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What It’s Like to Transition to Work After Cancer Treatment

By Katie DeMasi

Four days before I was supposed to start my job as a registered nurse in New York City, I received a surprising Hodgkin lymphoma diagnosis. One of the first and most difficult decisions that I had to make was to hold off on working while I went through chemotherapy. I had just graduated from college three months prior, studied all summer to pass my nursing board exam, and had a job lined up – and I felt like I was throwing it all away. I felt like cancer had taken away so much from me.

In April 2017, when my doctor told me I was cancer-free, I immediately thought about how my life was about to begin again. (Well, actually, the first thing I thought about was when could I eat a hot dog, which ended up being right after we left the hospital that day.) But after even more thought and a discussion with my doctor, I decided again to put off work. I had just gone through the hardest eight months of my life, and I felt that I deserved to enjoy my summer before going back to work.

And I did! I spent a lot of time with friends and family, I enjoyed myself at the Jersey Shore, I indulged in foods that I couldn’t eat throughout chemo, and I got to travel to Italy. It was a summer I needed. After so much worrying and anxiety during treatment, I could finally just chill out.

As summer ended and my tan began to fade, I got ready to start my job as a nurse. I was both nervous and excited. My life was about to change. I was finally doing what I wanted to do.

Aside from the transition from total beach bum to full-time employee, I had to adjust in other ways, as well.

I’m in a “New Graduate” program at work, so when I first started and my co-workers asked where and when I graduated, I would reply that I graduated in May of 2016 – a whole year earlier. Some people weren’t fazed by my answer, while some asked me what I did for the year in between. That’s when I got tongue-tied and felt self-conscious. The long, complicated answer would be, “I had cancer.” But the short answer I chose was that I took a year off. I don’t know why. I think it all comes back to me not wanting people to feel bad for me. Honestly, I don’t think anyone would; it’s just so hard for me to tell strangers my story…which is weird considering I openly blogged about it for a whole year.

There were moments in the beginning of the job when I was so angry that I had missed a year of nursing because I had to go through treatment. I kept thinking about how if none of that had ever happened, I’d be one year into my career and wouldn’t have to make up excuses about my hair or why I took a year off. I let myself feel bad for myself. I let myself think about the “what ifs.” But that didn’t help anything.

I finally put myself in front of a mirror for a little pep talk. Yes, if I had started working last year, I’d be over the jitters that come with being a new nurse. I’d be more settled into my life, and maybe wouldn’t be as stressed out all the time. But I also wouldn’t be the person I am now.

Katie DeMasi Scrubs

Over the past year, I learned what it was like to be a patient. I learned how much nurses can impact your day. I learned how to be positive and strong. Even though I wish I didn’t have to know what it felt like to be in a hospital bed, I’m glad that I do. I can’t always relate to everything my patients are going through health-wise, but I can relate to them emotionally. When they’re frustrated, I don’t just hand out an empty, “I understand;” I really mean it. When they’re happy or get good news, I celebrate with them, because I know what that feels like.

It is a blessing and a curse that I had to go through what I did. I sometimes feel like cancer took away a year of my life, stripped me of what I was supposed to be and who I was supposed to become. It made starting my career harder because I was nervous that I would forget how to be a nurse. And sure, maybe I forgot some names of drugs or proper techniques, but I never forgot how to actually be a nurse. That comes from within, not from a textbook.

I remind myself every day that I am better because of what I went through. This is who I am supposed to be, and I’m still waiting for what’s to come. I know it’s going to be something great.

Katie DeMasi was diagnosed with Hodgkin lymphoma at age 22 and treated by Dr. Lisa Roth, head of the Weill Cornell Medicine and NewYork-Presbyterian Hospital Adolescent and Young Adult (AYA) Lymphoma Program. Katie chronicled her cancer experience on her blog, Tuesdays with Katie, and shares how her diagnosis has impacted her outlook on life as a guest writer for the Lymphoma Program blog.

 

Lymphoma Program Hosts Oncologists from Brazil for Hematologic Malignancies Update

A group of more than 20 Brazilian oncologists traveled to Weill Cornell Medicine and NewYork-Presbyterian Hospital from South America to attend the 2017 Update in Hematologic Malignancies, a two-day interactive educational symposium organized and presented by members of the Weill Cornell Lymphoma Program’s research and clinical faculty. BrazilianHeme

The meeting, directed by Dr. Sarah Rutherford, featured didactic lectures on chronic lymphocytic leukemia (CLL) and Richter’s Transformation (RT) by Drs. John Allan and Richard Furman, discussions of controversies and challenging cases in mantle cell, follicular and diffuse large B-cell lymphomas (MCL, FL, DLBCL) led by Drs. Rutherford and Peter Martin, a lymphoma-specific hematopathology update from Dr. Amy Chadburn, and a tour of Dr. Leandro Cerchietti’s research laboratory.

Programs like this one foster partnerships that can propel us toward our goal of improving health outcomes for the nearly 100,000 people around the world who are affected by lymphoma. Our team is able to establish collaborative international relationships to teach and learn from medical practitioners of a diverse background, all while solidifying our role as a trusted, global authority on lymphoma research and care.

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Dr. Sarah Rutherford

“The relationship we have established with the Brazilian oncologists is fulfilling for all of us,” says Dr. Rutherford. “We enjoy teaching them and helping to manage complex cases that they face in Brazil. We also remain in touch with them after the conference – providing guidance on patients and even traveling to Brazil to participate in meetings. We look forward to continuing this collaboration given our shared mission of providing the best possible care for patients with lymphoma.”

Re-Thinking Epigenetic Therapies for B-Cell Lymphoma

Histone deacetylase inhibitors (HDACi) are small molecules that alter the function of histones, or proteins that bind to DNA and help to determine chromosome shape and gene activity. In cancer treatment, HDACi are traditionally considered epigenetic drugs because of their capacity to modify gene expression to halt tumor cell division, but new research from the Cerchietti Research Laboratory at Weill Cornell Medicine poses rationale for studying the inhibitors’ biological effects through a different lens – their impact on cell metabolism.

Benet Pera, Ph.D., along with Weill Cornell colleagues, as well as researchers from the Helmholtz Institute of Computational Biology in Germany and the Lady Davis Institute for Medical Research in Canada, conducted the study to improve the efficacy of HDACi in people with B-cell lymphoma, which is relatively low compared to that in T-cell lymphoma. Several HDACi, including vorinostat and romidepsin, have been approved by the United States Food and Drug Administration (FDA) for treatment of certain T-cell lymphoma subtypes.

Contrary to their namesake, histone deacetylase inhibitors are able to affect a long list of non-histone proteins, among them metabolic enzymes. These agents can be more appropriately referred to as lysine deacetylase inhibitors (KDACi). Due to the activity of KDACi in proteins involved in metabolic pathways, Pera et al. investigated the effects of the KDACi panobinostat in the cell metabolism of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients enrolled in a phase II trial. Metabolic profiling of the patients’ plasma before and after KDACi-treatment demonstrated that panobinostat prompts DLBCL cells to rely on a certain metabolic pathway, the choline pathway, for survival. The scientists found that in the lab, treating the cancer cells with a choline pathway inhibitor in combination with panobinostat produced superior anti-lymphoma effects in vitro and in animal models.

benet-pera“We are studying these so-called ‘epigenetic’ drugs from a different angle, hoping that metabolomics might hold the key to improving their clinical efficacy,” says Dr. Pera.

The research data recently published in the open-access journal EBioMedicine help to substantiate the team’s innovative re-application of epigenetic reagents, demonstrating the value and promise of the metabolic mechanisms by which KDACi/HDACi can improve current therapeutic options for people with B-cell lymphoma. The results also highlight the need to explore the unknown biological effects of this class of drugs before they can be successfully implemented in a clinical setting.