Jana Batson was just 31 years old and had a 1-year-old daughter when she was diagnosed with nodular sclerosing Hodgkin lymphoma, a type of cancer that affects the lymph system, which helps the body fight infections.
In late 2022, Batson, a registered nurse, felt a strange, enlarged lymph node on her collarbone. She went in for blood tests, then an ultrasound, but her providers told her they were not concerned by the results of either test.
But Batson wasn't convinced. She opted to go to the emergency room at EvergreenHealth for a CT scan. It revealed a 10-centimeter mass in her chest. Batson was devastated.
“I was by myself when I found out, because I was there just to get peace of mind,” said Batson, who lives in Maple Valley, southeast of Seattle. “I was in complete shock and instantly thought of my daughter. My whole body was tensing up; they had to give me pain meds to calm me down. I was just so scared. It didn’t feel real.”
Batson was in top shape at the time, running daily, eating a healthy diet and “taking great care” of herself overall. She experienced no strange symptoms other than an enlarged lymph node. She was young and having a mass of this size just didn’t seem possible, she said.
An oncologist from Fred Hutch Cancer Center at EvergreenHealth called her that night and helped ease her mind. If it turned out to be lymphoma, the doctor said, it was a very treatable and often curable disease. The next steps were additional tests and a biopsy.
Hodgkin lymphoma is a blood cancer affecting lymphoid tissue (found in the lymph nodes among other places), which is responsible for producing lymphocytes and antibodies. Hodgkin lymphoma often affects young people between the ages of 15 and 35; the cause is unknown.
After receiving her official diagnosis, Batson’s care team recommended a four-drug chemotherapy regimen. Unfortunately, there was a slight risk that the treatment could impact her fertility.
Batson hoped to have more children, so potential infertility was a big concern for her.
She spoke to a fertility specialist and learned that preserving fertility by freezing her eggs required a month-long delay in treatment. Her doctors thought the small risk to her fertility was not worth delaying treatment, so she proceeded with the six-month chemotherapy course, which meant she had to stop breastfeeding her daughter.
After four infusions of the four-drug cocktail, 80% to 90% of patients usually go into remission and can drop one of the drugs, bleomycin. This was not the case for Batson. Although her PET scan showed a good response to chemotherapy, it was not enough to drop bleomycin.
After four additional infusions, Batson entered remission, but the drug caused inflammation and scarring in her lungs and made breathing more difficult.
Instead of continuing chemotherapy for the remaining four sessions, her doctors recommended radiation.
“I was terrified of radiation,” Batson said. “I was not in a good mental state about it. But my oncologist recommended proton therapy, and when I consulted with Dr. Yolanda Tseng about it, she was able to lessen my concerns.”
“Proton therapy has less exit radiation dose compared to photons,” Tseng said. “Because of this, we may be able to reduce the dose to the normal nearby tissues, decrease the risk of toxicity, and improve long-term outcomes for patients. Jana’s tumor was close to her heart. Using protons reduced the risk of future heart and lung damage, as well as secondary cancers. This is especially notable given her lung injury from the bleomycin chemotherapy.”
Tseng planned 15 proton therapy sessions aimed at the full area where Batson’s Hodgkin lymphoma had originally been located, ensuring any lingering cancer cells would be destroyed.
Although Batson suffered mild burns on her skin and some fatigue and pain when swallowing, proton therapy felt significantly easier on her body than chemotherapy, she said. And it improved her pulmonary (lung) function.
Batson finished treatment in May 2023 and has had follow-up scans at three months and a year. The scans have shown no growth, and her blood tests are all within normal ranges. She continues to see her oncologist.
“After my diagnosis, I lost trust in my body,” Batson said. “Lymphoma is not caused by bad habits; it’s bad luck. I had been taking really good care of myself and yet my body betrayed me. It took a while to get over that, especially after treatment, when I was no longer getting constant, intensive care from the team at Fred Hutch. It was a little bit scary.”
In addition to surviving the cancer, Batson was able to have another baby, a boy, who will soon be 9 months old. And despite having had radiation to her chest, she can breastfeed her son without problems.
These days, Batson is enjoying being a full-time mom and working part-time as a nurse at an elementary school. She tries to live in the moment and treasures her time with family, which has helped her heal emotionally.
Her advice for others?
Advocate for yourself. Bastson feels that if she hadn’t insisted on tests, she would have been diagnosed much later.
She also emphasizes the importance of taking care of your mental health. “Do therapy or have an outlet that makes you smile," she said. "Accept help to work through emotions, including during survivorship. Survivorship can also be hard.”
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