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Acute Myeloid Leukemia (AML) Stories: Mackenzie Navigates with Faith, Joy, and Family

Acute Myeloid Leukemia (AML) Stories: Mackenzie Navigates with Faith, Joy, and Family

Mackenzie P.

Her first symptoms of acute myeloid leukemia (AML) hit Mackenzie in 2023, a medical student, when she experienced excessive bleeding while shaving and noticed an increase in fatigue when working out. Then during a clinical rotation, she suddenly vomited and then passed out. When Mackenzie finally got her diagnosis, she found herself more concerned about how her family members were taking the news.

There was a significant shift in Mackenzie’s diagnosis with the discovery of a biomarker. This provided her and her medical team information about risk levels of things like relapse. Her treatment experience began with induction chemotherapy, leading to remission, followed by two rounds of consolidation chemotherapy as she awaited a stem cell transplant.

While the transplant proved successful, Mackenzie’s leukemia relapsed on a molecular level six months post-transplant. She underwent more chemotherapy, but the treatment was unsuccessful, leading to a full relapse. She faced severe complications during her hospitalization, including pneumonia. Her faith, however, provided a glimmer of hope. After an unsuccessful initial clinical trial, she embarked on a new trial at MD Anderson, holding onto her optimism.

Watch her story and read more below to hear from Mackenzie on many topics:

  1. The importance of clinical trials and how they offer hope to patients, including herself.
  2. How she held onto her optimism even during the most difficult times.
  3. What she found solace in as she learned how to navigate losing her sense of self.
  4. Her top takeaway for others.

  • Name: 
    • Mackenzie P.
  • Age at Diagnosis:
    • 23
  • Diagnosis:
    • Acute Myeloid Leukemia (AML)
  • Symptoms:
    • Shortness of breath
    • Passing out
    • Getting sick easily
    • Bleeding and bruising quickly
  • Treatments:
    • Chemotherapy: induction and maintenance chemotherapy
    • Stem cell transplant
    • Clinical trials

Kura Oncology

Thank you to Kura Oncology for supporting our patient education program. The Patient Story retains full editorial control over all content.

This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.



Interviewed by: Taylor Scheib
Edited by: Chris Sanchez

Every day, find something to be grateful for. Something that you love. Something that makes you happy, smile, or feel light.

Live for it, no matter what it is.

Introduction

My name is Mackenzie. I’m a medical student.

I was diagnosed with acute myeloid leukemia (AML) in 2023.

Before My Diagnosis

The first time I said, “This is weird, it’s time to get it checked out,” was on the first day of my second year of medical school. I was on a clinical rotation and we were in a patient’s room, but we weren’t performing any procedures. I threw up and passed out. It was quite random and embarrassing. I called my doctor to get blood work done. 

Before that point, though, I had also been experiencing a few suspicious symptoms that I had been pushing to the side. When I shaved, my legs would bleed a little more than they usually did. I realized that it couldn’t have been anything else, like a razor that wasn’t sharp enough.

Additionally, I was an athlete in college and had been finding it harder to work out than I normally did. The passing out was the final straw.

I had been waiting all this time to figure out what was wrong and then to have it confirmed as cancer… it turned my world upside down.

I knew everything was going to change at that point. 

My Diagnosis & Reaction

Because my family is in healthcare, my story might be somewhat different from other cancer patients’ stories. My dad is president of the hospital in my hometown where I got my biopsy, and my stepmom works there, too. Because of that, they got my results through MyChart, which I didn’t have then. Instead of getting a phone call and being told, “Hey, you need to come to the office right away,” I found out that I had cancer through them.

It was a normal Thursday in August 2023. I was back home from a simulation lab and was typing up the History and Physical form for the patient I had seen earlier that day. I heard a knock on the door, and my mom, dad, and stepmom walked in. I knew right away that it wasn’t good news.  

My dad was trying to talk, but he was crying. My stepmom looked at me and said, “It’s leukemia.” Part of me had known it all along, so I was almost prepared for it. But I wasn’t sad — I was mad. I had been waiting all this time to figure out what was wrong and then to have it confirmed as cancer… It turned my world upside down. I knew everything was going to change at that point. 

When I received my acute myeloid leukemia diagnosis, I felt more hurt for my family and friends than for myself. In my line of work, I’ve made a few phone calls to inform other people of their diagnosis and they were very hard to do. My way of coping with this diagnosis for the longest time was trying to make sure that everyone else was okay and show how strong, brave, and optimistic I was. I believed that I was going to get through this, so I needed my friends and family to believe it, too.

Learning My AML Mutation

The doctors tested my bone marrow for different mutations and found out that I have a mutation for AML that means that I have a high risk of relapse. Patients can be at high, moderate, or low risk for relapse. Those at moderate to high risk might need to consider a stem cell transplant or might require a transplant. And I did have to undergo a transplant.

What was worrisome for me was that I had a first cousin who had acute lymphocytic leukemia (ALL) when she was little and a second cousin who had prolymphocytic leukemia (PLL) when he was in his 30s. I was worried for my sister and for my future kids. The doctors took a skin biopsy to try and determine if this mutation developed spontaneously in my leukemia cells or if it was an inherited mutation that was in my DNA. They determined that it was a spontaneous mutation that I won’t be passing down. I just got unlucky and wound up getting cancer. 

I believed that I was going to get through this, so I needed my friends and family to believe it, too.

My Treatment Plan and Remission

Right after my acute myeloid leukemia diagnosis, I started induction chemotherapy to try and get myself into remission. I also had my first long hospital stay. Thankfully, after that, I got into remission and then we waited for my first stem cell transplant. It takes a while to find a donor and coordinate the transplant, so in the interim, I had two rounds of consolidation chemotherapy, each round lasting one week, in the fall of 2023. I was in the hospital for about three weeks during that time. 

I underwent the transplant and afterward, the doctors determined my chimerism. A chimera is an organism whose cells don’t all have the same DNA. When a patient receives a bone marrow transplant, they get stem cells from a donor that contain the donor’s DNA. The patient ends up with a mix of their own and the donor’s DNA. The higher the percentage of donor chimerism in the patient, the more donor cells they have and the better their outcomes could be. I had a 100% chimerism, which means I had 100% donor cells. I was also still in remission at this point.

Relapse

However, six months after my transplant in July 2024, I had a bone marrow biopsy and it revealed that my acute myeloid leukemia had relapsed on a molecular level. The doctors had observed a change in its molecular marker. Further tests found that 0.002% of my cells lit up for leukemia.

I underwent chemotherapy again to try to put me back in remission. I got two rounds of a lower-dose chemo medicine. Neither of them worked; my leukemia kept growing. At a certain point, it got to an 8% blast in my marrow — it was no longer just a molecular relapse but a full relapse.

I was admitted to the hospital again for more induction chemotherapy, but there were complications. I ended up in the ICU with pneumonia. Then, after I got out of the ICU, I had a bone marrow biopsy, which determined that the induction chemo had been ineffective.

I can’t think about my situation too much or it’ll overwhelm me. I have to stay positive. Otherwise, I’ll wallow in hopelessness and doom.

Frustration and Faith

That entire hospital stay was quite unpleasant. I couldn’t breathe on my own. I had to wear an adult diaper. And then after all that, my biopsy results came back and showed that I wasn’t in remission. I felt like I had undergone all of that for nothing. I felt doomed and hopeless. At a certain point, I felt like I was going to die and accepted that.

But my faith gave me some hope. The doctors sent me home and by the grace of God, I got on a clinical trial, which was about four weeks long. The results from that trial were inconclusive — it worked but not all that much. I’m in a new trial at MD Anderson in Texas. I’m still optimistic and I feel that this is where I’m supposed to be and that it’ll get me back into remission.

Having hope and faith has also helped my family get through this. We’re optimistic with every opportunity that God gives us. 

I also realize that I can’t think about my situation too much or it’ll overwhelm me. I have to stay positive. Otherwise, I’ll wallow in hopelessness and doom. My family, friends, and husband matter very much to me, and I need to fight for them.

Clinical Trials and How I Feel About Them

When I got on my first clinical trial, the conversation I had centered around how the chemotherapy regimen I underwent for my acute myeloid leukemia wasn’t working any longer and that other types of chemo were too toxic for my body, especially given how tough my last hospital stay had been.

However, we had previously taken up the subject of clinical trials when I first relapsed and when the disease burden was lighter. Back then, the doctor laid out the chemo regimen and also said that clinical trials were available in case the chemo didn’t work.

A clinical trial is research that tests new ways to find, prevent, and treat cancer. Different trials include treatment, screening, prevention, and supportive care. Clinical trials are not right for everyone, but they can give patients access to the latest treatment options. Patients who join these trials may not have to pay full expenses because researchers may cover the costs, but this can vary. Patients will need to talk to their healthcare providers to understand the options they can access.

When standard treatments don’t work, doctors and patients can see if clinical trials can help. Fortunately, I joined one clinical trial and when that didn’t work, another one was available after I got discharged from my first trial.

Clinical trials make me a little nervous, like being a part of something that no one else has been a part of. But there’s a lot of science and research behind them, and they also start you depending on where you’re at in the trial. If, for instance, you come in right at the start of the trial, you begin with a small dose of the medicine, and as the trial progresses, the doses increase. That’s how they find the best dose of the drug — the effective amount that isn’t toxic or harmful.

I would urge those considering joining a trial to ask questions about it. Both the trials I joined have already been tried in other countries and are now being brought to the USA, so there’s already some data on their effects and how patients have responded to them.

Realize this is bigger than you and out of your control. All you can do is your best.

How I’ve Responded to My Treatments

So far, the more treatments I’ve gotten for my acute myeloid leukemia, the harder it’s gotten for me. I struggle to do something as simple as standing in the kitchen to cut fruit. Sometimes I need to be in a wheelchair to attend appointments or to walk long distances, like in an airport.

That’s very frustrating because I joined three varsity teams in high school, played basketball in college, and was a runner. It’s hard and humiliating, but it also opens my eyes and helps me empathize with others who are dealing with chronic illnesses and who can’t do things the way they want to. 

I try my best. I walk around when I feel good and rest when I need to. I also do chores around the house because those are exercises for me right now. Additionally, I should point out that I’ve been so blessed. My husband, friends, and family know when I need help and take on the little things that I find hard and are a burden to me now. They free me up to enjoy the things that make me happy.

From the perspective of my emotions, there are different stages. The first stage was losing a sense of myself in every aspect of my life. I was no longer a medical student, a runner, or a beautiful wife who goes out with her husband or meets up with her friends. There are lots of parts of me that I feel like I’ve lost and I’m reminded of that every time I look in the mirror. 

When I was first diagnosed, I felt like I could overcome this — it’s not beating me, I’m not going to die from this, I’m going to have a low-risk mutation, I won’t need a stem cell transplant, the chemo is going to work immediately, I’m going to go right back to school. And that’s the second stage

Realize this is bigger than you and out of your control. All you can do is your best. Take care of yourself and your body. That’s when I dove into my faith and gave it all to God. I’m very type A and usually want to have control of my situation. 

My Message of Hope

Every day, find something to be grateful for. Something that you love. Something that makes you happy, smile, or feel light. Live for it, no matter what it is. If you’re having a hard day and your mom makes you feel special, call her to brighten your day. Find something every day that gives you something to fight for.


Kura Oncology

Special thanks again to Kura Oncology for supporting our patient education program. The Patient Story retains full editorial control over all content.


Mackenzie P.
Thank you for sharing your story, Mackenzie!

Inspired by Mackenzie's story?

Share your story, too!


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Sasha T., Acute Myeloid Leukemia (AML)



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Luisa L., Acute Myeloid Leukemia (AML) with FLT3 Mutation



Symptoms: Painful hives on legs, migraines
Treatments: Chemotherapy, total body radiation, stem cell transplant
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Hayley A., Acute Monocytic Leukemia (AML-M5)



Symptoms: Severe fatigue, excessive bleeding after oral surgery
Treatments: Chemotherapy, bone marrow transplant
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Nicole T., Acute Myeloid Leukemia (AML)



Symptoms: Severe itchiness, night sweats, fatigue
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Mary Clare B., Acute Myeloid Leukemia (AML)



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Categories
Bone marrow transplant CAR T-Cell Therapy Chemotherapy Immunotherapy Multiple Myeloma Patient Stories Treatments

Krystal’s Stage 4 IgM kappa Multiple Myeloma Story

Krystal’s Stage 4 IgM kappa Multiple Myeloma Story

Krystal, a 42-year-old mother from Georgia, shares her journey after being diagnosed with Stage 4 IgM kappa multiple myeloma in June 2022. Before her diagnosis, she experienced troubling symptoms like tachycardia, shoulder pain, and shortness of breath, but initially dismissed them as effects of aging, weight gain, and other factors. A critical moment arose when she felt a severe pain in her back, leading to an urgent care visit, where she learned it might be cancer. Her 2 daughters were present during the devastating diagnosis.

Interviewed by: Taylor Scheib
Edited by: Chris Sanchez

Krystal emphasizes the importance of self-advocacy in navigating cancer treatment. Initially overwhelmed, she grew to actively participate in her care, seeking multiple opinions and eventually finding a team that communicated effectively and monitored her condition closely. She initially underwent chemotherapy and a bone marrow transplant, which provided temporary relief. However, persistent relapses led her to pursue CAR T-cell therapy, a promising avenue that has since improved her condition.

The journey has strengthened Krystal’s bond with her daughters, who have been her caretakers and constant support. She highlights the mental health challenges accompanying cancer, advocating for therapy and open communication. Despite the physical and emotional toll, she leans on her faith and resilience to maintain a hopeful outlook.

Community support plays a pivotal role in Krystal’s coping mechanism. Family, friends, colleagues, and online connections have provided essential emotional and practical support, allowing her to manage daily life and medical responsibilities. While acknowledging she is no longer the person she once was, she embraces her new reality and encourages others facing similar challenges to advocate for themselves, accept help, and stay encouraged. Her story is one of perseverance, faith, and the transformative power of love and community.


  • Name: 
    • Krystal S.
  • Diagnosis:
    • IgM kappa multiple myeloma
  • Staging:
    • Stage 4
  • Initial Symptoms:
    • Back and shoulder pain
    • Tachycardia
    • Heart palpitations
    • Shortness of breath
    • Loss of appetite
    • Fatigue
    • Malaise
  • Treatments:
    • Chemotherapy
    • Bone marrow transplant
    • CAR T-cell therapy
Johnson & Johnson - J&J

Thank you to Johnson & Johnson for their support of our patient education program! The Patient Story retains full editorial control over all content.

This interview has been edited for clarity and length. This is not medical advice. Please consult with your healthcare provider for treatment decisions.



… as hard as myeloma is, you can still come out of it and still rock it.

Introduction

Hi, my name is Krystal. I currently reside in Georgia. I am 42 years old. I was diagnosed with IgM kappa Multiple Myeloma in June 2022.

I am a mother of two beautiful young adult daughters. I am an accountant. I love light hiking, walking on trails, parks, painting, and just spending time with family when I can.

Pre-diagnosis

Before I got diagnosed with multiple myeloma, I was having tachycardia, shoulder pains, heart palpitations, shortness of breath, nausea, loss of appetite, and back pain. My resting heart rate was at 130 beats per minute, which is not normal at all. And these things were not getting better with over-the-counter medicine. 

I was also experiencing some weird pop-like sensations. After I felt the first pop, which was on the right side of my chest area, I went to the doctor and they told me that I had probably pulled a muscle. They did do a chest x ray, but that was clear. And after that, the shortness of breath progressively got worse, as well as the heart palpitations. 

I went to the doctor again in probably the second week of June 2022, and I got an EKG done. It was normal sinus. And then the next day, I felt another pop, this time on the left side of my chest area. I didn’t go to the doctor because of the diagnosis last time. 

About a week after that, I felt and heard a really loud pop in my back and fell to the ground in excruciating pain. Later on that evening, I ended up going to urgent care and they did a bunch of tests and scans. That’s when they told me that it looked like cancer. I was finally diagnosed with multiple myeloma in June 2022.

I just couldn’t put my finger on what was happening to me. I would blame it on things like my age, the fact that I had gained weight, and so on. It was just extremely frustrating because I didn’t have any answers and I couldn’t figure it out. But never in a million years would I have thought it was cancer.

Reaction to the diagnosis

When I heard that, looking back, the first word that comes to mind is devastation. We cried so hard that day. It was just unbelievable. And it really felt surreal — this can’t be happening. There is no way that I have cancer. 

My daughters were with me at that time. We were just heartbroken. I think I blanked out at that point, and I don’t really remember anything else until one of the days I was in the hospital.

There was so much I had to learn. I have extensive bone damage, including lesions literally all over my body from the skull, all the way down. So I was confused — how is it a blood cancer? You’re talking about my bones all the time. They did explain it, but there was just a lot going on. 

But the doctors really did educate me. And then I was overly consumed with trying to learn about multiple myeloma and read and do my own research.

Finding the best care

I saw a doctor while I was in the hospital, and she is still currently my oncologist. I did also see a multiple myeloma specialist, which is something that other multiple myeloma patients should also consider doing. So I had that team of doctors to support me. 

However, that team was not the best. I just feel like the communication wasn’t there, and I really feel like they dropped the ball with me. I also don’t think they were monitoring me as closely as I needed them to. 

So now I see another specialist, and this team is awesome. They are really on top of things. I’m getting blood work, bone marrow biopsies, and bone surveys, which are X-rays. 

Also, the communication is great. They have different numbers that I can call anytime and I can ask them as many questions as I want. They will call me back. I’m always going to get an answer. If they don’t know something, they’re going to figure it out. 

They’re also making sure to monitor me. Right now, it’s not as often as before, when it was as often as every day, even on weekends and holidays. 

The importance of self-advocacy

I think self-advocacy is one of the most important things that you can have when you’re dealing with cancer. In the beginning, I was so scared. I didn’t know what was going on. And so I was just going with the flow. But I’ve been in the game for a couple of years now, and so I’m asking all the questions.

You just have to speak up. I mean, let the doctors know how you feel. If you don’t want to do something, let them know and discuss it with them. And maybe there are other options. They should be talking to you about those things. 

It’s your body and it’s your life, and you deserve the best. I mean, it is so hard going through this, and you need to have a team that you feel like is for you, and who’s going to support you no matter what. 

I’ve talked to my specialist about getting the vaccines again. I’m on the fence about that. And she said, that’s okay. If you don’t want to, you don’t have to. She explained to me, it’s about exposure and you might have to do some lifestyle changes, but if you don’t want to, you don’t have to. And I love that.

Definitely speak up. I know, sometimes it can be intimidating, but you just have to. You’ll get used to it.

I keep going and fighting because I love life and I want to be here. 

Treatment plan for IgM kappa multiple myeloma

Chemotherapy

I first started intravenous chemotherapy in August 2022. Initially, I would have to go twice a week for that IV chemo, and each session took about 4 hours or so. I wasn’t doing well in the beginning, so I did pills as well, daily for 21 days and then off for a week. 

I didn’t feel really bad. I mean, I was sleepy because I had pre meds. And then after the second treatment, I was starting to feel better. And so then after that, I just got better and better.

However, I ended up relapsing at least 2 or 3 times. And usually when I relapse, I know something’s going on. My body just feels prickly and I get a little achy. And the fatigue gets a lot worse. That’s how I know — oh, something’s happening.

Bone marrow transplant

I had my bone marrow transplant on February 28th, 2023. I would say that the procedure itself is simple; everything before the transplant, as well as the recovery, is all the work. 

So beforehand, I got a large dose of chemo and that made me really fatigued. I also experienced nausea, mild vomiting, and diarrhea. And then I got my transplant, which took just 10 minutes and I felt fine immediately afterwards.

After the procedure, you just build up strength. You go through a basement period where you really, really feel bad, where your immune system plummets down to nothing. And then it ramps up. 

It took me about 2 weeks before I felt better. And then that’s how long you’re usually in the hospital, or at least it was for me. 

But after my bone marrow transplant, I quickly relapsed. The bone marrow transplant ended up lasting me maybe 2 or 3 months at the most. And the old specialist that I had didn’t have a plan, and so my oncologist was trying to figure out what to do next. That’s where I feel they dropped the ball. The myeloma had gotten out of control, and then finally I started another chemo regimen. 

And that is when I started seeing the new specialist, and she told me, since the bone marrow transplant did not work for you, you need to do CAR T if you relapse again. And so we had a plan. So when I was in the hospital for that month, it was so I would stabilize in order to get CAR T.

CAR T-cell therapy

Just like with a bone marrow transplant, there’s a lot of stuff that you have to do prior to getting CAR T. There are so many appointments and so many tests. And then finally you get to the CAR T procedure itself.

I had my CAR T procedure on September 3, 2024. It took me maybe only 15 minutes. As an aside, it tasted and smelled like tomatoes to me, and they say it can taste like tomatoes or creamed corn for some people.

After CAR T, my body would feel sore, but other than that I would be feeling fine.

I’m done now with CAR T and I’m feeling good.

 It’s not my time to go yet. I am too young.

So I have to fight and get through it. 

Her motivation

I keep going and fighting because I love life and I want to be here. 

I have 2 beautiful daughters that I want to be here with. It’s not my time to go yet. I am too young. So I have to fight and get through it.

People probably wouldn’t believe me if I were I tell them all the things that have happened. But yeah, I’ve gone through them. I’m a resilient person, and I’m truly blessed. And I’m thankful that I’m here and I’m going to keep fighting.

My daughters are amazing. They have taken care of me throughout this whole time. They literally stopped their lives to take care of me, and I just appreciate them so much. We’ve gotten a lot closer, and we were already close. But, you know, this brings a better bond. Because they are with me every step of the way. And they’re my cheerleaders. 

My girls have gone through a lot. It’s [a parent’s IgM kappa Multiple Myeloma diagnosis] mentally draining on them as well. But they handle it well. They rely and lean on each other a lot. We definitely keep the communication going. I’ve had them in therapy. We just keep praying and just try to keep positive.

Her mindset

I haven’t been diagnosed with multiple myeloma that long, I’m going on 3 years. Having relapses as often as I have had is tough, but I have to keep going. 

Mental health, I think, is a huge factor. I don’t think it gets discussed enough. I think anybody that has a cancer diagnosis, and maybe their family too, would need to speak with somebody. I will be honest. I haven’t talked to a therapist as much as I would like to, but I have seen one, and it absolutely helps. 

I also try not to stay in a negative mindset. I mean, I allow myself to feel all the feelings. They are valid. I’m frustrated, angry, sad, and I do get depressed sometimes. Though I allow myself to be in those feelings, I try not to stay there that long. You have to come up out of it and just get through it. And, really, it’s a day by day thing.

I’m never going to be the same person I was before all this happened. Not ever again.

But it’s okay. 

Creating community

Community is so important. You need to have a support system, or you would just be a mess.

I have lots of support from my daughters, my mother, my friends, my family, my coworkers. Without that support system, I don’t know how I would have survived.

People want to help, and there are a lot of good people out there in the world. The little things count so much and are so helpful. I’ve had people bring us groceries or just bring us a meal, come down to visit and clean the house or whatever. That is super helpful.

Coworkers have given me leave donations, and that has been such a blessing, to be able to still pay the bills even though I’ve been in and out of work.

I’ve done online chats and connected with people on Tiktok. That helps. Because just meeting people living with the same thing as you is just really heartening. It really has been almost therapeutic. Because it felt like I found my people.

Her life right now

I’m never going to be the same person I was before all this happened. Not ever again. But it’s okay. 

It is hard. You know, you think back sometimes — oh, man, I used to be able to do this or that, or, I used to be so lively — that’s no longer the case. It’s hard and it’s definitely challenging. It takes time to get used to. 

But I feel like you’ll be fine once you get to that point where you realize and accept that you’re no longer that person you used to be, but you’re just a different version of that person. I’m still the old Krystal, but I’ve just had to tweak some things. 

It did take me a while, though, you know? And even now, I’m kind of hard on myself, so just giving myself grace, learning how to do that.

My biggest piece of advice is to stay encouraged.

What Krystal wants to share

I always feel like multiple myeloma has taken literally everything from me. 

It’s taken my vision. At one point, I couldn’t walk. I was using a wheelchair. I was in excruciating pain. I’ve had strokes. I’ve had everything. But I’ve come out of it like nothing ever happened. 

Hope is a good word. Yes, I hope for the best. And I think I go more towards faith. My faith has gotten stronger during all of this. And that is really what I hold on to.

My biggest piece of advice is to stay encouraged. It is going to be so rough at times. You’re going to feel waves of emotions. It will be like a rollercoaster. But just stay encouraged. Speak up and ask all the questions. Be your own advocate. Accept help. You’re going to need that support from others, and you will be surprised at how many people really want to help you and will support you throughout all of this. 

So as hard as IgM kappa multiple myeloma is, you can still come out of it and still rock it.

Johnson & Johnson - J&J

Special thanks again to Johnson & Johnson for their support of our patient education program! The Patient Story retains full editorial control over all content.


Thank you for sharing your story, Krystal!

Inspired by Krystal's story?

Share your story, too!


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Tim H., Multiple Myeloma



Initial Symptoms: None that could be identified; cancer found through CT scan for gallbladder removal

Treatment: Chemotherapy, stem cell transplant
Scott

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Symptoms: Pain in hips and ribs, night sweats, weight loss, nausea

Treatment: Clinical trial, chemo, kyphoplasty, stem cell transplant
Jude

Jude A., Multiple Myeloma, Stage 3



Symptoms: Pain in back, hips and ribs; difficulty walking

Treatment: Bilateral femoral osteotomy, reversal due to infection; chemotherapy

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Biomarker Testing

Biomarker Testing

You may have heard your care team mention the possibility of biomarker testing when trying to develop a plan of action for diagnosis or a potential diagnosis of cancer. While biomarker testing has been around since the 1950s, it’s not a term you come across often if you aren’t in the medical field. 

Biomarker testing is an effective tool for doctors to help identify targeted therapies for driver mutations or issues with the immune system for cancer patients. 

In this article, we will help you better understand what biomarker testing is and answer any questions that you may have about biomarker testing. This way you can make an informed decision about what is best for you and your body. 

What is Biomarker Testing?

Biomarker testing, also known as molecular or genomic testing, is the use of a laboratory test to measure biomarkers found in your bodily fluids or tissue. A biomarker is a biological molecule found in any bodily fluid that may indicate a sign of abnormality as in a disease or a condition. 

Doctors are able to use the tissue of a tumor to test for abnormalities in its DNA and levels of specific proteins in the tumor in order to identify what is causing the tumor to grow. In turn, they can then apply targeted therapy that will help remove the cancerous cells without damaging healthy cells. 

Why is Biomarker Testing Useful for Cancer Patients?

Biomarker testing is a great tool for cancer patients because it allows your care team to diagnose the type of cancer. This in turn can help your doctor determine the best treatment plan.

According to the National Cancer Institute (NCI), biomarker testing can also be used to identify genes the may lead to cancer or see how your treatment plan is progressing. 

“It’s helped us on three different occasions not only with diagnosis, but on each time that he had progression of his cancer, the liquid biopsy was able to say, here’s the mutation, here’s the new mutation, and here’s the direction the clear plot path that you need to take for survival.”

Read more about Rhonda’s success with Biomarkers

When Should I Consider Biomarker Testing?

The National Institutes of Health recommends biomarker testing for all patients with non-small cell lung cancer. Biomarker testing can also be useful for several other types of cancer including melanoma and breast cancer.

Three key times you should consider asking your doctor about biomarker testing are:

  • When your doctor suspects cancer and you are getting a biopsy done.
  • If you have been diagnosed with cancer but did not get biomarker testing done.
  • If lung cancer reoccurs after treatment

Essentially, if you are diagnosed with lung cancer you should discuss the potential for biomarker testing with your doctor.

“I wish I had actually asked for the full biomarker testing to see what their report was and ask questions about it. Cancer runs in my family, but I had done genetic testing. I didn’t understand this was different testing.”

Read More about Terri’s lung cancer story

Which Types of Biomarker Testing Should I Be Asking For?

There are two types of biomarker testing that should be done if you’ve been diagnosed with or your doctor suspects lung cancer:

  • Driver Mutations – an error in a gene’s DNA
  • Expression of PD-L1 – an immunotherapy biomarker

Let’s dive further into the two types of biomarker testing to understand what they indicate and how they impact your treatment plan.

Driver Mutations

In order to understand driver mutations, it’s important to understand the basics of how genes and DNA work. 

DNA makes up genes. When everything is working normally each gene has its proper DNA code which then results in the production of proteins. 

mutation occurs when a gene has an error in its DNA. Mutations are normal and happen often. A single mutation likely won’t cause cancer; however, the accumulation of multiple mutations over time is what typically results in cancer. 

Mutations are often sorted into two general categories:

  • Somatic (acquired) – The mutation is limited to just the tumor and is not passed to offspring.
  • Germline (inherited) – The mutation is present in all cells of the body and can be passed to offspring. 

There are several different types of driver mutations that can result in cancer. Some of the most common ones include:

  • Activating Mutation – The protein is always active.
  • Fusion – The fusion of one gene with another.
  • Amplification – More copies of a gene than normal.
  • Deletion – Part of or the entire gene is missing. 

Research has so far found 20 different driver mutations commonly found in non-small cell lung cancer treatment and small cell lung cancer treatment. Much more research is needed to continue identifying the potential mutations and develop targeted therapies. 

Expression of Programmed Death Ligand 1 (PD-L1)

The testing of your PD-L1 levels is what helps identify if you need immunotherapy. According to the National Library of Medicine, a PD-L1 test helps measure the amount of PD-L1 on cancer cells. 

This is important because PD-L1 proteins are what prevent your T-cells, otherwise known as immune cells, from attacking the cancer cells. Essentially, the abnormal cancer cells are hiding behind the PD-L1 proteins to stop your body from doing its job.

To learn more about immunotherapy visit our FAQ page.

“If you catch a patient stage one, you can have a greater than 90% chance of curing that patient from lung cancer. So that’s what it’s all about.”

– Dr. Michael Gieske

Read more about Dr. Gieske’s fight for early lung cancer screening.

Are There Different Types of Biomarker Testing?

Yes, there are several different biomarker tests that can be done. The type of biomarkers and test that is performed depends on the type of cancer that you may have. 

Some common tests include:

  • Single Biomarker Test – Only looking for one single biomarker.
  • Multigene Test – Looking at a panel of several different biomarkers.
  • Whole-Exome Sequencing – Looking at all of the genes in your cancer.
  • Whole-Genome Sequencing – Looking at all of the DNA in your cancer.
  • Tumor Mutational Burden Testing – Looking at genetic changes in your cancer to determine if you need immunotherapy.
  • Liquid Biopsies – Assessing blood or other bodily fluids for biomarkers.

The type of biomarker that is run depends on your cancer type and what your doctor is trying to learn from the test. 

How is Biomarker Testing Done?

An important part of deciding if biomarker testing is right for you may be how the actual test is performed. The test can be done in one of three ways depending on the type of biomarkers that are being tested for:

  • If you are having surgery, the surgeon can take a sample of your tumor during the operation.
  • They may need to take a biopsy of your tumor if you aren’t having surgery.
  • Some biomarker tests can be completed using just a blood draw.

In some instances, you may need to get an additional biopsy done if the cancer is reoccurring, or they didn’t get enough tissue to complete the test.

What Will My Biomarker Test Reveal?

The results of your biomarker test may help identify the best course of treatment by indicating what type of mutation is causing your cancer or if you are a candidate for immunotherapy. If there is an FDA-approved drug to treat your results you may be able to avoid chemotherapy or even potentially surgery.

“Research is going to biomarker testing that’s going towards targeted therapy. That’s the future of cancer care. That’s not just about lung cancer. So as we make it more people more aware of biomarker testing that goes across all cancers, that’s an education that is critical research.”

Read more about Chris Draft’s experience with lung cancer and his efforts to build awareness.

Biomarker Testing Patient Stories

Learn about how biomarkers impact a cancer diagnosis and treatment from real-life patients.

Lung Cancer

Chris Draft



Background: Chris' wife Keasha passed away from stage 4 lung cancer one month after they married. He's been a passionate lung cancer advocate ever since.
Focus: Leading with love, making connections to grow lung cancer community, NFL liaison

Rhonda & Jeff Meckstroth



Background: Jeff was diagnosed with stage 4 lung cancer and given months to live, but his wife, Rhonda, fought for a specialist that led to biomarker testing and better treatment options
Focus: Education of biomarker testing for driver mutations, patient and caregiver self-advocacy

Terri C., Non-Small Cell Lung Cancer, KRAS+, Stage 3A



Symptoms: Respiratory problems
Treatment: Chemotherapy (cisplatin & pemetrexed), surgery (lobectomy), microwave ablation, SBRT radiation

Stephen H., Non-Small Cell, ALK+, Stage 4 (Metastatic)



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Shortness of breath, jabbing pain while talking, wheezing at night
Treatment: Targeted therapy (alectinib), stereotactic body radiation therapy (SBRT)
Stephanie W. feature profile

Stephanie W., Non-Small Cell Lung Cancer, ALK+, Stage 2B



Symptoms: Persistent cough, wheezing
Treatments: Surgery (bilobectomy), chemotherapy, targeted therapy
Breast Cancer

Francina B., Breast Cancer, Stage 2B



Initial Symptoms: None

Treatment: Surgery (lumpectomy, removal of cancerous sentinel nodes), chemotherapy, radiation

Abigail J., Metastatic Breast Cancer, HER2-low, PIK3CA+



Symptoms: Back and leg pain, lump in breast



Treatments: Surgery, chemotherapy, radiation, CDK4/6 inhibitors
Leukemia
Mary Clare

Mary Clare B., Acute Myeloid Leukemia (AML)



Symptoms: Extreme fatigue, upset stomach, bad & persistent headaches
Treatments: Chemotherapy, radiation, bone marrow transplants

Medical Experts on Biomarkers

Dr. Saad Usmani

Saad Z. Usmani, MD



Dr. Saad Usmani, Chief of Myeloma Service at Memorial Sloan Kettering, talks about CAR T-cell therapy, bispecific antibodies, novel therapies and combination therapies.

Deciding Best Myeloma Treatment for a Patient Using a New Strategy



Focus: Possible way of determining optimal treatment for patients without them having to go through treatment first, via using new approaches of studying tumors outside the body, gene expression, and computational data.
Featuring: Praneeth Sudalagunta, Ph.D, Moffitt Cancer Center

Tim Fenske, MD, MS



Role: Hematologist-Oncologist
Focus: chronic lymphocytic leukemia (CLL) & leukemia and lymphoma | CAR T, targeted therapy
Provider: Medical College of Wisconsin

Irene Ghobrial, MD



Role: Clinical investigator and professor of hematological oncology
Focus: Multiple myeloma, Waldenström’s Macroglobulinemia, early screening, clinical trials
Provider:Dana-Farber Cancer Institute (Boston)