Abby Custer was a healthy, active 36-year-old, who exercised five days a week at her local gym, ate nutritious meals and enjoyed keeping up with her niece and nephews as “Aunt Abby.”
Then, last summer, finishing workouts became a challenge.
“I was so exhausted, anxious and lost a significant amount of weight,” says Abby, who had just moved to Chicago from Boston. “Then at the end of August, my neck started bothering me and my veins on my left shoulder did not look normal.”
A primary care provider suggested she see a shoulder specialist, but Abby knew it was more urgent than that. On Sept. 2, she went to the emergency room at Rush Oak Park Hospital, where she received an ultrasound, an EKG and CT scan.
The results showed that she had a buildup of fluid around her heart, multiple blood clots from her neck to her elbow on her left side, and a 5-inch mass in her chest.
That night, she was transferred to Rush University Medical Center.
Finding a diagnosis
The next morning, Abby was prepped for a biopsy.
“I’d never been in a hospital before, so it was all a bit overwhelming and scary. But then Nicole Geissen, DO, walked in and said to me, ‘We’re going to figure this out. You rest and eat. It’s you and me — I got you,’” Abby says. “She was confident and reassuring.”
Geissen, a thoracic surgeon at RUSH MD Anderson Cancer Center, performed a biopsy of Abby’s mass and drained the fluid around her heart.
A week later, Abby was diagnosed with B-cell, non-Hodgkin lymphoma. It’s the most common type of non-Hodgkin lymphoma, a cancer of the lymph nodes.
“All the signs were there. I just never imagined hearing the words ‘You have cancer,’ especially in my 30s,” Abby says. “In that moment, all I could think about were my niece and five nephews — all under the age of five — that wouldn’t remember me.”
Getting a care team in place
The next day, Abby met with Parameswaran Venugopal, MD, a hematologist at RUSH MD Anderson.
“Abby came in for arm pain, but she also had a large mass in her chest. That doesn’t develop overnight. It had likely been growing for three to six months. She also had fluid around her heart that normally affects heart function,” Venugopal says. “I think it shows that she was young and otherwise healthy, and that’s why she was able to tolerate it for so long.”
After additional testing, Venugopal confirmed Abby’s cancer was stage 4 with an aggressive subtype — and there was no time to waste.
“Lymphomas that are aggressive are actually more curable,” Venugopal says. “But just because it’s more curable doesn’t mean we wait and watch. We tend to recommend starting intensive treatment right away.”
In early October, Abby began the first of six rounds of inpatient chemotherapy with immunotherapy. By November, Abby had a PET scan that confirmed that she was responding well to treatment.
She completed her final round of chemo in late January, and her niece and three of her nephews — who live in Glen Ellyn — were able to visit her on her final day in the hospital.
“My niece and nephews knew I would come to the hospital for medicine to make me strong again,” Abby says. “My nurses would ask about them by name. It was so special having them there.”
A setback
Abby was doing so well her doctors’ initial impression was that she might not need any further treatment. So she went back to her gym and resumed her normal routines.
But in March, her follow-up PET scan results suggested there were remaining active cancer cells in her chest that needed additional treatment. So Gaurav Marwaha, MD, a radiation oncologist at RUSH MD Anderson, recommended radiation to help put Abby in remission.
“I appreciated how receptive Abby was to the conversation about radiation, even though it wasn’t the news she wanted to hear,” Marwaha says. “She was committed to being aggressive and doing everything possible to get rid of the cancer.’”
So, Abby continued her treatment.
“Trying to work hard for a body that’s failing you is challenging, but I didn’t want to disappoint myself or my doctors,” Abby says. “Dr. Marwaha and his team were so kind. I asked a lot of questions, and they answered them all with such grace and care.”
Abby completed 20 radiation treatments over four weeks on April 21, marking her last day of radiation and the end of her cancer treatment.
By late June, Abby was officially in remission.
Finding joy and gratitude
Venugopal and Marwaha agree that Abby’s positive outlook played an important role in her treatment.
“Abby had an endearing and upbeat attitude towards life and overcoming cancer from the beginning. She was always smiling and motivated,” Marwaha says. “My whole team really loved her, and we’re grateful for her trust in us.”
Abby’s advice for others going through a similar experience: “Find joy and gratitude.”
“Each day is hard and it can be lonely. But remember to give yourself grace and create your own joy,” Abby says. “And keep treatment as bite-sized as you can. Take it one day at a time, one appointment at a time and one blood draw at a time. Every step forward is something to be proud of.”
She’s immensely grateful, meanwhile, to everyone who cared for her at RUSH MD Anderson, including Venugopal, Marwaha, Geissen, Jen Garson, PAC, and the nurses and staff on the hospital’s hematology-oncology floor.
“I couldn’t have dreamed of a more compassionate, caring team. They were my backbone and brought me hope every single day. The days I felt so weak, they reminded me how strong I was. They knew I had a lot of life left in me,” she says. “To my team: From the bottom of my heart, thank you — you saved my life.”
For more information about lymphoma care at RUSH MD Anderson, or to make an appointment, visit us online or call (312) CANCER-1.
