One of the small pleasures Emily Dao misses sharing with her Delta Zeta sorority sisters is painting her nails.
Link: Learn about Delta Zeta's relay team, "Down for Dao"
Since she started an aggressive chemotherapeutic regimen battling stage IV cancer, Emily can no longer enjoy the activity that helped take her mind off of a stressful 20-credit workload.
Now Emily sleeps 23 hours a day. She is so weak that flipping her phone open to answer a call or text messaging a friend takes exorbitant energy.
Even with Emily's fatigue, painting her nails is still out of the question. Her nails are so brittle from chemotherapy that they have started to flake off her fingertips.
"I GUESS MOST PATIENTS THAT ARE IN MY SITUATION DON'T DO ANYTHING AT ALL"
Emily is the victim of a cancer so rare in younger females that doctors she visited after concerns over abdominal pain didn't even consider the possibility. The 20-year-old junior accounting and finance major had to pull out of her classes last semester in order to return home to Fairfax to begin treatment for colon cancer. On Nov. 7, Emily was diagnosed and almost immediately underwent surgery to remove a growth five inches in diameter that had been trapping toxins inside her lower intestine. The surgeons successfully removed almost all of her colon and the largest masses but an initial PET scan noticed smaller tumors beginning to pop up in other parts of her body as well. Emily's team of oncologists offered her two suggestions. She could either be prescribed chemotherapeutic drugs that they assured her would devastate her body, or she could live the next 6-12 months peacefully.
Emily chose to keep fighting. She started her treatments in December.
Used as a strategy against cancerous growths, chemotherapy aims to inhibit the growth of fast developing cells, such as cancerous cells, according the National Cancer Institute. However, the drugs are largely indiscriminant. Treatments often dismantle proteins in skin cells, hair cells and nail cells.
During her bi-weekly visits to the doctor's office she receives drugs intravenously and then is sent home with a fanny pack that drips a melange of chemicals into her bloodstream over a two-day span. After these treatments, she sleeps without almost any interruption for five to seven days, depending upon the week.
"Chemo was a completely different scenario," Emily said in an interview a couple of weeks after her first treatments. "I did not think it was going to be that bad at all. It was really a lot worse than going through surgery. I thought that the surgery was bad, but chemo was a lot worse."
When she's awake, she suffers from side effects that include extreme pain and nausea, an intense sensitivity to cold and debilitating weakness. She still uses a 50mg time-release patch of Fentanyl, a high-potency pain reducer, and also takes 10mg Percocets every three to four hours, but soon she'll have to see a pain management specialist because the pain is becoming so intense. The pain medications help, but don't help her throat, which is so raw from the treatments that it's very difficult for her to talk on the phone or swallow water. The skin on her hands and feet is so dry it has started to slough off in layers, like after severe sunburn, and she's also developed dark spots on her face. She shivers even in warm spaces, and bundles up in sweatshirts and has a space heater in her room. She's lost 10 pounds off her thin frame because the nausea caused by her pain medications and chemotherapy makes her feel like vomiting at the thought of eating.
"I can't even hold a pencil or hold up food utensils to eat," Emily wrote in an e-mail. "I can't have anything that's cold, or else it'll feel like icicles forming down my throat and in my stomach."
Yet Emily can't be stopped. Ever the academic, she's enrolled in 12 credits of upper level finance and accounting classes through a "distance" learning opportunity. Her professors are allowing her to take their classes' exams and quizzes at times that accommodate her schedule and health.
On top of her rigorous chemotherapy schedule, and a full load of classes, she's taking part in a dream internship with Ernst &Young as a level one auditor.
"I'm currently on a huge client that they have -- Marriott International," Emily wrote. "It's a busy season right now, so I've been working overtime every week, but I love it."
Since beginning her internship in January, working in such a positive learning environment has helped Emily to keep her mind off cancer and more on her future career. But one February afternoon visit with her doctors would focus Emily's future into a narrowing perspective and bring her to tears.
"I THOUGHT I WOULDN'T MAKE IT ANYMORE"
Despite almost two months of chemotherapy, Emily's doctors have recently described sobering news to her and her family. A full-body PET scan in early February revealed her colon cancer had indeed metastasized to multiple locations, and showed the original tumors had only gotten larger.
"My doctor says that typically with younger patients, the cancer is much more aggressive and is less likely to respond to treatments." Emily wrote. "I didn't respond to my current chemotherapy at all. Instead, it's continuing to spread aggressively. It has already spread to my abdomen and around my pelvis. It also worsened in my liver and my colon. It is continuing to spread to other organs in my body as well if we don't get it under control as soon as possible."
Her doctors had originally scheduled further surgery to remove some of the masses, but, since her latest PET scan, have decided to postpone it until they develop a strategy to hinder her cancer's progress.
"I was extremely discouraged because the thought of these past two months of hell have been for nothing," Emily wrote. "I cried a lot because I thought I wouldn't make it anymore."
But her doctors have not run out of options. They have decided to adjust her chemotherapy treatments with a different mixture. New drugs mean new side effects, but perhaps also yet unseen success. Emily refuses to be distracted from her ultimate goal, though, even in front of the daunting repercussions she soon faces.
"I'm going to lose my hair, for one," Emily wrote. "My doctor is going to get me to go through a different kind of chemo treatment now. We're not sure if it's going to work, but we can only hope for the best."
And with the help of some very special people, Emily has kept her hopes up and spirits strong.
"I REALLY DO FEEL LIKE THE LUCKIEST GIRL IN THE WORLD"
Steven Chiang believes everything happens for a reason. Which is why instead of heading into Washington, D.C., to celebrate New Year's with some of his friends, he went over to the Dao family house with a bottle of sparkling apple cider, to clink glasses with the girl he calls "the bravest and most thoughtful" he's ever met.
"I just think things happen for a reason, like maybe the reason why I went through this," Chiang said. "To spend this part of time with her, because it's important to be there for her, so that she has a reason to live. I just see that as my purpose."
Chiang, 23, is Emily's boyfriend of a few months. They met through friends of friends, and began talking a year ago. Chiang, who recently graduated from George Mason as a double major in accounting and finance, is Emily's main caretaker. He drives her to the doctor's office for chemotherapy, wakes her up in the middle of the night to remind her of medication times, and supports her, "so that she's not alone and feeling like she's going through this by herself." Chiang said his favorite way to keep a smile on Emily's face is to joke around and keep her laughing.
"You know how some people when they are sick they are just like, 'Oh, you know I'm sick, how could this happen to me, what's the point in living like a real person,' you know, just depressed all day," Chiang said. "But she's not. She's actually really positive. She has a really strong will."
Along with caring for Emily, he is currently working full time as an accountant for a friend's father's international grocery chain. He's also studying for the LSAT he plans to take in June.
But his own efforts hardly match Emily's, he said. He's most impressed by her ability to take on cancer, an internship and 12 credits of classes.
"Honestly, it does hurt me because she had so much going for her, her school, her career, and she had all these dreams of going to law school, going to b-school to get her MBA," Chiang said. "It's like she's top of the class and then all this happens and it's preventing her from doing a lot."
Between Chiang and her sorority sisters, Emily's supporters are many.
"They told me that this is just another hurdle that I have to get through but that I'm strong and I'm going to get through this no matter what, and that they would be there for me, 110 percent," Emily wrote of her Delta Zeta sister's dedication to her situation. "That's really what is giving me the courage and hope to get through all of this. The day I heard about the bad news, I feel like all of my friends got in touch with me and gave me words of encouragement. I'm truly really thankful for all the friends I have in my life, and I really do feel like the luckiest girl in the world despite my illness."
She's also met a new acquaintance who has pumped an invigorating perspective in to her battle against cancer.
"IT'S TOUGH. IT'S NEVER EASY."
Erica Paul is a 2004 graduate of Northwood University in Michigan, a Delta Zeta sorority sister and about two years into chemotherapy treatments for stage IV colon cancer that has also mestastisized to multiple locations in her body. Paul first heard about Emily's situation by reading the Collegiate Times online. She and Emily met up a couple weeks ago while they both went in for similar chemotherapy sessions at their doctor's office in Fairfax.
Emily felt encouraged seeing a cancer patient so similar to herself doing so well.
"She looks great though, and you probably wouldn't be able to tell that she's sick," Emily wrote. "I really hope that I end up like her."
Paul thinks it's inevitable. She and Emily keep in touch through e-mail and whenever they run in to each other at the clinic.
"From talking to her, she just exudes hope, and she seems really strong, and even though she's a little thing, she seems really strong and has a strong will," Paul said. But, Paul admitted, stage IV cancer is not easily eradicated. "It's tough. It's never easy."
Paul described her own situation as that of a person with diabetes. She treats her cancer like a chronic disease that can be sustained, and lived with, so long as it's kept under control.
"Even though it's a late-stage cancer, people beat it," Paul said. "They go into remission and they live long lives without having to be on treatment or have evidence of cancer. And they come back, and that's just the reality of the disease."
Chiang said some days are better than others for Emily. While her condition has not necessarily gotten better, he knows anything can happen. He believes this new treatment may lead her to brighter horizons. He stands resolutely by Emily despite not knowing where Emily's cancer may take her.
"Maybe a miracle could happen and this new treatment could turn it around and her body would react to it and reduce all the tumors and stop the spreading," Chiang said. "But, honestly, you can't help but to think what could happen."
And Emily occasionally can't help it, either. Chiang said when they do discuss the future, it's a future together. Sometimes they talk about taking the LSAT together and maybe both heading to law school in a few years.
"I'm actually interviewing for a job out in San Francisco, but it actually won't start until January," Chiang said. "But she's like, 'Oh, my god, you're going to leave me; if you leave, I'm going to be sad,' but then sometimes she'll be like, 'Honestly, maybe it's better that you leave in case anything happens to me, at least you won't be as sad because you'll be in a different place, living your life.'"
But Chiang steadfastly focuses on keeping Emily's occasionally fragile outlook at bay: For Valentine's Day they spent the night in Atlantic City, letting the dice, and the chips, fall where they may.
"I'M STILL HANGING IN THERE"
Emily is continuing with her chemotherapy treatments. She's found inspiration through Erica Paul's success story and her boyfriend Steven Chiang's unselfish dedication. Though her doctor's plan of attack is evolving, she's still as game as ever, especially with the prospect of warmer weather and springtime in Blacksburg in her sights.
"Nothing makes me happier than being at Virginia Tech, and it's really the greatest school on Earth," Emily wrote. "No where else would I meet such great people that are so supportive and helpful."
Emily hopes to make it back to Tech for a benefit concert her sorority sisters are sponsoring in her honor scheduled for Friday, March 20, at the Lyric Theater featuring The Shack Band. A group of girls in her sorority have also formed a Relay for Life team, "Down for Dao," and are already fundraising in Emily's name.
The co-payments for Emily's chemotherapy treatments "are in the thousands, which is more than surgery," Emily wrote. She said working has helped make a dent in the cost and also said she is so proud of her sisters for helping to support her financially.
"I have so many people that care for me, and that is truly the most important thing to me," Emily wrote. "I wouldn't be able to get through all of this without my sisters, friends, faculty and all the other good-hearted people (random people that contact me because they've heard about my situation even though I don't know them; they do it just because they care so much) that have been giving me such strength and encouragement."