Feeling “Tired” Medical Student, 23, Mysteriously Faints During Rounds– Turns Out To Be Leukemia

@kenziepaul3

How I found out I have cancer! #AML #leukemia #cancer #fuckcancer

♬ Aesthetic – Tollan Kim

It wasn’t until she started feeling dizzy again, while doing another clinical rotation at Spectrum Health Hospitals Butterworth Hospital, that she suspected something was wrong with her body.

She explained, “I was just standing in one spot not moving in a patient’s room. I’ve seen lots of different procedures. There’s a difference between seeing blood and being grossed out by it but it wasn’t anything like that.”

Paul, who admits in a video on her TikTok page that she thought what was happening to her was “weird,” then decided to reach out to her doctor, who advised her to get bloodwork and other labwork done to check if everything was ok.

She received her cancer diagnosis of acute myeloid leukemia (AML) weeks later, on August 17.

Recounting how she felt leading up to her diagnosis, Paul told People, “Other than being more tired I really didn’t have any symptoms. My whole life I’ve been really healthy. I was a college athlete. But I remember looking at my labs and I was like, ‘Oh my gosh, this is horrible.’

She noted how the doctors were impressed that she wasn’t sick, despite her blood cells being low, adding that she “came into the hospital as an outpatient with my diagnosis and most AML patients are admitted after going to the ER because they are so sick.”

“I was really lucky that I listened to my body and got the blood work done and figured it out before it did develop into something much worse,” she said.

Meanwhile, a GoFundMe for Mackenzie Paul, which has since raised more than $17,000, shared an update just week revealing the recent discovery of a genetic mutation she has “that puts her at high risk for recurrence” and “makes bone marrow transplant the best option for her to be cured.”

@kenziepaul3

Up next: consilidation chemo and bone marrow tranpslant! #AML #cancerfighter #leukemia #fyp

♬ original sound – kenziepaul3

“The plan now is to move forward with maintenance chemotherapy for five days every month until she has a donor established for a bone marrow transplant,” the fundraising page explains.

“Some great news is that Mackenzie’s most recent bone marrow biopsy showed no persistent leukemia, so she remains in remission from her first chemotherapy treatment!”

Paul’s GoFundMe page, created by her older sister Hailey, concludes, “The goal is to stay in remission until she is ready for transplant within the next few months.

“We are hopeful that she will be able to return to medical school in fall of 2024 if everything goes as planned. Thank you all for the continued love, support, and prayers Mackenzie and Brandon are so thankful.”

@kenziepaul3

Bald is beautiful!!! #AML #cancer #fuckcancer #cancertok #leukemia #baldisbeautiful #fyp

♬ What Was I Made For? [From The Motion Picture “Barbie”] – Billie Eilish

According to People, Paul took a leave of absence from medical school while she battles cancer and she spent five weeks in the hospital following her first round of chemotherapy.

Paul has returned home and will continue chemo until she finds a donor for bone marrow transplant.

“My entire life, everything’s been in my control. This you can’t study harder for, to make your labs go up or have the outcome you want. It’s very humbling and I just have to have faith. I don’t know why this is happening to me, but it’ll make me a better person and a better future doctor,” Paul told People.

“I hope people take away that faith, family, and community give us strength when things are out of our control, and that those things have kept me fighting every day.”

Genetics Of Acute Myeloid Leukemia

Learning About Acute Myeloid Leukemia (AML)

Acute myeloid leukemia (AML) is a cancer that affects bone marrow, the spongy tissue inside of your bones. It’s a rare cancer overall, but it is the most common type of leukemia in adults. Rarely, children also get AML.

To understand acute myeloid leukemia (AML), you have to know how bone marrow works, explains Dr. Mikkael Sekeres, director of the Cleveland Clinic Cancer Center Leukemia Program 

This disease is caused by DNA damage to the cells in your bone marrow that give rise to blood cells. Red blood cells carry oxygen to tissues, white blood cells fight infections as part of the immune system, and platelets help stop bleeding. Those cells are damaged in AML, and the damage results in an overproduction of unnecessary white blood cells.

Acute Myeloid Leukemia Symptoms

Acute myeloid leukemia (AML) may be the most common form of acute leukemia for adults, but recognizing symptoms can be difficult.

The Symptoms of AML Can Be Subtle, Says Dr. Mikkael Sekeres

Dr. Gail Roboz, a medical oncologist at Weill Cornell Medicine, previously spoke with SurvivorNet about common symptoms of AML, and the how the diagnosis is determined. According to Dr. Roboz, AML symptoms including shortness of breath, decreased exercise tolerance, unexplained bruising, or infections. In some cases, patients may have no symptoms of AML at all, and therefore are diagnosed unexpectedly during a routine health evaluation.

RELATED: What is Acute Myeloid Leukemia? 

“Often patients have no idea leukemia is even anywhere on the radar,” Dr. Roboz tells SurvivorNet.

How To Recognize Symptoms Of Acute Myeloid Leukemia

Dr. Roboz says that these symptoms are due to problems with bone marrow, which produce white blood cells, red blood cells, and platelets. For patients with symptoms, physicians will perform a blood test, and if results come back unusual, then patients will be referred to a hematologist-oncologist. Abnormal blood test results typically show low blood cell or platelet counts. From there, physicians will perform a bone marrow biopsy in order to conclude an AML diagnosis.

What Increases Your Risk for AML?

SurvivorNet’s experts say doctors don’t know exactly what causes cells to turn cancerous in AML. It’s likely there is no one cause. However, there are environmental risks that, along with genetic changes, might cause cells to change into leukemia.

A risk factor is something that can increase the likelihood of you developing a disease. Just because you have a risk factor doesn’t mean that you will get the disease, and not having the risk factor doesn’t mean that you will definitely not get it. Some risk factors can be changed (for example, smoking) and others can’t be changed (such as your age or a genetic mutation).

You might be at higher risk for AML if you:

• Are age 65 or older. The risk rises as you age.
• Are male. Men are more likely to get AML than women.
• Have been treated for cancer in the past. If you’ve had certain chemotherapy or radiation treatments, they might increase your risk of getting AML.
• Have had certain exposures. Radiation or chemicals like benzene and formaldehyde might increase your risk.
• Smoke, or smoked in the past. Cigarette smoking has been linked to AML.
• Had another blood disorder. Myelodysplasia or myelofibrosis could put you at greater risk.
• Have certain genetic disorders. Down syndrome and other genetic syndromes affect AML risk.

Remember that AML is rare overall. So even if you have any of these factors, your likelihood of getting this cancer is very low.

How To Make Important AML Treatment Decisions?

Some preventive measures you can take to reduce your risk of developing AML are:

• Not smoking, or quitting if you already smoke. Smoking is the biggest controllable risk factor for AML.
• Avoiding exposure to cancer-causing chemicals like benzene.

Chemotherapy and radiation treatment for other cancers could increase your risk of getting AML, but doctors haven’t yet found a way to circumvent this issue.

AML Treatment Options

AML treatment is typically done in two phases:

Induction chemotherapy uses strong drugs to reduce the number of leukemia cells in your body and put you into remission.

The initial chemotherapy treatment includes a combination of two drugs. Sometimes doctors add a targeted drug, which blocks certain proteins or other substances the cancer cells need to grow.

Dr. Richard Stone of Dana-Farber Cancer Institute describes the two phases of AML treatment

Post-remission, or consolidation therapy is the next phase of treatment, which starts once you’re in remission. The goal is to get rid of any remaining cancer cells and keep you in remission.

This phase can include high-dose chemotherapy or a stem cell transplant (also called a bone marrow transplant), in which you get very high doses of  chemotherapy to kill the abnormal bone marrow cells, and then healthy cells from yourself or a donor to replace the cells that chemotherapy killed. Targeted drugs may be used for consolidation, too.

Other, newer treatments are being tested in clinical trials. Ask your doctor if any therapies under investigation might be appropriate for you.

The effects of leukemia treatment are very individualized. Treatment may get rid of all leukemia cells for some people, while others will have to remain on chemotherapy long-term to control their cancer. Expect to have follow-up exams after treatment, usually every month to begin with, and then at longer intervals. These repeat visits are designed to help your doctor spot the signs of a relapse, if it occurs.

What Acute Myeloid Leukemia (AML) Patients Should Expect During A Bone Marrow Transplant

Many people work with their cancer care team to develop a survivorship care plan. This helps them strategize next steps, figure out ways to cope with the side effects of treatment, schedule follow-up exams, and manage their diet/exercise goals.

Cancer Patients As Their Own Advocates

Pushing for more answers and options is key for cancer patients after diagnosis and during treatment. Additionally, every patient to learn as much as possible about their diagnosis.

“It’s important to educate yourself and be your own healthcare advocate, and that’s something I think is very important,” Dr. Zuri Murrell, the Director of the Cedars-Sinai Colorectal Cancer Center, tells SurvivorNet.

“You should leave each doctor’s appointment with a plan.”

By speaking up, cancer patients can learn about multiple options for care, which is something Dr. Steven Rosenberg, Chief of Surgery at the National Cancer Institute and pioneer of genetics and immunotherapy, encourages every patient to do.

The Importance of Being Your Own Advocate

Contributing: SurvivorNet Staff

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