It turned out the new tumor was aggressive -- a stage 4 glioblastoma and it was sitting on the right side, touching three parts of her brain: the temporal, parietal and occipital lobes.
The lower-grade tumor had turned into a more aggressive one, which is not unusual in a glioblastoma, according to Spetzler, who took over her treatment in 2007.
"I opted not to have the entire tumor removed or my left side would have been paralyzed -- so I asked Dr. Spetzler to debulk it. I didn't want quantity, I wanted quality," she said.
When her mother was brave enough to ask how long she would have to live, one of the doctors said about six months.
"For whatever reason, because of being an athlete or just being mad, I wanted to defy him and the medical world and show that no one is a statistic," Knies said. "I was immediately defiant. I never once thought it would be the death of me."
The tumor caused massive headaches and vomiting from the pain, and on Friday, April 13, 2007, she went into surgery. "Friday the 13th will never scare me again," she said.
Surgery was followed by heavy doses of chemotherapy and radiation. Knies will be monitored with MRIs for the rest of her life, but for now, her brain shows no sign of residual cancer.
"I would not feel comfortable calling it a cure," said Spetzler. "But there is no evidence of a tumor as you would expect with someone who has lived much longer than expected. There is a hole where the tumor was. Her survival is remarkable."
At her cancer diagnosis, her boyfriend at the time had "freaked out," according to Knies. "It makes you very insecure when someone tells you up front they can't handle it -- bye-bye."
But in 2010, she met Joe Knies, now 54, an engineer who was 22 years her senior.
"It didn't even faze him, and it blew me away," she said. "He made a good point -- we can all die in a car crash tomorrow."
They married in October while Knies was still undergoing chemotherapy one week each month. She had always wanted children and was warned the aggressive treatments could have damaged her eggs.
"It was almost as scary for me as hearing about the cancer," she said.
On her oncologist's advice, Knies decided to undergo in vitro fertilization with a surrogate because of the unknowns associated with cancer and pregnancy.
"I prayed hard," she said. "After egg retrieval there were only two follicles and the rest were empty."
In the three days they took to mature, only one was viable. "We had that one, and she is my daughter," said Knies.
"My husband had never been married before or had kids and his parents thought they would never see the day, so it was a miracle to his mother that he now has a child," she said.
"Every morning I wake up and thank God that I can feel my 10 fingers and toes and have a loving daughter and husband," said Knies. "There have been so many miracles. One after another, as my dad said, so many angels must be sitting on my shoulders."