Stepping Out of the Shadow of Cancer

This August, my kids and I were among the millions of people watching the solar eclipse with awe. At the apex, in that moment of relative cold and darkness, I tried to lighten the mood with a bad mom joke: “It must be hard for the sun to feel so powerless today, huh?”

But rather than laugh or roll his eyes, my 10-year-old son replied with innocent wisdom.

“Don’t worry, Mom,” he said. “It will pass. All shadows do.”

He’s right. One thing I’ve learned from working with families facing childhood and adolescent cancer is that the shadow of cancer – that loss of control, that fear, that stress – does eventually lift. In fact, the history of human experience includes a myriad of examples of overcoming adversity. Think of the wars, natural disasters and other serious illnesses humans constantly encounter. In general, we recover, and ultimately learn from the experiences.

How do we do it? The answer is “resilience” and it is what I study. Allow me to share some of what I have learned through my conversations with patients and families. Read full post »

Childhood Cancer “Awareness”

Dr. Abby Rosenberg, medical leader of Seattle Children's Adolescent and Young Adult Cancer Program

Dr. Abby Rosenberg, medical leader of Seattle Children’s Adolescent and Young Adult Cancer Program

Sometimes I hesitate to tell people what I do for a living. This isn’t because I don’t love what I do (I do), but because the idea of kids with cancer seems to make people uncomfortable. Perhaps this is because they think of their own children and feel that urgent need to protect them, coupled with sudden gratitude that their own kids are healthy. Perhaps they think of the heartstring-pulling commercials featuring cute, bald children. Or, maybe they think of melodramatic movies where the patients with cancer always die. Perhaps they relive their own experiences involving older adults, friends or family members who suffered from cancer.

Regardless of their reasoning, the expectation seems to be that pediatric cancer must be sad. And sometimes, it is. But there’s also a lot of hope. So, in honor of Childhood Cancer Awareness Month, I thought I would take this opportunity to share what I think of kids with cancer below. Read full post »

Electricity, Dishwashers and What Really Matters

Dr. Abby Rosenberg, medical leader of Seattle Children's Adolescent and Young Adult (AYA) Cancer Program

Dr. Abby Rosenberg, medical leader of Seattle Children’s Adolescent and Young Adult (AYA) Cancer Program

This past week, my 10-year-old son was assigned a science experiment to conduct at home: exist for a full hour without electricity. During our family’s allotted hour, some things became incredibly difficult (imagine hand-washing dinner dishes in darkness). But the rest became wonderfully easy. With no way to do routine activities involving smartphones, TVs, computers, or other electronics, we just sat, talked and played board games by candlelight.

My son’s conclusion from this assignment? Without electricity, life is richer. He commented that he appreciated this opportunity to just be present and be together. “It’s different,” he explained. “In a weird way, electricity takes us away from each other. When you remove the electricity, you spend more time doing what’s important to you – what matters. You realize how lucky you are to have each other…and to have electricity the rest of the time.”

This was when my son’s simple assignment suddenly reminded me of what I see in and strive to teach our patients and families everyday. Read full post »

Clinical Research: What Would You Do if it Were Your Child?

Dr. Abby Rosenberg is the medical leader of Seattle Children's Adolescent and Young Adult (AYA) Cancer Program

Dr. Abby Rosenberg is the medical leader of Seattle Children’s Adolescent and Young Adult (AYA) Cancer Program

After a child has been diagnosed with cancer, one of the first conversations we have with families is about clinical research. In fact, almost all children with cancer have the opportunity to participate in research, and many parents are asked to make decisions about enrollment early in their child’s cancer experience. The question we as researchers have to ask ourselves: Is this unfair? Parents are already struggling with the nearly impossible tasks of accepting their child’s cancer, assimilating huge amounts of new (perhaps confusing) medical information, and uprooting their lives to meet the demands of illness. Can they also make educated decisions about enrolling their child in clinical research?

Many ask, “What would you do if it were your child?” The question is not surprising; parents often make cancer-treatment decisions by “trusting staff.”1 Unfortunately, the answer is often, “I don’t know.” And that answer is true.

We don’t know how it feels to walk in your shoes, with your family’s values, perspectives and relationships. We also come from a different perspective, one where research is embedded in our training and guides almost all of our medical decision-making. We believe in research, but we don’t want to bias you with that belief. (As an aside, I’m pretty sure that all of my training and perspective would be forgotten if it were my own child, and I would ask the very same question of my medical providers. Like you, my single goal would be to do the right thing for my child.)

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Remembering Daniel and the Legacy He Left Behind

Daniel Mar

Daniel Mar

In my last post about “The Fault in Our Stars,” I made a comment about how most patients live, if not thrive after their cancers. I am deeply grateful for the readers who correctly commented that some patients also die.

There are no words to express how tragic, painful, or unjust, the death of a young person from cancer can be. I particularly appreciated these comments because they came a day after the death of one of my own, and very beloved, patients. I wrote this memoir the day he died. With his parents’ permission, I am sharing a few pieces of his story, his legacy, with you.

Remembering Daniel

Daniel Mar died early this morning at the age of 20. He was one of my first patients as an independent oncologist. For that alone, I could say he will not be forgotten. Daniel was a “patient” simply because he happened to have cancer; terrible cancer that ultimately took his life. But beyond that, he was so much more. He was an advocate. A son. A brother. A devoted friend. To me, he was my muse. My teacher. And, through it all, my friend.

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The Fault in “The Fault in Our Stars”

I loved “The Fault in Our Stars.” Both the book and the movie. I read the book a few years ago during a flight. I cried so hard that I’m sure the other passengers were alarmed, if not downright uncomfortable sitting near me. This summer, I saw the movie with a girlfriend. Same thing – I went through a whole pack of tissues and left red-faced, swollen and physically dehydrated.

As we walked out of the theater, my girlfriend (also a pediatrician) turned to me and said skeptically, “I don’t get it, Abby. Why are you so emotional? Isn’t this what you DO for a living?”

The answer is yes. Taking care of teens and young adults with cancer is what I do. And, perhaps, that is why this book/movie hit me so hard. For one thing, we oncologists are often so busy thinking about chemotherapy and side effects, we don’t see the other side of cancer. We get to know our patients and families, but we see them in the contrived settings of clinic and the hospital – not at home, amongst their friends or on a trip to Amsterdam. We aren’t always privy to their witty internal monologues or their poignant observations about the injustices of life, the things that really matter to them, or the life lessons they’ve learned during their arduous journey with cancer.

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New AYA Cancer Leader Helps Teens and Young Adults Balance Life with Cancer

Dr. Abby Rosenberg recently assumed a leadership role in the Adolescent and Young Adult (AYA) Cancer Program at Seattle Children’s Hospital. She is also a researcher in Seattle Children’s Research Institute’s Center for Clinical and Translational Research. Dr. Rosenberg happens to love to write, so she’ll be contributing to On the Pulse from time to time. Below, she talks about her own experiences as a teen, and what it’s like for teens with cancer to balance those struggles while battling a serious illness.

Dr. Abby Rosenberg is the new medical leader of Seattle Children's Adolescent and Young Adult (AYA) Cancer Program

Dr. Abby Rosenberg is the new medical leader of Seattle Children’s Adolescent and Young Adult (AYA) Cancer Program

It is with excitement and some nervousness that I begin my role as the new medical leader of our Adolescent and Young Adult (AYA) Cancer Program at Seattle Children’s Hospital. Why am I nervous? I love working with teens and young adults. But, I also remember my own adolescence and young adulthood. It wasn’t easy. I was socially awkward. Painfully insecure. A little bit lonely. I was a good student, a decent soccer player, and (unfortunately) an inconsistent friend. I wanted desperately to fit in, but never quite did. I believed that each boyfriend was “the one”…until suddenly he wasn’t. I fought with my mother constantly; I wanted her to be my friend and never would have admitted that I really needed her to be my mom. I couldn’t wait to move out, to be independent, to prove to the world that I was somebody.

Adolescence and young adulthood is a period of life that is supposed to be characterized by struggle. Maybe that sounds melodramatic, but I think it’s true. It is the time when we develop our self-identities. Our independence. We navigate peer relationships. Romantic relationships. Family and community roles. We begin to set our educational, vocational, and other life goals. We take on real responsibilities. Put bluntly, we grow up.

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