<p>The feelings of helplessness kept bubbling up.</p>
<p>Alissa Smiley was a brand new mom, having given birth to her son Henrik just months earlier. The 21-year-old should have be reveling in the chaos of motherhood, connecting with her infant and doing all of the feeding, playing and bonding that she dreamed about.</p>
<p>Instead, she could only watch others take care of her child, as she recovered from surgery to remove malignant melanoma from her ear and neck.</p>
<p>"When you have a baby that young, you lose those very first moments. You don’t get to watch your baby grow up like you want to," she said.</p>[sc:text-divider text-divider-title="Story continues below gallery" ]Click here to purchase photos from this gallery
<p>Recovery from her surgery took months, and Smiley is still undergoing immunotherapy. But she is back on her feet and caring for Henrik, and appears to be cancer-free. The experience has been a difficult one for the Edinburgh resident, not only because of going through cancer treatment at a young age, but for it to have come at a time that’s normally so joyous.</p>
<p>She has learned to simply go slow and think about the present.</p>
<p>"There’s no way to prepare yourself at all. It’s just one day at a time," she said. "You have to think about your baby, you have to think about the people around you."</p>
<p>Henrik was only three months old when Smiley was diagnosed with malignant melanoma. She had a mole on her left ear that had grown to the size of a quarter, likely as a result of her hormones changing during pregnancy. Tests in mid-January showed that it was a Stage 3 melanoma.</p>
<p>For a young mother, hearing the word "cancer" was catastrophic.</p>
<p>"I had a baby to think about, the rest of my career to think about. It was a very hard thing to deal with," she said.</p>
<p>Dr. Pablo Bedano, a medical oncologist for Community Cancer Center South, was her doctor. He recommended a multi-pronged approach to treating the cancer.</p>
<p>Surgery into her ear, neck and shoulder would take out all cancerous tissue that had spread from the mole. The operation to remove the cancer had lasted more than six hours, as surgeons worked to carefully remove cancer from muscle and tissue in her neck.</p>
<p>Her medical team had to remove the muscle from the left side of her neck as well as 36 lymph nodes taken from her neck, with another 12 lymph nodes taken from her ear.</p>
<p>The ear was in such disarray that surgeons had to reconstruct it.</p>
<p>Because she couldn’t lift or carry anything — her left arm was so weak and numb she could barely feel it — her mother and husband, Zachary, did all of the care for Henrik.</p>
<p>Following the surgery, Smiley was subjected to 20 sessions of radiation, five days each week for four weeks.</p>
<p>Bedano also wanted Smiley to take precautions against the melanoma recurring.</p>
<p>“Because of how quickly it had grown in that area, the surgeon felt there was a very high risk that the melanoma could come back, even if you took it out,” he said. “What our concern was to start a systemic treatment to prevent it from coming back.”</p>
<p>The suggestion was to start immunotherapy. The treatment would comprise of medications to super-charge her own immune system to recognize and attack any cancer cells that were left.</p>
<p>In recent years, immunotherapy has become much more effective in treating cancer such as melanoma. Immune therapies in the past were very harsh, activating the immune system in a very wide-ranging way, Bedano said.</p>
<p>“It wasn’t just activated against the melanoma. It made people feel like they had the flu all the time,” he said.</p>
<p>People were hesitant to go entirely through the recommended treatment. Response rates against recurrence were very low, close to 10 percent, Bedano said.</p>
<p>But new advancements in immunotherapy has honed the technique, which allowed it to be used early on in treatment to ensure the cancer does not return. Medications removes a protein from melanoma cells that normally hides the cancer from the immune system, Bedano said.</p>
<p>“That allows the immune system to identify them as an enemy, then attack them and remove them,” he said.</p>
<p>Response rates have improved to nearly 60 percent, Bedano said.</p>
<p>Every three weeks, Smiley goes to the cancer center and sits through treatment for one hour. The process leaves her extremely fatigued and tired, a challenge while trying to balance caring for her son and working at her job with the Bureau of Motor Vehicles.</p>
<p>"You don’t have as much energy as I used to. It slows you down while going through all of that," she said.</p>
<p>Prior to the second session, the medication she was on reacted horribly with her body, resulting in collapsed lungs. She actually stopped breathing briefly.</p>
<p>"They had to reverse the medicine back out of my body. So ever since then, they’ve given me pre-medications in the beginning. I wanted to quit, I didn’t want to do it anymore. But you have to think about your family," she said.</p>
<p>Smiley has also gone through physical therapy to restore the muscles in her neck, shoulder and arm on her left side. Surgery had damaged the function of that side of her body, so she’s been going to regular sessions to built it back up.</p>
<p>"It was like I didn’t even have an arm — I was numb from the shoulder to my neck," she said.</p>
<p>Smiley will continue to do immunotherapy for the next year, unless scans reveal the cancer has reappeared. To this point, the cancer has been kept under control.</p>
<p>She and her family are still dealing with the financial repercussions of her ongoing treatment. Her surgery alone cost more than $22,000, and insurance has covered much less than she and Zachary had anticipated.</p>
<p>They’ve worked with a nurse navigator at Community Health Network to get financial help if they need, and that’s been incredibly useful.</p>
<p>"With something that serious, life-threatening, you’d think insurance would do more. But it’s still very, very pricey," she said.</p>
<p>As she has become more familiar with the routines of being a cancer survivor, Smiley has been able to slow down and enjoy parts of motherhood that she had missed up to this point.</p>
<p>She, Zachary and Henrik are building a house in Franklin, which they’ll move into later this month.</p>
<p>"Being a new mom, you have to think not only about yourself, but about everyone around you, including your child. I always will say that he’s the baby that came to me and saved me," she said.</p>[sc:pullout-title pullout-title="The Smiley File" ][sc:pullout-text-begin]<p>Alissa Smiley</p>
<p>Age: 21</p>
<p>Diagnosis: Stage 3 melanoma on her ear; 48 lymph nodes with cancer</p>
<p>Treatment: Surgery to remove the cancer and the infected lymph nodes; immunotherapy to help prevent the cancer from returning.</p>[sc:pullout-text-end][sc:pullout-title pullout-title="At a glance" ][sc:pullout-text-begin]<p>What has cancer taught you?</p>
<p>Make sure you talk to people if you need to talk. If you have something you’re worried about, the doctors are always there to help you with it.</p>
<p>How has cancer changed you?</p>
<p>I realized I had a responsibility to follow through on this treatment. I couldn’t just think about myself. I had to think about everyone around me, including my baby.</p>
<p>What would you tell someone just diagnosed?</p>
<p>You have to take it one day at a time. You have to think about what’s going on, and you have to think positively. You can’t give up on yourself.</p>[sc:pullout-text-end]
