Finding an Outlet in the Face of Rare Cancers

I've been a medical oncologist for 10 years. Every day I think about my patients and the relationships I've developed with them and their families. Caring for people with cancer is rewarding, inspiring, and profound, but it is not without heartbreak.

Kelly Knab was a larger-than-life 26-year-old when she was diagnosed with stage IV pancreatic neuroendocrine carcinoma -- a rare cancer -- in October 2013. At diagnosis, her disease was already advanced, and had spread to her liver and bones. But thanks to modern medicine, she responded well to chemotherapy for many months. Kelly continued competitive skiing, working at Text 100, writing her blog, spending time with her family, and doing all the things that an energetic, intelligent, ambitious, soon-to-be-married twenty-something does.

Her appointments at my office at Memorial Sloan Kettering Cancer Center were known as visits from the "famous foursome": Kelly, her fiancé Matt, Matt's brother Justin, and Justin's wife Sarah. I will never get used to seeing young faces enter an oncology suite to support a friend whose tumor is incurable. The sight causes a visceral reaction every time.

Kelly's family and friends all stayed positive. We had hope. Yes, we knew that Kelly's and Matt's lives were irretrievably altered, but we kept fighting. We fought for time. None of us, however, had any idea how short that time would be.

In September 2014, I rode on a stationary bike next to Kelly. We sat together among the 300,000 people who pass through Times Square daily. We were participating in Cycle for Survival's Times Square Takeover -- an annual event that celebrates the opening of registration for the indoor events that raise millions of dollars for rare cancer research every year, including my research studying Kelly's disease. We rode to tell the world about the need to support rare cancer research.

Times Square -- with its iconic, oversized billboards, bustling energy, and glittering lights -- screams intensity, but in a we-own-this-night kind of way. The music was pumping; Equinox instructors were leading us through the synchronized routine; and Kelly was a vision on the bike. It's a moment we all wanted to hold on to, and a memory I think of often. Kelly wrote on her blog, "It feels so good to be a part of [the Cycle for Survival] community. Cycle for Survival is a reminder that everyone has a story; everyone is affected by cancer in some way. I am not alone in this battle."

Two days before our Cycle for Survival ride in Times Square, Kelly's radiology films showed that the tumor had grown dramatically, and her liver was affected by the growth. We needed to act, and act fast. Kelly received strong intravenous chemotherapy. Her determination to ride with us was unwavering -- 48-hours later, with chemo circulating, Kelly mounted her bike with a vengeance. She was awesome and beautiful and smiling every minute. Three months later, she was gone.

In September 2015, I returned to Cycle for Survival's annual Times Square Takeover to ride. Kelly's parents, Dick and Sheryl, and her colleagues, cousins, and friends rode, too. The "famous foursome" was there as well: three on their bikes and one in spirit.

As an oncologist, I share a journey with my patients that is immensely rewarding and an enormous privilege, but it can also hurt. When I lose a patient, I channel that pain into my research. Cycle for Survival has become an incredible force for supporting critical research. It's empowering for me, and for many coping with the many emotions of cancer. The national movement, owned and operated by Memorial Sloan Kettering, funds rare cancers studies with every dollar raised going to research and clinical trials. I don't want anyone to face cancer without a treatment option, and the funding gets us closer to making that a reality.

Being part of the Cycle for Survival community gives me renewed energy and determination. Patients, their families, and healthcare providers all need an outlet when facing the devastation caused by cancer. It's so important for everyone who lives through cancer to know that we are not alone. Cycle for Survival moves and inspires me. We are driving research forward for Kelly and for everyone gone too soon. We are in this battle together.

Diane Reidy-Lagunes is a board-certified medical oncologist in the Division of Gastrointestinal Oncology in the Department of Medicine and Co-Director of the Department of Medicine's Hematology-Oncology Fellowship Program at Memorial Sloan Kettering Cancer Center.

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