Mark Cantrell

When Mary Colasuonno, B.S.N., RN, BMTCN, set her first career goal, it was about as far from nursing as it could be: She wanted to be a commercial artist. In her senior year of high school, one of her paintings won a contest sponsored by the 

, and it appeared on the front page of the newspaper. That led to a number of offers to attend local art schools. But Colasuonno felt that in order to succeed at an art career, she needed to be in a place with a vibrant art scene. So at age 20, she boarded a Greyhound bus to California.

But instead of the land of opportunity, California seemed to be the land of struggling artists. Sleeping on her aunt’s couch helped her financially, but she needed a source of income. So she took a job at JCPenney. While she was working there, Colasuonno began to think about her mother’s dream of being a nurse. But her mom had to drop out of high school to help her single mother provide for the family. Perhaps, Colasuonno thought, she could pick up that dream where her mother had left off.

She enrolled at Citrus College in Glendora to work on a nursing degree and started working at Methodist Hospital in Arcadia as a courier. She applied for a position in the surgery department and was offered a job as a surgical assistant. In 1987, she was laid off from that job but immediately took another as an anesthesia technician while still attending college, eventually attaining her associate’s degree in nursing and setting her sights on becoming an RN. Citrus College didn’t offer that program, so Colasuonno moved to Pasadena City College, from which she graduated in 1989.

“But my very last clinical was at City of Hope, where I worked with cancer patients. And I just fell in love with the patients there,” she says. “Working in surgery, I didn’t really get to know them, but in oncology, you get to sit and talk with patients and provide an ear when they need to talk to someone about what they’re going through.”

Before long Colasuonno was working at City of Hope in Duarte as an interim practice nurse, helping patients with aggressive breast, bone marrow, testicular and other cancers. When the hospital opened a bone marrow oncology unit in 1991, she worked there as a bedside and charge nurse for the next 10 years, earning her oncology nursing certification in 1993.

But working full time while raising three boys was taking its toll, and in 2001 Colasuonno left her job to become a stay-at-home mom. With her innate desire to help others, she was anything but idle, volunteering at her church and her boys’ schools. But gradually, she began to miss clinical life.

“Even though I was extremely busy as a stay-at-home mother, I wasn’t getting the mental stimulation you have when you’re working as a nurse,” she remembers. When she finally picked up the phone and called City of Hope, the first person she reached was her former interim manager, and soon Colasuonno was back in the career she loves.

“Because I hadn’t been there for (more than 7) years, I asked to be put with a group of newly graduated residents,” she says. “They really impressed me with how smart they were, and it became apparent that there were things I didn’t know that I felt I should. So at 50 years of age, I decided to go back to school for my bachelor’s degree.”

Colasuonno notes that although nurses often assume the role of teacher, it’s a two-way street — their patients often educate and inspire them as well. One of her patients had been so sick as a child that her parents thought she had died, but she told Colasuonno that she knew it wasn’t her time yet. After her ordeal, she felt every day was a blessing and was no longer afraid to die.

“She’s not the only patient with those kinds of stories,” Colasuonno says. “Moments like that with my patients really make me feel I was meant to be a nurse.”

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When Mary Colasuonno, B.S.N., RN, BMTCN, set her first career goal, it was about as far from nursing as it could be: She wanted to be a commercial artist.

An Oncology Nurse Who Changed Her Dream

Many nurses who choose oncology as a career have had cancer or had a relative or friend with the disease. Kerry O’Neil, B.S.N., RN, OCN, took a more circuitous route. 

After graduating from Fitchburg State University in Massachusetts, her roommate’s mother invited her to come to California for a visit, so O’Neil and five of her friends headed west. The mother lived in a one-room apartment, so the girls were dispersed to neighbors’ homes.

The neighbor O’Neil was staying with encouraged her to explore career options, saying she could stay as long as she liked. She’d become interested in nursing while in Massachusetts, so she took her nursing boards and signed up at Hoag Hospital, a local community facility in Newport Beach. There were quite a few nurses with associate degrees at the time, but not that many with bachelor’s degrees. 

O’Neil remembers: “California was kind of desperate for nurses with a bachelor’s degree, so they asked me where I wanted to work. That caught me off guard because it’s not a question many new grads are asked.”

O’Neil’s most difficult class in college had been oncology, and although she’d passed the final, she realized she didn’t really understand all she’d been taught. “So I thought, ‘Well, I’m a new grad and I’m supposed to be learning,’ so I asked them to put me on the oncology floor. I ended up with amazing preceptors who took me under their wing and taught me everything they could. And they were very nurturing and so supportive,” she says.

After a few years after O’Neil started working as an inpatient nurse, cancer treatment had started to migrate to outpatient clinics. So O’Neil moved to the outpatient world and worked in a community clinic. Two years ago, City of Hope opened a clinic in Newport Beach, and oncology patients no longer needed to drive all the way to Los Angeles for their treatments. O’Neil applied to be an oncology infusion nurse at the new facility, and the center countered with an offer for a supervisory position. She accepted with one condition: that she could still continue to do patient care.

“Generally, when you get into a management position, you’re no longer working in the clinical arena,” O’Neil says. “I’m a little unusual in that I still give patients their chemotherapy, have relationships with them, and I’m still on the floor with the other nurses. I like having that patient interaction; I don’t think I could do it if I didn’t have that, because that’s where my heart is — it’s why I got into nursing in the first place.”

When City of Hope added another clinic, O’Neil became nurse manager for both. “I’m in charge of all the nurses and clinical staff within the two centers, which is quite a bit of responsibility,” she notes. Another challenge is the speed at which technology is changing the field of oncology. But O’Neil got into the specialty because of the opportunity to learn all that it offered, and she still enjoys the challenge.

“You’re learning so much every single day, and there are always so many new things coming down the pike,” she says. “Oncology nurses have been able to see those changes and how it affects their patients. It means we have to stay on top of our game all the time.” One role O’Neil particularly enjoys is that of patient educator, especially to patients with a new diagnosis. Anyone who has received a cancer diagnosis is naturally in shock, and it’s crucial to have someone there to explain things. “You let them know why they’ve been given certain medications and how they work,” O’Neil says. “Much of a patient’s anxiety can be alleviated just by letting them know what’s going to happen to them.”

That education often pays off when patients begin treatment. “The first treatment is always stressful.” O’Neil says. “But it’s so nice when they come back for the second one saying, ‘Oh, it wasn’t as bad as I thought it would be. I took the medication as you told me to, and it made things better.’”

An interview with Kerry O’Neil, B.S.N., RN, OCN, finalist for the 2023 Extraordinary Healer® award. 

Every Day, She Helps Make Things Better for Patients With Cancer

Abbey Kaler, M.S., APRN, FNP-C, CMSRN (left), touched the lives of many patients with cancer, including Alex Frenzel (right).

Most 9-year-old children are innocent and carefree, with the challenges and travails of adulthood still far ahead of them. But for Abbey Kaler, M.S., APRN, FNP-C, CMSRN, that wasn’t the case. When she began vomiting and having headaches, her parents became worried, and when she fainted and woke up with tunnel vision, her mother rushed her to the emergency department. There she received a diagnosis of juvenile pilocytic astrocytoma, a rare childhood brain tumor.

After surgery to remove the benign tumor, Kaler spent two weeks in recovery and then was referred to The University of Texas MD Anderson Children’s Cancer Hospital in Houston to monitor her health to make sure the growth didn’t return. Although she didn’t know it at the time, the experience would guide her career path as an adult. 

In fifth grade, “I had to complete a science fair project. I chose to learn more about the anatomy of the brain,” she remembers. “The science fair project helped me to understand in my own way about the diagnosis and my new reality.”

Remembering how caring and helpful the nurses at MD Anderson had been, Kaler decided she wanted to be a healer as well. She earned a Bachelor’s of Science in nursing at Baptist Health Sciences University in Memphis, Tennessee, then returned to MD Anderson as a clinical nurse on a general internal medicine and telemetry unit, where she worked with patients in phase 1 clinical trials.

“That was my goal,” she says, “to return to the institution that had cared for me and my family at such a vulnerable time. I wanted to provide the same level of care in my work that was shown to us.” 

As a bedside nurse on the telemetry floor for five years, Kaler honed her skills working with patients at the most vulnerable time in their lives, just as nurses had cared for her. It also was where she realized the importance of patient education. 

“I believe that knowledge is power,” she says. “Working with patients to teach them and help them understand more about their unique situation is truly a highlight of my career.”

Kaler returned to school to earn a master’s degree and family nurse practitioner (FNP) certification in 2015. In her last semester of the master’s degree program, she completed a practicum in the Nellie B. Connally Breast Center at MD Anderson and immediately knew she’d found her niche. 

“I fit well with the team of physicians, nurse practitioners, pharmacists and nurses,” she says. “The Advanced Breast Cancer (ABC) program was hiring for the role of APRN (advanced registered nurse practitioner) navigator about the time I graduated with my master’s degree and FNP certification.” She was offered the job and immediately accepted it, a position she still holds.

But Kaler had a desire for further education. She is in her second year of a doctorate program, while still working full time at the MD Andersen ABC program. She has written a paper to define patient voice in the metastatic cancer population. It describes how it can be incorporated into a patient’s overall care plan to improve patients’ experiences in treatment.

But her true calling is still one-on-one patient care. “I love being an APRN navigator!” Kaler says. “I love talking with my patients and helping to educate them on their current situation. I enjoy being part of their support structure and creating a relationship – knowing I’m part of their team and will always be there to support them.”

An interview with Abbey Kaler, M.S., APRN, FNP-C, CMSRN, winner of the 2023 Extraordinary Healer® award. 

An Oncology Nurse Who Is Part of a Patient's Team

Until the 1990s, there was no such thing as crowdfunding. Financially compromised patients with cancer relied on help from friends and relatives, bake sales, art and craft fairs, garage sales and other in-person events to raise money for their treatments.

But in 2010, GoFundMe was established and is now the largest crowdfunding platform in the world. It changed the way many patients with cancer raise funds for their care.

One reason so many patients resort to crowdfunding is the 

, says Dr. Benjamin N. Breyer, chief of urology at Zuckerberg San Francisco General Hospital and Trauma Center, who co-authored a 2019 study of crowdfunding for cancer care.

There are really innovative and groundbreaking technologies here in the United States,” notes Breyer. “Those surgical techniques and advanced medical care can lead to prolonging the life of or even curing cancer patients.”

And it’s not just the uninsured who are affected, according to Dr. Andrew J. Cohen. “Even when patients have insurance, there are co-pays and coinsurance fees that need to be covered,” says Cohen, director of trauma and reconstructive urologic surgery at Johns Hopkins Medicine in Baltimore and lead author of the 2019 study.

“Here at Johns Hopkins, we see patients from all over the country with rare cancers,” he explains. “To come here, they have travel expenses, hotel fees, child care expenses, and have to deal with the time taken off work.”

Cohen reveals that many patients who turn to crowdfunding have already tried every other avenue of fundraising and have reached the limit of their energy and resources.

“These are individuals who are at the end of their rope, facing the toughest challenge of their lives,” he says. “Some have had to sell their possessions and declare bankruptcy. Others have eliminated all leisure activity, and still others have had to cut back on food purchases.”

The need for crowdfunding, Cohen notes, is a commentary on society and how the public takes care of those who are ill.

“The fact that people have to go this route tells me we’re not doing as good a job as we could be — it really puts an asterisk on our current health care system.”

“Contributions come from a somewhat limited pool, and people can only give so much, so campaigns really end up jostling for attention,” he explains. “But one of the great aspects of it is that a site like GoFundMe is massive, so you get to tap into a very large pool of people who can potentially help you.

“Those who are technologically literate, who are in tune with social media and who have large social networks are more likely to reach their goals. Unfortunately, sometimes we Americans have trouble asking for help.”

That was the case for Susel Gonzalez, a 46-year-old elementary schoolteacher from Austin, Texas, who never imagined she’d have to ask anyone for financial assistance. Although she chose teaching rather than one of the more lucrative careers selected by her college classmates, it paid the bills and helped her feel she was making a difference.

Susel Gonzalez recalls how she felt so overwhelmed after receiving her cancer diagnosis and broke down in her living room. She remembers thinking, "I can’t do this alone. I’m going to need help."

But in January 2022, she began feeling so exhausted that she made a doctor’s appointment and learned she had a massive paraesophageal hiatal hernia — which is when the upper part of the stomach protrudes through an opening in the diaphragm into the chest — that was causing esophageal bleeding. Gonzalez needed three blood transfusions to restore her hemoglobin level and underwent a hernia repair procedure in April.

But that wasn’t the end of it. During a physical before her surgery, Gonzalez told her internist that she’d had painful menstrual cramps for years, so she was referred to a gynecologist specializing in pelvic pain. The doctor prescribed tests to check for pelvic dysfunction, including a pap smear and ultrasound. She also ordered an endometrial biopsy.

When the test results came in, Gonzalez learned she had endometrial cancer. “If it hadn’t been for the pain, they wouldn’t have found the cancer until it was too late,” she says.

With two upcoming surgeries to pay for in addition to post-surgical care, Gonzalez’s friends urged her to set up a crowdfunding campaign. Although she had donated to others’ campaigns, she resisted because the prospect of requesting money for herself was daunting.

“I felt very exposed, vulnerable and embarrassed,” she remembers. “It’s pretty terrifying because you’re a teacher, you’re educated, you’re supposed to be a productive member of society.”

But because of a number of factors beyond her control, such as the skyrocketing rent at her apartment complex and the cost of the special diet required in the lead-up to surgery, Gonzalez felt as if the walls were closing in. She recalls coming home on a Friday to no hot water in her apartment because of an unresponsive management company, only to find another stack of bills in the mail.

“I just felt so overwhelmed and I broke down in my living room. I remember thinking, ‘I can’t do this alone. I’m going to need help,’” she says.

Her friends and co-workers immediately rallied. Her best friend, knowing she was reluctant to ask others for money, reminded Gonzalez of the donations she had made in the past. “She asked me if I thought less of the people who’d reached out for help,” says Gonzalez.

The last thing someone newly diagnosed with cancer needs is 

, but Gonzalez said she found the campaign setup process relatively straightforward.

“I had to upload a photo, and I was still feeling guilty about it, so I thought, ‘If you’re going to go full grifter, put up a cute photo of you and the dog,’” she says. “Then I wrote up my story and uploaded it. I had to prove my identity by uploading a picture of my driver’s license and give them a bank statement to prove it was my account. It was actually surprisingly simple to set up.”

Leslie Hughes also found the process easy when creating a campaign for her 30-year-old photographer boyfriend Elliott Howell. The 34-year-old writer met Howell four years ago when she, as Howell puts it, “slid into my DMs.”

Hughes said they met in person and then connected on Instagram, which was “so millennial of us.” She recalls picking Howell up at the airport when he returned from a five-day trip on March 13 only to awaken to him having a seizure around midnight. “It was absolutely terrifying,” she recalls. “I didn’t really understand what was going on.”

At UCLA Health’s emergency department, a scan showed a tumor in Howell’s brain, but doctors believed it was benign. When the couple were referred to a surgeon a week and a half later, however, they learned it was anything but. “He said that from the scans, it looked like stage 3 cancer, and he wanted to get Elliott into surgery as soon as possible,” says Hughes.

Younger patients face a unique set of challenges after a cancer diagnosis, says Lauren Ghazal, a research fellow at the University of Michigan School of Nursing’s Department of Systems, Populations and Leadership. Ghazal, herself a cancer survivor, led a 2022 study of young patients with cancer to determine their perceptions of medical crowdfunding.

Lauren Ghazal, a cancer survivor, led a study on crowdfunding.

“We looked at young adults 20 to 39 years old,” she says. “The good news is that due to treatment advances, young adult cancer survivors are living longer than ever before. But they also face unique hurdles and are burdened by those challenges.”

Their diagnoses come at a time of milestones such as completing their education, living on their own, establishing employment and romantic relationships and sometimes starting a family, Ghazal explains. A cancer diagnosis short-circuits that process.

“It creates a pretty big financial shock to your quality of life and then you have to struggle through our complicated health care system,” she notes.

As with most patients who turn to crowdfunding, younger people are often averse to asking for help. Perhaps they’ve recently moved out of their parents’ house, are finally on their own and are looking forward to taking care of their own affairs.

“You’re trying to be financially independent but then you get sick and have to lean on others for help. Our study showed that there are huge psychological implications in having to ask others for money,” Ghazal says.

Hughes explains how she has experienced what Ghazal was referring to.

“I hate asking for money,” she says. “It makes me uncomfortable. I don’t even ask my parents for money, let alone friends or strangers. It felt really weird for me, even though the GoFundMe campaign was on behalf of Elliott. But in the end, I realized we had to move forward because he needs the money to help him through this, and if other people can do it, so can we.”

Elliott Howell (right) and Leslie Hughes note that they were hesitant to turn to crowdfunding until they realized it was necessary to pay for Howell's cancer care.

The couple are fortunate to have an extensive friend network at home in Venice, California, and they made good use of it. One friend who knew someone who’d crowdfunded told them their original goal amount of $10,000 to $15,000 was way too low and suggested increasing it to at least $125,000.

Hughes put her travel writing on hold to care for Howell, but she put her writing experience to good use crafting Howell’s campaign. “At first I geared his story more toward friends,” she says, “but realized there would be donors who didn’t know Elliott, so I went further and told his whole story.”

Howell notes that he is grateful for all the help.

“Her skill set makes her very good at crafting the story,” he says. “I want to give her full credit for putting the story down and letting people follow along in my journey. And she’s been constantly updating it, which is something I probably wouldn’t be doing. My writing skills are terrible.”

Because wording is so crucial in telling a patient’s story, Hughes suggests retaining a writer if they’re unsure how to proceed. Patients may also look at other crowdfunding sites to get ideas on how others communicated their personal story.

Gonzalez highly recommends crowdfunding to anyone in financial distress from a cancer diagnosis and hopes telling her story will help those thinking of trying it. Although it may be difficult, Howell recommends trying to stay as positive as possible.

As he wrote in an Instagram post: “I’m setting my sights on the moon, the path we call life that is ahead of me, and whatever adventures, travels, friendships, and connections await. I hope that anyone reading this is moved to do the same.”

Many patients with cancer who have limited financial resources or high insurance co-pays have started to use crowdfunding campaigns to pay for the daunting bills associated with their treatment and subsequent care.

Mark Cantrell

An Oncology Nurse Who Changed Her Dream

Every Day, She Helps Make Things Better for Patients With Cancer

An Oncology Nurse Who Is Part of a Patient's Team

Desperate Measures Have Led Patients With Cancer to Turn to Crowdfunding to Raise Money for Necessary Care

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