Leukemia Survivor Gets Care Years After Remission

Nicole Schulz has three arrows tattooed on her right arm with a single word underneath: "Irrepressible." The 34-year-old says the harder she's pulled back by life's struggles, the stronger she shoots forward.

She was just a high school freshman in 2005 when doctors diagnosed her with acute myeloid leukemia. She survived, but those three words "you're in remission" didn't mark the end she expected.

Almost immediately after treatment, Schulz's body started breaking down. Avascular necrosis ate away at her connective tissue, leaving her with two metal knees. She developed chronic graft-versus-host disease from her bone marrow transplant, causing ongoing inflammation and organ damage.

The mental toll proved just as heavy. "Any time I feel a bump or see a mark, I freak out because I think, 'Oh no, it's cancer again,'" says Schulz.

She's not alone. Nearly 19 million cancer survivors face similar challenges, and many navigate these years with little support.

The Ripple Effect

At City of Hope, Schulz found something different. The hospital's Childhood, Adolescent and Young Adult Survivorship Clinic treats remission not as a finish line, but as a new chapter requiring specialized care.

Every year, Schulz meets with doctors who have documented every detail of her treatment history. They screen for heart disease, secondary cancers, and cognitive decline based on her unique risk profile.

"They know everything," says Schulz. "They can look ahead to make sure those things aren't becoming a problem. It eliminates so much fear."

Dr. Saro Armenian, who leads the program, calls long-term survivorship care "one of the most pressing and preventable challenges in cancer care today." As people are diagnosed younger and live longer, that need only grows.

The care has already proven its worth. When squamous cell carcinoma appeared on Schulz's lip recently, her team caught it early and treated it quickly.

Then came the unexpected blessing. After years of being told chemotherapy and radiation had likely stolen her ability to have children, Schulz discovered she was pregnant during the COVID-19 pandemic.

She named her now 5-year-old son Kaiden, meaning "fighter." Her strength comes not just from within, she says, but from knowing her care team hasn't let go of her hand.