Bilasan Hammo, MD, had just turned 30, and everything seemed set up for a successful move into adulthood. As she wrapped up her residency at Cleveland Clinic Children’s, she landed a prestigious fellowship in Boston Children’s Hospital’s Gastrointestinal-Nutrition Department.
Heavily influenced by her father – who is also a pediatric gastroenterologist – the fellowship felt like a dream come true. It started in a month, and in the meantime, she looked forward to celebrating Eid al-Fitr with her family and friends in her familial homeland, Jordan. Just one day before the holiday began, her physician called her to tell her she had Ewing sarcoma.
“I will never forget it,” Hammo says. The news cast a pallor of fear and dread over everything, even the holiday. “I’m about to finally start ‘adulting,’ if you will, and then suddenly it’s like, ‘Nope, you can’t do that anymore. We have to stop.”
Life on hold
Adolescent and Young Adult Sarcoma Program Manager Liz Marconi, LICSW, MSc, says this is a common feeling among her patients who are between the ages of 15-39. “Whether it is finishing school, starting a career, or settling into relationships, these young patients are just starting to build their lives,” Marconi explains. “Then, they get a cancer diagnosis, and it is a major disruption.”
Fortunately for Hammo, the Boston Children’s fellowship program director arranged a delayed start date, and her co-chief resident was able to take on Hammo’s leadership responsibilities as she began treatment at a hospital in Ohio.
She continued to work in Cleveland Clinic’s inpatient pediatric clinic as she underwent her first round of chemotherapy and surgery. It was exhausting, but it provided Hammo with a sense of normalcy and agency.
After completing treatment and receiving clear scans, Hammo began her fellowship. When she moved to Boston, she transferred her care to Dana-Farber. She sometimes jokes that she had a Boston oncologist before she had an apartment.
In the first days of her fellowship, Hammo felt like she had found her calling. “It was like I was finally doing what I was meant to,” she says.
Then, a scan found that her cancer had returned. Life was, once again, interrupted.
Providing a roadmap
The path ahead seemed unclear. Knowing that Ewing sarcoma was a rare and aggressive cancer, Hammo was feeling less hopeful about second-line treatment. Her team, led by Andrew Wagner, MD, put together a personalized care plan that included another regimen of chemotherapy before surgery, and then radiation.
Through it all, Hammo was able to continue her fellowship with the support of her colleagues and leaders. She would sometimes call herself a “patient by day and doctor by night.” Friends and family came to visit from Cleveland. Her colleagues at Boston Children’s showed up with meals and rides to appointments. She felt supported but isolated at the same time.
Hammo did not know anyone her age who had been through something like a cancer diagnosis, and she wanted to know how to navigate this new world. When she voiced this to Wagner, he put her in touch with Marconi and the Adolescent and Young Adult Sarcoma Program.
Marconi coordinates initial outreach to new patients before or during their first appointment, connecting them with resources based on their individual needs. She connects adolescents and young adults to Dana-Farber genetic counseling, sexual health and fertility specialists, pain and palliative care, social workers, support groups, resource specialists, parenting groups, and clinical trials.
“We look at their clinical care in a comprehensive way, thinking about what they’re going through in different parts of their lives,” Marconi says.
Facing a new cancer diagnosis is already a dizzying and challenging period for many patients. Trained as a social worker, Marconi approaches each conversation with empathy, recognizing that every patient needs different kinds of support at different points in their treatment. “It’s about meeting patients where they are mentally and emotionally,” she says.
To help in her search for patients with similar perspectives, Marconi pointed Hammo to the One-to-One Program, a Dana-Farber initiative that connects patients with peer mentors who have shared similar experiences.
Through the Dana Farber Young Adult Program, Hammo learned about the Leonard P. Zakim Center for Integrative Therapies and Healthy Living. After meeting with an exercise coach through the Health Coaching Program, Hammo felt like she was regaining some of the agency that had been stripped from her by cancer.
“It completely changed my life,” Hammo says. “It made me look forward to something because I could see improvements week to week.”
At a recent Young Adult Conference hosted by the Young Adult Program at Dana-Farber, Marconi and Hammo reunited briefly. They embraced. For Marconi, it was a sign that she was in the right place. “That’s the whole point of our work,” she says. “I’m glad I could make some of an impact.”
For Hammo, this was an extension of the gratitude she feels for so many people in her life who made it possible for her to enter her third and final fellowship year. She believes her experiences have made her a better physician, especially for young patients who may be facing a new chronic condition.
“I can tell them, ‘I know how you feel,’” she says. “’Look at me, I’m here. I’m working. I’m living my life. You’re going to be okay too.’”