Anthony with wife and baby
Anthony Marrato says his cancer diagnosis has given him perspective on what's important in his life – including the time he spends with his wife, Lalli, and five month-old son, Leo. (Photo: Courtesy Anthony Marrato)

Anthony Marrato wouldn't take back what his cancer diagnosis has taught him.

The 39 year-old says it's taken time, work, and support to feel that way about his cancer, which was diagnosed four years ago, but he's grateful for the perspective the experience has given him.

"All those things you want to do that you think, 'I'll do it next year', or 'It's not the right time,' – I don't think like that anymore," Anthony says. "You give yourself more 'yes' days."

Many people view cancer as a disease that happens in older age, but more than 8,000 adolescent and young adults (15 to 39 years old) are diagnosed with cancer in Canada every year. They are often going through important life milestones at the time of diagnosis – beginning their careers, moving away from their family home, pursuing romantic relationships, starting a family.

Given these unique concerns, adolescent and young adults (AYA) require a tailored approach to their cancer care. Anthony will be sharing his experience as a panelist at the first AYA Survivorship Care Symposium [Editor's Note: Link is no longer available], sponsored by the Michael Kamin Hart AYA Fund.

'A steep cliff'

In September 2014, Anthony noticed swelling in his neck while shaving. He had brushed off concern from his mother some weeks earlier when she noticed it and suggested he get it checked.

Anthony was busy – he had recently been married and returned from his honeymoon in Europe, and was consumed with his work at a top management consulting firm.

"I was working 14, 15-hour days and my work-life balance was non-existent," he says. "So I was pretty out of tune with my body – constant fatigue and living off caffeine made it difficult to identify changes in my energy levels."

Noticing the swelling and hearing his mom's voice in his head, Anthony decided he should book an appointment with his family doctor. They did an ultrasound of his neck, a CT scan at the Juravinski Cancer Centre in Hamilton, and later a biopsy at St. Joseph's Health Centre in Toronto with Dr. John Blondal. The biopsy results came back negative, however the CT scan results were suspicious.

Dr. Blondal was not convinced – even after a second biopsy came back negative – and he advised Anthony he'd be sending his sample to the lymphoma experts at Princess Margaret Cancer Centre.

Dr. Michael Crump, medical oncologist at the Princess Margaret, and his team would determine that Anthony had Stage 3 gray zone lymphoma. It's a rare type of cancer of the immune system that has features of both classical Hodgkin lymphoma and diffuse large B-cell lymphoma (DLBCL). It cannot be assigned specifically to either type, which is what made Anthony's lymphoma difficult to diagnose.

"You're suddenly confronted with your own mortality," Anthony says. "It felt like I was on a steep cliff struggling to find my footing."

Anthony in a chair
Anthony Marrato says being proactive about his physical and mental health helped him after his cancer diagnosis four years ago. (Photo: Courtesy Anthony Marrato)

Adolescent & Young Adult Oncology Program

Approximately 800 newly diagnosed AYA undergo cancer treatment each year at the Princess Margaret. The AYA Program provides education, resources, emotional support, and navigation to other specialized services based on each patient's identified needs and they can access it at any point in their cancer trajectory.

"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 through a multidisciplinary approach to care, help ensure AYA can still accomplish at least some of their goals – even if it means exploring alternative ways of doing so."

Solving a problem

Anthony underwent six rounds of chemotherapy at the Princess Margaret. He says his professional and academic background made him view the diagnosis as a problem to be solved and he was determined to learn about the resources that would help him regain his footing.

He was diligent with his chemo class, kept a strict diet, exercised, followed specific oral and household hygiene routines, and sought support from the psychosocial oncology department.

"I figured I could compliment my treatment by doing my best with all of these ancillary things," he says. "Being proactive in those ways made me feel as though I had a bit of control."

In September 2015, Anthony was told he was in remission. But he would hit a major roadblock shortly after when he was hospitalized with meningitis. Within weeks, Anthony lost the ability to perform simple tasks, like writing his name, bringing his finger to touch his nose, and eventually his ability to walk.

AYA Conference logo
This week’s two-day AYA Symposium was created for healthcare practitioners, allied health professionals and community stakeholders to address gaps and build a framework for the delivery of survivorship care for survivors of young adult cancer. (Photo: Courtesy AYA Program)

Over several months, Anthony slowly recovered, but the cancer and meningitis had taken their toll, both physically and mentally.

He sought out Wellspring's exercise programming, took part in mindfulness-based cognitive therapy sessions, and used the resources of the Cancer Rehab and Survivorship Program to regain his strength.

"It's challenging psychologically to have had these experiences, and with cancer it's this thing that no one can definitively tell you won't happen again," Anthony says.

"It's a terrible experience knowing your life can end so quickly, so it's been important for me to look after not just my physical health, but my mental and emotional health as well."

Anthony is still in remission, and he and his wife Lalli now have a five-month-old son, Leo. His advice to other young cancer patients is to take advantage of all the services and resources that can help support mental and physical well-being not just during, but also after treatment.

"There's the saying, 'death by a thousand cuts' – I call my supplementary approach 'healing by a thousand bandages' because all of the seemingly smaller things you can do to compliment your treatment can add up to a significant sum that may help," Anthony says.

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