The following pages represent three stories of childhood cancer patients who paid a high price -- in the form of additional cancer and side effects -- for the treatment they received as children. But for each of these survivors, continued screening and treatment likely also saved their lives and allowed them to live as normal lives as possible.
As a young child, Kelly Krauel of Baltimore had her first encounter with a potentially deadly cancer. It would not be her last.
In 1982, doctors diagnosed Krauel with leukemia at the age of 4, a diagnosis that required chemotherapy treatment. While the initial treatments were successful, her leukemia recurred in the fluid around her brain and spinal cord three times over the next few years.
As a result, Krauel received more chemotherapy, as well as radiation to her brain and spinal column.
The leukemia went into remission and has never recurred since then. But the radiation used to treat her leukemia led to the development of the skin cancer melanoma along her scalp and spine at the age of 14, a cancer for which she would require surgery.
At the age of 18, she developed thyroid cancer, another malignancy likely linked to her prior cancer treatment. Surgeons removed the half of the gland that housed the tumor, but in 2007 the cancer returned and she had to have the rest of her thyroid removed to eliminate it.
In 2007, doctors also diagnosed Krauel with inflammatory breast cancer, a rare but aggressive form of the disease. She received treatment for this cancer and is now in remission from it as well.
Now 31 years old, Krauel said her fight against cancer has not been an easy one. In addition to cancer, she has faced cataracts and osteoporosis as consequences of her treatment.
"There is a ton of stuff that creeps up on you that you would never think as a younger person you would have to fear," she said.
But despite this, Krauel said that she does not regret having the life saving treatment she received as a child.
"It saved my life, so I am not condemning anything," she said. Indeed, Krauel is preparing to celebrate her seven-year wedding anniversary in September. She has two children, 5-year-old Jake and 3-year-old Emma. Both, she said, are healthy.
And just as her life has changed, so too, she said, have her reasons for seeking continued cancer screening and treatment.
"It was different then because I was a child, and I had my parents making decisions for me," she said. "Now I have to make these decisions for the sake of my husband and kids. So it was a lot different before because I just had to survive for myself."
Krauel regularly attends the survivorship program that Shad leads at Georgetown University. She said that she would recommend to any childhood cancer survivor that they get in touch with a similar clinic.
"Until the mid-2000s, I think a lot of people didn't know that they really needed to follow up, because I don't think that we were told," she said. "I also think that a lot of people don't get follow-up treatments because they don't have the right insurance or they don't have it at all."
Shad said that given the option, she finds that most survivors of childhood cancer would make the choice to opt for sometimes difficult treatments to fight the disease.