Dory and her now husband
Dory and her now husband were forced to think about family planning early on in their relationship when Dory was diagnosed with breast cancer two years into dating. (Photo: Courtesy of Dory Kashin)

Dory Kashin remembers "complete shock" when she got her cancer diagnosis.

At 29, she was established in a busy career as an event planner, enjoying living in Toronto, and in a committed relationship with her boyfriend of two years.

One day while getting dressed, she felt a lump on her breast.

Dory had had a scare with basal cell carcinoma (most common form of skin cancer) and during a follow up with her doctor, she asked about the lump. To be safe, her doctor sent her for an ultrasound.

Tests confirmed Dory had breast cancer and she was referred to medical oncologist Dr. Eitan Amir at Princess Margaret Cancer Centre.

"When I was told I had breast cancer I was in complete shock," Dory says. "I didn't really know how to react – it's kind of a numb feeling when you're told. I think when it really hit me hard was when they told me what would happen and that I'd need about nine to 12 months off.

"Things got real for me at that point – I was pretty career driven and I was in a good spot at my job, so being off for a year was just crazy to me."

Her treatment plan involved surgery – where she chose to have a double mastectomy – and reconstruction. From there, Dory would undergo both chemotherapy and radiation treatments.

Dory says her introduction to the Adolescent & Young Adult (AYA) Oncology Program at the Princess Margaret is what helped her navigate many of the personal and professional concerns that came with her diagnosis.

Adolescent & Young Adult Oncology Program

Approximately 800 newly diagnosed AYA undergo cancer treatment each year at the Princess Margaret and these individuals are known to have unique psychosocial and medical care needs that require tailored support. These needs are often related to information on school and work transitions, fertility risks and preservation options, sexuality/body image, social relationships, nutrition, and exercise.

The AYA Program provides education, resources, emotional support, and navigation to other specialized services based on each patient's specific needs. The program is available to all patients at the cancer centre who are 39 years of age and younger and they can access it at any point in their cancer journey.

"When someone young is diagnosed with cancer it is devastating for them," says Laura Mitchell, Clinical Nurse Specialist with the AYA program. "Not only is it difficult on their physical health, but also on their careers and academic goals, peer relationships, and potentially their ability to plan a family."

"The program has been established to normalize these concerns and help ensure AYA can still accomplish at least some of their goals – even if it means exploring alternative ways of doing so."

Dory Kashin
“I’m a very organized person and like to keep busy, so I really liked that the AYA Program helped me find all of these different resources to support me during and after treatment,” Dory says. (Photo: Courtesy of Dory Kashin)

Dory says she remembers one of the early discussions that came with her diagnosis was around fertility, as cancer treatments can have an impact on patients' ability to have children. Prior to starting chemotherapy and radiation, she made the decision to go ahead with fertility treatment.

"My boyfriend, now my husband, and I had been dating just over two years when I got diagnosed so it sparked the conversation with him kind of early on in our relationship about, 'are we going to be together long-term?'" she says.

"As a young person there were a lot of different factors, like having a family, that I suddenly had to think about sooner than I might have planned to."

Dory met with Laura who gave her an overview of the various resources available to help support her through her cancer journey, such as Gilda's Club, Wellspring, Rethink Breast Cancer, and Pink Pearl.

"Initially my biggest concern was finances. I had never been in a position when I wasn't working, so I went to Wellspring and got some help with that," she says.

"I was also concerned about my relationship with my boyfriend and what that was going to look like, so being connected to different support groups specifically for young people helped me find others who shared similar worries to mine."

Dory says she even met one of her now best friends through Gilda's Club and Pink Pearl. Having that one person who has been through a similar experience and "just gets it" has been critical in her journey, she says.

New normal

Now 31, Dory has completed her treatment, but will be on hormone replacement therapy for 10 years. She is enjoying married life and she and her husband are ready to start a family.

Dory says she has a different perspective on the importance of having balance in her life.

"Life after active treatment was a lot harder than I thought it would be – getting back to the new normal, which I think a lot of people feel," she says. "Even having my hair now back to the spot it was before chemo - which I know is just visual – has helped because I don't look in the mirror and see cancer every second.

"I volunteer a lot more than I used to and I'm trying to fill my time with more positive things – finding what makes me feel good other than just my job and stressing over things. Work-life balance is really important to me now and just focusing on my health."

Michael Kamin Hart Awards
The AYA Lectureship and Michael Kamin Hart Awards will take place on May 7 from 12:30-1:30 p.m. in the Bob Bell Auditorium (6-604) at the Princess Margaret. (Photo: AYA Program)

It takes a village

Supporting the unique needs of AYA at the cancer centre requires the dedication of various staff across many departments.

To raise awareness about AYA care and acknowledge the exemplary work of the staff at the Princess Margaret, the AYA Program is hosting its fifth annual lectureship and awards in honour of Michael Kamin Hart during AYA Awareness Week (May 7-11).

The Hart family wishes to recognize Princess Margaret staff members (clinicians, allied health, service staff and/or volunteers) who demonstrate excellence in AYA care – similar to those who provided care to their family throughout Michael's cancer journey.

Michael was a promising second-year Biochemistry Masters student at McMaster University. He was diagnosed with lymphoma and died on June 5, 2011 at the age of 25.

This year the lectureship will feature a talk from Dr. Mary Elliott, a psychiatrist in the cancer centre's Psychosocial Oncology Department.

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