June is National Cancer Survivors Month, a perfect time to meet some of the patients who have been through disease and come out on the other side with a renewed sense of purpose and inspiration to carry on in their next chapter.
Lymphoma survivor Cary Chang, 61, is one of those patients. She said she truly feels that she was given a second chance at life after a grueling journey with refractory aggressive non-Hodgkin lymphoma, a rare form of blood cancer.
After her initial diagnosis in 2014, Chang was devastated to learn the cancer had returned two years later. She said it was “much harder” to get the news than the first time. Still, with the remarkable advances in medicine and a committed team taking care of her at City of Hope, led by her oncologist Elizabeth Budde, M.D., Ph.D., Chang beat lymphoma a second time. In the years that have followed, she has embraced her second chance with grace and gusto, and in a big way: as a global medal-winning athlete.
It has been nearly 10 years since Chang’s original cancer diagnosis, and five years since she bet everything on a then-newly Food and Drug Administration (FDA)-approved medication called axicabtagene ciloleucel (axi-cel), commercially marketed as Yescarta. Chang came to City of Hope from Hong Kong after she found City of Hope online and contacted its Center for International Medicine (CIM) via WeChat within a week of Yescarta’s FDA approval in October 2017. The drug was not available in China at that time and at only a handful of institutions in the U.S., making City of Hope quite literally her last hope after every other form of treatment had failed to stop the forward march of her relapse.
“When I read the news [about Yescarta], I immediately began researching where I could get treated,” Chang said. “I looked at all the hospitals in the United States who could offer this treatment, and City of Hope was the first to respond.”
CIM worked out the details for her travel, insurance coverage and admittance as an international patient and quickly got her to the Duarte, California, campus, where she was scheduled to receive the make-or-break medication.
“City of Hope dealt with everything so efficiently,” she said. “It took only a few days from my first encounter with the center to my travel to California to my first appointment. I was truly impressed with City of Hope right from the beginning.”
The single dose of Yescarta — called a “living drug” because it fights cancer using a patient’s own healthy T cells — was the only chance she had left.
But it was the answer she needed.
Family, Friends and Faith
Following the Yescarta dose, Chang recuperated until she was healthy enough to undergo a stem cell transplant. She also benefited greatly, she said, from City of Hope’s supportive care offerings to augment her mainstream medicine, including pet therapy, taking tai chi lessons and working out with physical therapists, even when she didn’t think her body could do it. There were days, she admitted, that she wanted to give up.
“Everyone was so wonderful. Dr. Budde was wonderful,” she said. “So professional. She always wears a smile and was very caring. She would answer any question I had with patience and made it easy to understand various things that were part of my treatment. Everyone at City of Hope made it a worry-free experience.”
Chang’s care team monitored her progress daily. The first few days and weeks are critical, and the more days that pass, the more likely the drug is responding favorably. So, her care team was delighted when, after 28 days, nearly a month from the time she underwent therapy, Chang showed no signs of cancer.
“We saw complete remission 28 days after Cary’s treatment,” Budde said. Upon hearing those words — “complete remission” — Chang said she didn’t believe it at first, but then “cried tears of joy.”
“I had been disappointed so many times before. I was overjoyed. I could never imagine a cure working so fast that it took only 28 days for my cancer to be gone.”
“I am so thankful to have found City of Hope and the Center for International Medicine,” she said. “They were so thoughtful of my critical condition and so responsive. I was terminal and told I had a few months to live. Now it’s been years. City of Hope saved my life. Thank you for giving me my second take at life.”
There have been some side effects over the years since then, including graft-versus-host disease (GVHD) and some other ailments, in addition to a global pandemic to contend with while trying to schedule follow-up appointments. But overall, Chang said it turned out that none of it was too much for her to handle. She credits the support and love of her family and friends, her integrated care team and her faith for being able to persevere. She has been through the dark and come into the light, not only surviving, but thriving.
“I have been very busy, living a very full and meaningful life,” said Chang through an interpreter from her home in Hong Kong, about her life since she became cancer free. “I am involved with some nonprofit organizations and volunteer in areas with cancer patients like myself.” Chang said she shares her story of survival in hopes that she can be a source of inspiration and motivation to other cancer patients.
“I want people to know that I understand what they are going through, and I understand that it is a very emotional experience, and that’s OK,” Chang said. “There is fear, and there is uncertainty, and I hope that I can help them manage some of that by showing them it is possible to make it through.”
World Transplant Games
Out of that fear comes courage and wisdom, Chang said, and a zest for life that she felt even more after emerging from the most challenging time of her life. It was that renewed “take” on life, as she calls it, that led her to get involved with a local athletic event in Hong Kong designed specifically for transplant patients. Emboldened by her success at the local event and excited to challenge herself physically, Chang entered the World Transplant Games this spring as a first-timer. The games were established in 1978 with the aim of raising public awareness of the importance and benefits of organ donation by demonstrating the health and fitness that can be achieved post-transplant. Held every two years, the Games took place in Perth, Australia, this year.
“I don’t have a background in sports or athletics at all,” Chang said. “The games gave me training, encouragement and guidance.” Chang has taken up rigorous hiking in recent years, with a trek to Hong Kong’s famed Lion Rock being a favorite hike. She had done some exercise and physical preparation before entering the games, but said she had “no idea” what to expect.
The self-described “beginner” competed in several events at the games as one of 1,500 athletes gathered from 45 countries, including ladies’ singles and doubles badminton, singles pétanque (a type of lawn bowling), singles ball throwing and the 100-meter sprint.
Double Silver Medalist
Chang brought home not one, but two silver medals from the games, in ladies’ badminton singles and doubles. She said that, for her, winning those medals was equivalent to being an Olympic silver medalist.
“I was very impressed and so proud to be a part of the World Games and to win, to prove something to myself,” Chang said. “I was expecting something along the lines of a high school sporting event, but it was very professional and organized, and that made my victories that much more meaningful.”
Chang represented her native Hong Kong at the event and participated in the World Transplant Games’ opening and closing ceremonies, leaving the games as a champion and with a personal triumph.
She said she has every intention of competing in the next summer World Transplant Games in Germany in 2025.
Accept With a Positive Heart
“From the day I was diagnosed with cancer to becoming an athletic medalist was of course not something I ever planned, but it happened,” Chang said. “From the very beginning, I was determined to survive. And I know that I am a miracle, thanks to my strong faith and the path that led me to the Center for International Medicine and to City of Hope.”
Chang likes sharing her story and personal testimony. She said she knows it has helped others.
“I tell people no matter what life gives you, no matter what your health status, receive the news with a positive heart — don’t try to escape that reality,” she said. “Accept it, yes, but know that this is not necessarily ‘it,’ — that it is over. You have to look to the future and not focus on the present, not on the moment of this. It is not the end of your journey here, but the beginning of a new one.”
You can watch highlights from the 2023 World Transplant Games in Perth here.