Andrea Kurt rings the bell signalling the end of her chemotherapy treatment at MUSC.

Andrea Kurt rings the bell signalling the end of her chemotherapy treatment.
Image Credit: Andrea Kurt

Since her freshman year at Clemson University, all Andrea Kurt wanted to hear was her name called at graduation. But, just a few days before graduation, the desire to hear her name was replaced by something else–the ringing of a bell.

Ringing a bell has become a common ritual nationwide when cancer patients reach the end chemotherapy. Friends and family applaud a patient who gets to that bell. The sound means it’s been beaten, or at least beaten back.

Kurt graduated on May 11 with her bachelor’s degree in nursing and a tumor in her chest that was growing by the week. She donned a mask and attended graduation despite her low white blood cell count due to the chemotherapy.

“Being able to graduate was incredible,” Kurt says. “I had reached my goal.”

Despite the achievement, all she could think about was the sound of that bell at some point in her future.

Her cancer started with back pain in December 2018, but it wasn’t until the end of April 2019 that she received a diagnosis of mediastinal b-cell lymphoma. She was determined to graduate despite the tumor causing her back pain and impaired swallowing and breathing.

In August, Kurt heard the sound she had been dreaming of since she got her cancer diagnosis in April. On her last day of chemotherapy, she held a bouquet of purple balloons in her left hand and cried as she rang the bell at the Medical University of South Carolina Hollings Cancer Center.

“I was so happy to hear the bell ring – happier than I was to hear my name called at graduation,” Kurt says. “During treatments, I’d heard the bell ring for other people for months, and I wondered if it would ever ring for me. It finally did.”

A few days later, she received news that her tumor had shrunk to half of the size it was in May, she said. An end-of-treatment PET (positron emission tomography) scan revealed positive results, and she said her doctors told her that they believed she was free of active disease.

With chemotherapy behind her, she’s now looking forward to her nursing career, a passion refueled by her 10-month journey as a cancer patient. This Clemson alumna hasn’t let anything stop her from remaining focused on starting her career as a nurse.

Searching for answers

Kurt, a Charleston native, worked as a patient care technician at Prisma Health Oconee Memorial Hospital her senior year at Clemson University. When her back began to ache, she thought she had just hurt it at work.

Kurt’s roommate and best friend Kelsey Costa remembers her friend’s added stress to an already stressful senior year.

“Senior year was tough with classes, work, clinicals and the practicum,” Costa says. “Andrea had this horrible back pain. She was going to appointments and even took up yoga. She thought it might be a muscle problem or a pinched nerve, but nothing seemed to help.”

Kurt went to several doctors for consults. They all told her it was nothing to worry about, and after a couple months of physical therapy, her back still wasn’t feeling better.

“I was really frustrated with my doctors,” Kurt says. “They thought it was a muscular thing. I was in so much pain all the time, I just knew that wasn’t the answer.”

Kurt went to a chiropractor, who saw a shadow on an x-ray. Around the same time period, she started having difficulty swallowing.

The chiropractor then referred her to a radiologist to take another scan of her chest. By 10 p.m. that day, Kurt received a phone call with the scan results and the news about a mass in her chest.

“It was the scariest thing I had heard,” Kurt says. “You think about getting tumors in your stomach or in your lungs, but not in your chest.”

The tumor was under the breastbone and in front of her heart, which was causing her difficulty swallowing. But despite the disturbing news, she went to work at the hospital that same night. She said she wouldn’t have slept that evening anyway.

Kurt continued on with schoolwork, classes and the practicum despite the back pain and a potential cancer diagnosis. Even though the School of Nursing faculty said she could take time away from school, Kurt was determined to push forward. She said it was a mental relief to continue working and worry about other people instead of herself. It gave her strength to keep going, and her focus was on graduation.

“I kept going because I didn’t want this to ruin everything for me,” Kurt says. “I had worked so hard for the last four years.”

Andrea started chemotherapy right before graduation.

Andrea started chemotherapy right before graduation.
Image Credit: Andrea Kurt

Joining a club

During a biopsy on April 30, a surgeon removed half of her third rib. The biopsy revealed that the tumor was mediastinal b-cell lymphoma, and Kurt got the answer to a question she had been asking for months.

“I should have been crying and freaking out, but I finally learned I had cancer, and it was a relief,” Kurt said. “It was a relief to be told this is what’s wrong with you and this is how we fix it.”

Comparing her X-rays, Kurt said the tumor had grown by a third in just two and a half weeks, which is normal as this type of cancer. The tumor starts in what is called the mediastinum, the area in the middle of the chest behind the breastbone.

According to the American Cancer Society, the tumor can become large enough to cause trouble breathing and even block the large vein that returns blood to the heart from the arms and head. The American Cancer Society states that this type of tumor occurs mostly in young women, and usually responds well to treatment.

Even though Kurt was partially relieved by the news, that relief didn’t curb the sadness, anxiety or fear that comes along with a cancer diagnosis. Kurt says she cried on many occasions over the following four days. She worried about losing her hair and getting sick from chemotherapy. She was worried she wouldn’t see a birthday in her late 20s. She says she had every worry that comes along with joining a club to which she never thought she’d belong.

After her biopsy, she started having trouble breathing, and it got to the point where she couldn’t lie flat anymore. She had to sleep sitting up or bent over because her tumor was pressing on her trachea. When she spoke, she had to pause every four words to breathe.

She eventually told herself she had to get back to reality, and by sheer willpower, she changed her entire thought process about her diagnosis. She went from thinking, “I can’t believe this happened to me” to “I can’t wait to get over this.”

Throughout the weeks of deciding a treatment plan, Kurt said all of her health care providers were positive because this type of cancer responds well to treatment.

“No one gave me the impression that the outcome wouldn’t be good,” she says. “I was sad about the situation, but I wasn’t afraid anymore.”

School of Nursing Director Kathleen Valentine held an impromptu pinning ceremony for Andrea Kurt in case she missed the ceremony due to chemotherapy.

School of Nursing Director Kathleen Valentine held an impromptu pinning ceremony for Andrea Kurt in case she missed the ceremony due to chemotherapy.
Image Credit: Andrea Kurt

Her professors were positive and supportive of her as well. One day, Kurt went with her parents to School of Nursing Director Kathleen Valentine’s office with some paperwork. The simple visit turned into a special moment neither Valentine nor Kurt would forget.

“We were talking about her next steps, and how this treatment was going to affect her employment,” Valentine says. “She didn’t know when she would have to start her chemo, or if she could come to the pinning ceremony or graduation. I said, ‘Let’s do the pinning now.’”

Valentine gave her own white coat to Kurt and attached the nursing pin to her lapel. The pinning ceremony is a special tradition within a nursing major’s collegiate experience in which they receive the nursing academic pin, and Kurt said she was grateful to not miss it.

“It was a bittersweet moment for me. I was very upset I might be losing the chance to participate in such an important ceremony, but I was really honored that Dr. Valentine would take the time to do something so special for me,” Kurt says.

Looking to the future

According to doctors, Kurt had a 93 percent chance of remission with chemotherapy. Of course, she was happy with that number, but there were still uncertainties that caused her stress.

Kurt said she was advised to freeze her eggs in case the cancer treatment rendered her unable to have children. But, because of the speed at which the tumor was growing, this wasn’t an option, and the week before graduation she began chemo.

Assessing her potential to have children would be something to do in the future after her chemotherapy treatment. But the thought of not being able to have children doesn’t scare her.

“At least I’m going to live,” Kurt says. “I could always use an egg donor or adopt kids, but I can’t bring myself back from the dead.”

She was happy to graduate and start chemotherapy, but she to reconcile herself to anger. Even a month after graduation and a couple of chemotherapy treatments, she was still angry. She thought cancer shouldn’t have happened to her.

“It’s derailed my life,” Kurt says. “But then I think about the patients I’ve treated who have been in worse situations, and I think to myself, ‘If they can do it, I can do it.’ In five years, this will all be a bad dream.”

Kurt had decided to become a nurse after volunteering at a local hospital in high school. She thought the nurses’ jobs were significantly more active and interesting than the doctors’ jobs. Her experience with cancer has caused her to realize that she was pursuing the profession for the wrong reason, and she says she has now red-dedicated herself to the nursing.

While undergoing chemotherapy treatments, Andrea Kurt got the news that she passed the NCLEX exam.

While undergoing chemotherapy treatments, Andrea Kurt got the news that she passed the NCLEX exam.
Image Credit: Andrea Kurt

Now that Kurt has been a patient, she says it’s much easier to empathize with her patients, and she now realizes how important empathy is in her profession. Kurt says her loss of connection with her patients was caused by burnout from school and work, but now she doesn’t think that will be the case.

“This has been such a humbling experience for me because I’ve been bedridden and so sick,” Kurt says. “I know that going forward, there will be nothing at work that can truly frustrate me. I’m just happy to be alive. I feel revitalized, and my experience has changed the way I look at people.”

Her dad, Tom Kurt, saw this change in his daughter as well, and said he was proud of the way she handled the diagnosis and treatment of her cancer and how she showed dignity and grace in the face of extreme adversity.

She could have done the bare minimum during treatment, but friends saw her do the opposite. Kurt’s friend, Kelsey Costa, says she admired her for studying for–and passing– the National Council Licensure Examination for nurses while undergoing chemotherapy in Charleston.

Kurt’s strength during the uncertain times before and after her diagnosis also inspired Valentine, the School of Nursing director, who admits that the uncertainty that Kurt faced was scary for her and the rest of the School of Nursing faculty.

“I was inspired by her strength and courage and by the love and support her family showed her,” Valentine said. “Andrea is committed to a career in nursing and has gone above and beyond to prepare for it despite adversity. She deserves this future.”

Kurt has a job at Trident Medical Center in Charleston, where she has begun her career as an emergency room nurse this month.

“I have the opportunity to take care of other people, which has helped me cope through my pain,” Kurt said. “I know I picked the right thing to do.”