After Hodgkin's disease turned her first three years of high school into a fight for life, Sara Shuckhart can finally focus on getting a life.

"This is a new year for me — a very new year," said Shuckhart. "I'm just trying to get everything back on track now."

Sara, an 18-year-old senior at Curtis High School in University Place, Wash., owes her fresh start — and a restored future — to the bone-marrow transplant she received from Fred Hutchinson Cancer Research Center at the Seattle Cancer Care Alliance (SCCA). The SCCA combines the patient-care strengths of Fred Hutchinson, University of Washington Medicine and Children's Hospital and Regional Medical Center.

"I always felt very, very confident in their treatment," said Maureen Shuckhart, Sara's mom. "One thing I appreciated is that they laid everything out for you. When you or someone in your family has cancer, it's a whole new world, so I really appreciated the education they gave us."

Sara's battle with Hodgkin's disease took several twists and turns. The last one was the most frightening. Just before her bone-marrow transplant, she and her family listened as doctors explained all of the possible complications. One of them was veno occlusive disease (VOD), a potentially fatal liver affliction.

With her older sister, Suzi Luna, as her donor, Sara received her transplant at the SCCA unit located Children's on Dec. 17, 2002. Shortly afterward, she developed VOD. When she heard that, Sara instantly flashed back to what doctors had said before her transplant. "I just bawled my eyes out because I thought it would be fatal," she recalled.

Hope came in the form of a clinical study involving a new drug called defibrotide. Knowing the threat VOD posed to Sara's life, Maureen and her husband, Robert, opted to enroll their daughter in the study. "No one in the family had any concerns regarding enrolling Sara in the study," said Maureen. "We were all very grateful that the doctors seemed to be doing everything possible to help her."

For the next four weeks, Sara received four intravenous doses of defibrotide per day. "After that," said Sara, "everything started going fine. The defibrotide pretty much saved my life."

Sara was a 15-year-old freshman at Curtis Junior High School when the first signs of Hodgkin's disease appeared in the fall of 2000. However, the disease escaped diagnosis for several months. "All of the symptoms were occurring, but we never put it together," said Sara.

One of two basic types of lymphoma, Hodgkin's disease is a cancer that develops in the lymphatic system, the part of the body's circulatory system that fights disease and infection. Looking back, Sara now knows why she was "sick in general all the time."

Hodgkin's disease also causes fatigue, which explains why Sara's role on her soccer team changed from "star forward to sitting on the bench." What finally led to her diagnosis was a large lump that appeared on her neck in February 2001. Later, the large lump turned into what felt like 10 or so smaller lumps. At first, Sara thought the lump was breaking apart and soon would disappear. In reality, the disease was causing more and more of her lymph nodes to swell.

That April Sara realized all of those lumps in her neck might mean something more serious, so she returned to her doctor. She was right. A chest x-ray and a biopsy revealed the truth — Sara had Hodgkin's disease. Sara's enduring memory of that moment is "mainly my mom standing there crying."

Sara immediately started chemotherapy. Not only was her chemotherapy quite tolerable — "I kind of just flew through it" — it was seemingly effective. By summer, her disease was in remission.

But the remission lasted only a year. Just three weeks after a checkup in June of 2002 showed she was still cancer-free, Sara felt something odd on the right side of her chest. Another checkup showed the cancer was back. A stunned Sara remembers thinking, "I was feeling fine. How could it grow that fast?"

Next came a more rigorous round of chemotherapy. Every three weeks she spent five days in the hospital receiving chemotherapy intravenously 24 hours a day. The treatment lasted about three months, but in the end, the cancer remained.

At first doctors recommended radiation treatment, but when Sara and her parents met with a radiologist, he suggested a bone-marrow transplant. Fred Hutchinson and the SCCA were the "logical choice" to provide the transplant."They were the experts in the field and located only a short distance from home," said Maureen.

Sara was hospitalized for 54 days. Besides battling VOD, she fought off pneumonia and sustained lasting lung damage from radiation treatment, which has forced her to shelve her soccer shoes. "My lungs won't ever be as strong as I would need them to be," she said.

Even so, Sara is grateful life is returning pretty much to normal after a post-transplant recovery period that curtailed many typical teen activities by forcing her to avoid large crowds for fear of infection. "I had to sit in the very back at movie theaters," she said.

These days, Sara divides her time between classes at Curtis High School and at Pierce Community College. Inspired in part by the care she received at the SCCA, she is considering becoming a nurse. "I thought it was the best care I could get," said Sara. "They always encouraged you to feel confident and to never give up."

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