INDIANAPOLIS — For most high school students, taking a chemistry final is hard enough. For Hope Banghart, it was even harder. While her classmates at Plymouth High School took their test in a classroom, Hope took hers at Riley Hospital for Children at Indiana University Health while receiving a bone marrow transplant.
Hope aced both.
It's a feat worthy of Hazel, the teen heroine with stage 4 thyroid cancer at the heart of John Green's best-selling novel, The Fault in Our Stars. The movie adaptation opens Friday.
The book — and now the movie — provide a look at the world of teens with cancer. They recount a budding romance between Hazel and Augustus, a boy who lost a leg to osteosarcoma, whom she meets in a cancer support group.
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Green deftly captures the emotions of a young adult whose world is turned upside down by cancer, Hope said.
"If anyone wants to know what a cancer kid feels like, this would be the perfect book to read," Hope said.
No age is a good age to weather a cancer diagnosis. But adolescents and young adults, poised on the brink of their own lives, face more challenges than others. Younger patients enjoy a little more oblivion; older ones perhaps a little more perspective.
"They have more life experiences than our younger patients. They're dealing with a lot of physical and emotional changes that they're going through, so in a sense it does make things a little more challenging to really deal with patients that are that age," said David Delgado, clinical director of pediatric stem cell transplant at Riley.
Cancer snuck up on Hope, now 17. As the summer of 2012 began, Hope reported being tired and worn out. At first, her mother Debbie chalked up it to the heat.
Then one night when Hope had chest pain and couldn't breathe, her mother rushed her to the hospital. Tests showed Hope's white blood cell counts were far from normal.
Doctors quickly sent them to Riley in an ambulance. By the time they arrived, the Riley experts knew Hope had leukemia.
Further tests showed Hope had acute myelogenous leukemia, or AML. Doctors began treatment almost immediately, starting Hope on the first of three rounds of chemotherapy.
At first, Hope felt too sick to comprehend what had happened. But once she realized that her life for the next year had turned upside down, her first thought was about show choir, not disease.
"Everyone laughed at the hospital because when I found this was going to be long term, I was more upset about the fact I wasn't going to be at school than about the fact that I had cancer," she said.
A reaction like this is common among young cancer patients, said Stacey Downing, an inpatient social worker for pediatric hematology/oncology at Riley.
School and its extracurricular activities represent normal life for teens; deviating from that is devastating.
"That changes completely in the course of having a cancer diagnosis," she said. "There's that feeling of loss of getting to do what every teenager gets to do."
By the end of Hope's first round of chemotherapy, she was in remission from the cancer, meaning no evidence of it remained in her body. But her doctors knew they had to stay one step ahead of the disease. Originally doctors told Hope and her family she had a 20% to 30% chance of survival, her mother said.
But her sister Christine, now 20, turned out to be a perfect match for a bone marrow transplant. In November 2012, Hope underwent the transplant. Because Hope's white blood cells were destroyed as part of the transplant procedure, for the next several months, she had limited contact with large groups of people and could not go out in public without a mask.
Toward the end of the year, Hope picked up The Fault in Our Stars. She couldn't put it down.
"My mom kept telling me to stop smiling when I was reading it," she said. "A lot of stuff they talk about is extremely accurate to how a bunch of cancer kids feel."
For instance, Hope admits she enjoys "cancer perks." In Green's tale, such perks include things such as balls signed by sports heroes or excuses not to finish one's homework. In Hope's life, such perks allowed her to take a shortcut to get to a certain area at her school.
The book also captures exquisitely what it means to be a teen with cancer, Hope said. She quotes the oft-repeated line that the world is not a wish-granting factory.
"It kind of brings reality to other people, and it kind of helps people see things as you see things," she said.
While Hope maintained an upbeat attitude for most of her treatment, the isolation periods were difficult. During these times, she rarely saw her younger brother, Joshua, now 6, and craved human interaction.
Not all teen cancer patients are as resilient. In Green's book, a close friend of the two main characters loses an eye to his cancer and his girlfriend as a result. Although he is cured, he is blind and bitter. But the two main characters charm readers with their snark and wisdom.
Often adolescents who survive cancer wind up wise beyond their years, Downing said.
"There's a certain level of maturity with a lot of our teenagers," she said. "Unfortunately our teenagers tend to grow up a little faster, and they tend to have a better appreciation for their life once they do finish treatment."
Hope, who plans to see the movie the day it opens, will bring a special perspective.
"I don't look at my experience of going through cancer as a negative thing," she said. "It didn't really bring as many negatives as it did positives. Yeah, cancer sucks, but with the experience that I got from it, it was worth it."