Hero Wishing Trees | City of Hope

Determined mom triumphs over breast cancer, leukemia and COVID-19

“I’m the luckiest unlucky person you know!”
 
So says Sandy Shapiro, a single mother from Los Angeles with two daughters, a career as a documentary producer, a “fierce” circle of devoted friends and a medical history that leaves even her doctors shaking their heads.
 
“I don’t know if I would have had what it took to overcome everything she has had to face,” marvels renowned City of Hope hematologist Stephen J. Forman, M.D.,  who shepherded Shapiro through one cliffhanger after another.
Sandy Shapiro | City of Hope
Sandy Shapiro fought breast cancer, then leukemia, then COVID-19.
So much has happened to Shapiro in so short a time it tends to overwhelm. In less than three years, she’s faced a breast cancer diagnosis, a double mastectomy, the shock of developing acute myeloid leukemia, a stem cell transplant, graft-versus-host disease and, to top it off, pneumonia caused by COVID-19.
 
But speak to this high-energy dynamo and there’s not a trace of “Why me?” in her voice. All you hear is single-minded resolve.
 
“Dying is not an option,” she said emphatically. “I have to be there for my girls.”
 
Divorced in 2016, Shapiro admits the time-gobbling job of singlehandedly raising two kids (Claire is in high school; Julia starts college in the fall) made her a little lax about keeping up her regular checkups. After getting no screenings for two years she finally resumed, only to learn in 2018 that doctors had found something “suspicious” in her right breast.
 
It turned out to be lobular breast cancer.
 
Shapiro decided on a double mastectomy.
 
“I’d been afraid of breast cancer my whole life,” she explained, noting that her mother and several cousins had also been stricken. “I just didn’t want to worry about it anymore.”
 
Recovered from surgery, Shapiro dismissed the frequent fatigue she was feeling. But during a follow-up visit months later, her bloodwork revealed something “slightly off.”

A Mysterious Diagnosis

It was acute myeloid leukemia, a diagnosis that left Shapiro in “shock and disbelief.”
 
While there are some women who develop leukemia after chemotherapy for breast cancer, Shapiro was not one of them. She did not have chemotherapy.
 
 “We don’t know what caused her leukemia,” Forman said.
 
To battle the leukemia, Shapiro would need several courses of chemotherapy — each requiring a month or more in the hospital.
 
Stephen J. Forman
Stephen Forman, M.D.
She began treatment near her home, but supervised by Forman — they’d connected through Shapiro’s local oncologist, who had worked with Forman in the care of other women with cancer. When the first round of chemo didn’t produce a remission, doctors began to seriously consider a stem cell transplant — and a switch to City of Hope, a world leader in the field, where more than 17,000 transplants have been performed.
 
It was a longer commute, but Shapiro looked forward to putting herself more fully in Forman and the City of Hope team’s hands.
 
“I knew that my part of the decision was to find my ‘general,’ the doctor in whom I would put my trust, be a good soldier and get through the battle together,” she said.
 
“Best decision I could have made.”
 
And not just for medical reasons.
 
“He’s so incredibly warm, friendly, funny — and serious when he needs to be,” Shapiro said. “He has this calm assuredness.”
 
Her sister Carla proved to be an ideal donor. The transplant went well.
 
But her challenges were far from over.
 
Her next hurdle: graft-versus-host disease, a potentially fatal condition in which the donated stem cells attack their new environment, mistaking it for a foreign “enemy.” Controlling it required additional immunosuppressive drugs, which can exact a price of their own.
 
“They can leave you vulnerable,” said Forman, adding that a bout with COVID-19 can be much more severe in an immunocompromised person.
 
Which is exactly what happened.

Next, Covid-19

In December 2020, Shapiro tested positive for COVID-19, but her symptoms were mild and didn’t last long. She thought she’d dodged a major threat.
 
The coughing started two weeks later. She called Forman, who hospitalized her immediately. Shapiro had developed pneumonia, brought on by COVID-19.
 
“I thought to myself, ‘Thank God I’m here.’ So many brilliant minds, coming together, making it all work,” she said. “With all their experience treating leukemia, they really understood how to handle an immunocompromised patient like me with COVID.”
 
Shapiro was treated successfully with oxygen and monoclonal antibodies. After six days, she was able to go home.
 
Now more than a year past her transplant, Shapiro remains in remission, and Forman is optimistic that she will continue to do well. She can’t say enough about her care at City of Hope.
 
“I had a real sense of comfort there. City of Hope made it so easy.”
 
Well, it may have looked easy.
 
City of Hope’s response to the pandemic is a monumental undertaking fought on multiple fronts, from specialized, isolated treatment facilities to massive screening, testing and vaccination programs. All of which is aimed at keeping everyone safe while continuing to provide the highest level of cancer care.

A Big Fan

Through it all, Forman vigilantly oversaw Shapiro’s care. It was personal to him, as it is with each of his patients.
 
“A person is not their disease,” he said. “Knowing who a person is is my way of earning their trust and  conveying that they’re not alone. We’re all with you.”
 
He admires Shapiro’s bravery, her positive attitude and her total commitment to getting well for the sake of her daughters.
 
“She made it easy for us because she was so focused on doing what she needed to do to survive,” he said.
“I’m her biggest fan.”