October 02, 2019
Leave it to an energetic, high-spirited college student to make chemotherapy fun.
That’s what Nicole Cummings did when she was diagnosed with lymphoma in September 2018. Her deliberate, upbeat attitude and optimistic outlook turned her treatment into a positive experience. The University of Missouri finance student then sought to recreate that positive experience for future patients – never imagining that one would be her own mother.
The cancer journey begins
The Cummings family’s whirlwind health journey began when Nicole, fatigued from intense studies and preparation for an upcoming “Tigers on Wall Street” leadership trip to New York City, uncharacteristically cut an evening short.
“It was one of the busiest weeks of my life,” she says. “I was at the library working on internship applications and studying for midterms. I had a quadruple big Starbucks in front of me, but I was still falling asleep. I decided to call it a night and walk back to my apartment. It was a short walk, but with my heavy backpack on, it seemed really long.”
At home, Nicole discovered a large lump on her neck. She FaceTimed her parents and heeded their advice by heading to the emergency room.
“I had never noticed this bump before, and now I felt like it was growing by the minute,” Nicole says. “I was always tired, but I was always go-go-going. I thought it was normal hustle and bustle causing the fatigue.”
After an ultrasound of the enlarged lymph node, a chest X-ray and bloodwork, Nicole was released to await the results. She woke the next morning to 6 missed phone calls from the ER staff and messages to return quickly for advanced imaging.
“And I was like, ‘Can I stop by the career fair and then squeeze in a quick CT scan before I go take my statistics exam?’” Nicole says. “My mom said, ‘No, Nicole. You need to make this your priority.’”
After the scan, 30 minutes passed, then an hour, and then 2 hours.
“That’s when I knew something was really wrong,” Nicole says.
A change in focus after lymphoma diagnosis
The attending physician told Nicole there was a mass in her chest. The pulmonology and hematology teams were beginning to develop a plan, but Nicole was advised to consider whether she wanted treatment in her college community in Columbia, Missouri, or at home in Kansas City. She and her parents decided to obtain her care at The University of Kansas Cancer Center, 1 of just 54 National Cancer Institute-designated comprehensive cancer centers in the nation. The Cummings family knew of its world-class reputation and thought Nicole would have more support close to home.
“I knew I wasn’t going to New York, wasn’t going on this trip I’d looked forward to for so long,” Nicole says. “I felt like I was letting people down. That’s when the tears came. My health was going to take priority. Whether I liked it or not, it was going to become my full focus. That was a lot to wrap my head around.”
Several of Nicole’s close friends went to her apartment and packed her suitcases. She traveled to Kansas City and went to The University of Kansas Cancer Center to confirm her diagnosis before beginning treatment.
The care team performed more bloodwork and a biopsy, ruling out various viruses and infections. Nicole and her parents met with hematologist/oncologist Marc Hoffmann, MD.
“We were still waiting for the pathology, but with his experience and vast knowledge, Dr. Hoffmann believed I most likely had Hodgkin lymphoma,” Nicole says.
She needed a pulmonary test, a cardiogram, port placement, a bone marrow biopsy and a PET scan. Dr. Hoffmann’s insight proved accurate, though Nicole was not at stage 2, as her spirits and energy level might have suggested, but at stage 4.
“That was a whirlwind,” she says. “Looking back, I had all of the signs. I easily dismissed symptoms that happen to lots of teenagers and college students. To think that it all happened so fast. If I hadn’t gone to the ER that night, where would I even be today?”
Sparking positivity as a lymphoma survivor
Today, Nicole is joyfully in remission. She has completed 6 rounds of chemotherapy and faces several more to continue reducing detectable cancer cells in her body. In keeping with her positive nature and entrepreneurial spirit, Nicole used the time spent in chemo constructively, launching an idea she hopes will make a difference for many following in her footsteps.
"I consciously decided to make my chemo a positive experience,” Nicole says. “We were always decorating the room, putting up streamers. As silly as that might sound, it made every difference in having a positive outlook. I had the mindset that I don’t ‘have’ to go to chemo. I ‘get’ to go to chemo. I’m going because I’m lucky to have access to this medicine. I know it’s weird to say chemo was fun, but it was, because I made it fun!"
Nicole wanted to help others find the positive spirit she believes was integral to her own outcome.
“I’ve had such overwhelming support and received a number of amazing and meaningful gifts,” she says. “One of those was a YETI cup. I use it every single day. It keeps my water cold. It keeps my teas hot. I always have it with me, and it’s just this little highlight in my day. I wanted to pay it forward and give someone else that little highlight.”
Nicole created CUREageous Cups, a project through which new cancer patients arrive to their first chemotherapy appointment to find the gift of a YETI cup of their own waiting for them.
“I just thought, how cool would it be if, when you go to your first chemo, and you’re on edge and nervous and scared, you could combat that with positivity?” Nicole says. “You look down, and you see this little gift in your chair, a gift you’re really going to use. It could change the whole experience and shift your mindset as you start on the biggest journey of your life.”
“Nicole’s attitude from the first day she came in was to hit the ground running,” says Dr. Hoffmann. “She was always asking me what extra things she could do, and even asked if she could do her usual intensive exercise program, which I thought was a little too much to do on chemo. But her whole demeanor and the fact that she’s starting CUREageous Cups is a testament to her altruism.”
With the help of her family and fundraising efforts and the partnership of The University of Kansas Cancer Center, Nicole distributed 500 CUREageous Cups in November and December in a pilot she called Cups for Christmas. Each cup is accompanied by a personal message of encouragement inspired by her own unexpected journey. Her motto for the project, and for the patients it serves, is “Live life like your cup, to the fullest!”
An unexpected turn
Nicole’s gratitude for the family and friends who supported her is without measure, and she was eager to pay it forward. But never did she anticipate one of the next patients in need would be her mother, Jamie.
For several months, Jamie hadn’t been feeling her best, but she didn’t push aggressively for test results, especially once Nicole’s diagnosis claimed her focus. Given her own experience, Nicole urged Jamie to be more proactive, to advocate for herself in getting answers to her health concerns. As Jamie pressed for imaging results and picked up the medical report, Nicole read findings that turned her world upside down again.
“I’d gotten world-devastating news and thought I’d just about come to terms with that, and then I read my mom’s report and saw ‘suspect leukemia or lymphoma,’” she says. “Reading that as a daughter was devastating. I had all this emotion that I hadn’t felt when it was my own diagnosis. It was much harder being on the other side and not able to do anything for her.”
But 1 thing Nicole could do was quickly schedule an appointment for Jamie with Dr. Hoffmann.
“I had prayed, if it’s cancer, give it to me. Let me have it so she doesn’t have to bear it,” says Jamie. “But there must have been some static in that line, because it turned out, we both had lymphoma.”
While Nicole had a fast-growing Hodgkin lymphoma, Jamie has a slow-growing form of non-Hodgkin lymphoma. Her disease is stage 4, having spread to her bone marrow, and she and her care team are currently determining the best course of treatment.
“To find out that Nicole was in remission was just the most amazing feeling, almost as good as when they put the beautiful gift of a beautiful girl in my arms the day she was born,” says Jamie. “We have always had a bond, and now there is this empathy for each other. We may not realize it all yet, but I think God’s plan was for us to be there for each other in this.”
Even in the face of her own disease, Jamie is most struck by love for her daughter and admiration for her determination to give back.
“Thinking of others increases your focus outside yourself,” says Jamie. “You don’t have control of cancer, but you still can’t let it control your life. I’m so proud of Nicole for her ability to come up with an idea and implement it. Cancer was in for a battle when it chose Nicole.”
Though Jamie’s fight is ongoing, the Cummings family and their care teams are facing it with optimism.
“Our goals are to cure the lymphoma and to leave the patient with as few long-term side effects as possible,” says Dr. Hoffmann. “Nicole and Jamie have been very aggressive about exercise interventions and dramatically changed their diets. I’m hopeful they’ll have good long-term outcomes because they have support and resources to be able to do it, and they have the right attitude about maintaining their health long term.”
To ask Nicole, attitude is everything. She feels called to help fellow cancer patients find the positive outlook her support system helped her embrace.
“I can’t emphasize enough what great people I am fortunate to have in my life,” she says. “I feel like I’m meant to learn so many lessons and do something that helps others. You can’t take life for granted. So many people suffer and are sad at times, and I wish they could just know how much they are loved.”
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