo. We had to make a decision quickly. 

The next morning, I began my immunotherapy infusion. Over the course of two weeks, I began to experience occasional fevers. Then, I had fevers every day. Shortly after my second infusion, my right lung collapsed. I was put on oxygen and awaited a procedure under general anesthesia, one that would remove over a liter of fluid from my pleural cavity. 

It seemed to me, up until about three weeks after beginning immunotherapy, that we had made the wrong choice.

On August 8th, 2017, after my third dose of immunotherapy, and, almost a year after my symptoms had begun, my physicians ordered repeat scans. 

“Significant response to therapy and decreased size of multiple pulmonary and hepatic metastases…Immunotherapy was working, and it was working well. All of my lesions were much smaller, and no new ones had been found. I was getting better for the first time in a year.

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Today, I received my 75th immunotherapy infusion. With my final dose tentatively scheduled for this summer, my physicians and I expect a full recovery.

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Being on one side of the stethoscope as a patient has provided me with a look into life on the other side. Now, as a senior in high school, I know that the career of a physician is one that I want to pursue. As a state-licensed and nationally-certified emergency medical technician, I’ve gotten a glimpse into the impact that a medical career can have on someone, the impact that it might have on me. My encounters with patients, both in the back of the ambulance as a provider and during my late-night shadowing experiences, have provided me with some of the most taxing and arduous moments of my life. But, they’ve also given me some of the most rewarding ones. 

With utmost confidence, I can state that cancer has not, does not, and never will define me. But, it would be inaccurate for me to say that my life has not been impacted by my cancer experience. And in some small and perhaps peculiar way, I’ll be grateful for the experiences, memories, and perspectives I’ve developed on the journey that shaped me into the person I am today. 

In honor of Cervical Cancer Awareness Month, I encourage everyone to be their own advocate. Get screened and tested regularly. Find it early. Treat it early. Address it early.