Adolescents and young adults with cancer

20 to 24 years

25 to 39 years

[Music playing]

Marell’s voice: I found out by accident. I thought I had a bug, the same bug that my mom and sister caught on vacation visiting family back in Syria. We went every year because all of the people I love lived there. I was born in Canada, but Syria is my home.

Sitting on the hospital bed waiting for results of my bone marrow biopsy, I thought that all I needed were some antibiotics and I would be on my way to my internship, my last year of undergrad, and on to travelling the world beyond the walls of the hospital or school that I had known for the past 5 years.

At 19 I traded two years of my life for chemotherapy, prescriptions, social anxiety, and depression, packaged in a 90% cure rate protocol, but that was behind me.

Suddenly, my phone screen flashed. I opened my email. "Patient has relapsed, with over 90% blasts."

I hit the big red buzzer, and moments later, my nurse walked in. I asked her to look at my phone and she shuddered. My doctors were already on their way. The cancer was back.

I'm immediately moved to my treatment hospital and I start signing papers. My oncologist told me I needed target therapy and a bone marrow transplant. It would start tomorrow. What about my fertility, I asked. A long pause.

I found out about the potential effects of cancer treatment on my fertility by accident. A survivor had told me. Halfway through my first treatment, she asked, “Have you preserved your eggs?” I said, “No. I was never given that option”. My oncologist responded, “With leukemia, we usually start treatment right away, but it's completely up to you”.

My inpatient doctor sat down with me and drew out the entire treatment plan on a whiteboard. He suggested that if I wanted to freeze my eggs, I would have to do it now. The bone marrow transplant would leave me infertile.

My heart was broken. I had never cried so hard or mourned so deeply after he left. I always thought that I would have kids someday, three little “mes”, a boy or a girl. It didn't matter. Generations of love to carry me into old age.

The thought of kids was supposed to come later, not here, not like this. Questions flooded my mind. Is it safe? Will my eggs even be viable with my leukemia? Will the hormone injections make things worse? And then, is this a test of faith? Will God be upset with me if I preserve my eggs? Why did my cancer come back? What should I do?

I was still weeping on my bed when the inpatient doctor came into my room and sat down next to me. He said, “I think you're afraid of cancer. I came back to tell you not to be afraid. I'm an old doctor, and I have seen many cancers, and we can treat your cancer. It would be a shame not to pass down those eyes and freckles to your baby. I wanted to tell you to go do it. If things get dangerous, we'll pull you out and start treatment.”

My next 2 weeks were filled with visits to the fertility clinic, ultrasounds, and hormone injections. The day came for my retrieval, and I waited to hear how many hopes I had to hold on to. The answer? Nine. “We won't know if they're good until you try to use them.”

I've learned that not everything can be recovered. Sometimes, there's no moving on. I still sit with the fear that I may never have my own children, but I take solace in the fact that I have done what I can to give myself that chance.

Some people have children by accident. Some patients try, only to learn later that they can't. For me, family planning may not be what I imagined it would be, but at least I can still make a plan.