Wendy Girbach, Program Director, Adolescent and Young Adult Program Hi, I'm Wendy Girbach. I'm the program director of our Adolescent and Young Adult program here at UT MD Anderson. I'm here today with Hannah Kahn, who is a survivor of astrocytoma. And this is the Cancerwise podcast. Welcome, Hannah. Thanks for joining me. 

Hannah Kahn, Astrocytoma survivor Thank you for having me. I'm so excited to be here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program So, today on this episode we're going to talk about survivorship. And so, I would love to hear a little bit about your perspective as a survivor. Probably a good place to start is just tell me a little bit about your experience, diagnosis, whatever you want to include. 

Hannah Kahn, Astrocytoma survivor OK. Well, I'll start off of how grateful I am to be a patient at MD Anderson. I just love being here, and I was telling some family members earlier in the week that I just feel happy walking around the halls, and that's probably crazy for a cancer patient to say, but it's just more of like the comfort of feeling that I'm getting treated here, and just the comfort and relief of knowing that I'm in the best of good hands here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I love that! I mean, I think that's what the staff obviously tried to do, so I love that's been your experience. Do you feel like you're the only one probably walking the halls like that? 

Hannah Kahn, Astrocytoma survivor Probably, because I feel like I'm the youngest one walking around here, and I kind of like wearing the wristband to be like, I'm the patient. It's me. Not, not my parent. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah, I get it. OK, so let's start from the beginning. So, tell me a little bit about your diagnosis. How did you get to MD Anderson? What was your treatment like? 

Hannah Kahn, Astrocytoma survivor So, I'm a very open book, especially while I'm here too, talking about this. I'm a very active individual. I was one to never really get sick, especially the flu, fever. I never really was home from school growing up to be sick. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor So, it was February 9 when I got diagnosed, if I want to count that day as my true diagnosis day. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor It was a normal day. It was a Saturday. I ran 10 miles that morning. I was training for a half marathon in Atlanta. That's why I'm like so active too. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I was like, that's very active. Yes. 

Hannah Kahn, Astrocytoma survivor Ran my normal errands. Then my husband and I went to dinner with friends. That night around 12:30 on February 9, is when I had a seizure. Never had headaches or anything. I don't really remember like how I woke up. I just remember it was 12:30 at night. My husband goes, "You just had a seizure." I'm like, "What?" 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Wow. And you've never had one before? 

Hannah Kahn, Astrocytoma survivor No. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor I'm like, "What do you mean I had a seizure?" 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And then he's on the phone. He already called 911 at that point. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I'm sure he was so scared. 

Hannah Kahn, Astrocytoma survivor He was so scared. Also, we just got married two months prior to all that. So, like, let's talk about, like, in sickness and in health. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Right? 

Hannah Kahn, Astrocytoma survivor Like, really fast. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Like, the vows are coming into play here. Yeah. 

Hannah Kahn, Astrocytoma survivor Exactly. And he called my parents and my dad was like, "You're going to the hospital." Because I was just like, "I'm fine." Like, "I don't need to go." Because you're just kind of like, what just happened? And you don't even remember. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor That it happened. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I'm young, I'm healthy. I just ran 10 miles this morning. There's no way this is serious. 

Hannah Kahn, Astrocytoma survivor So, we went to the E.R. They ran a CT scan, an MRI scan, and this is all like two, three, 4 a.m. in the morning. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Then they call the on-call neurosurgeon. He comes in around 6 a.m. My parents are on speakerphone the whole time because they're here. I'm originally from Alabama. In 2019, my parents moved here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. 

Hannah Kahn, Astrocytoma survivor And luckily, the on-call neurosurgeon said, "You need surgery, but it's not emergency surgery." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. 

Hannah Kahn, Astrocytoma survivor "There's a mass in your head." I'm just like, "What?" 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Oh, yeah. 

Hannah Kahn, Astrocytoma survivor Also, I've never had surgery. I've never broken a bone. The worst I've ever done was I had to get stitches. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Wow. 

Hannah Kahn, Astrocytoma survivor So, I'm just like, what is going on? This is not me. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. It's like, surreal. 

Hannah Kahn, Astrocytoma survivor Yeah. So, after that, we were like, "Oh, do you have any other surgeons you recommend to get a second opinion?" He was like, "Absolutely." So, he made an appointment for us, like got us the first available, which was my birthday, February 11, on a Tuesday. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Ouch. Yeah. 

Hannah Kahn, Astrocytoma survivor So, I'm walking the halls in that hospital. I'm just like, "Never thought I would be seeing a neurosurgeon on my birthday." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program As like, much less right after your wedding, on your birthday as a young, healthy person. 

Hannah Kahn, Astrocytoma survivor Exactly. I'm just like, "What is going on?" So, we also had a appointment with that same on-call neurosurgeon that Thursday that we all knew deep down we were going to come here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. And good for you all for getting a second opinion, because a lot of people I think just get in this, "OK. We saw this doctor. We have to do this. We're moving forward." Instead of, "Let's look at the options. Let's just confirm what the best treatment plan is." And then in the end, you know, you got here. 

Hannah Kahn, Astrocytoma survivor So, I flew here on February 18th for four months. At that point, I did not know I was going to be here for that long. I remember my mom saying, "Pack clothes for springtime." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Wow. 

Hannah Kahn, Astrocytoma survivor You're also in winter. So, I'm like, "What?" 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. So, you just came here thinking, yeah. Like, I'll pack up, and I'll be there for a while. And so, then what other services or what? I guess chemo, radiation, like any other people you saw. 

Hannah Kahn, Astrocytoma survivor So, I had surgery first, then radiation. Then, now I'm during chemo. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. 

Hannah Kahn, Astrocytoma survivor And then, on top of that, I did the whole egg retrieval.

 Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. Yeah. 

Hannah Kahn, Astrocytoma survivor Which is something like people don't really talk about when you are a young cancer patient. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. So, definitely let's talk about it. So, how did that come up. And then what was the resulting outcome? 

Hannah Kahn, Astrocytoma survivor I've always wanted to do it, but at the same time I was like, oh, it's so expensive. Don't know what that looks like. Because my husband and I just got married and we're in our early 30s, which we still are. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor We're still young. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor But I was like, we're not, in no rush to have kids at this point. Like, right after we got married, like, before all this, we were just more of like, let's just live our best life and maybe in like five years, but realistically, that's 37. We're like, well, we'll try. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Right. 

Hannah Kahn, Astrocytoma survivor So, I've always wanted to do an egg retrieval. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. 

Hannah Kahn, Astrocytoma survivor And then, perks of having cancer. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor All this happened. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program So, they mentioned it to you, or did you mention it to them? How did it come up? 

Hannah Kahn, Astrocytoma survivor Both. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. 

Hannah Kahn, Astrocytoma survivor So, I remember after my surgery I was starting to get all these calls from the AYA center. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. Very good. Yeah. 

Hannah Kahn, Astrocytoma survivor Connecting me to the young adult part of cancer. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And then they offered those services. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. Yeah. So, you got seen in the AYA clinic, they referred you probably to one of our reproductive endocrinologists, Dr. Laurie McKenzie, who's amazing. 

Hannah Kahn, Astrocytoma survivor She's awesome. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And so, then she helped you go through process A to Z. And so, how did that go? 

Hannah Kahn, Astrocytoma survivor I mean, I was overwhelmed at first because I was just like, this is so much like I'm still recovering from brain surgery. I have to go through another procedure. But I mean, let me just say egg retrieval is the most wild thing. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor They send you a whole box of needles and you're just, and I have no medical background. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And you're just like, what? I'm supposed to put all this together? 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And I think it's particularly just crazy for cancer patients because IVF and egg retrieval in general, it's just kind of a long process. It's a lot of medications and tests and appointments, but especially when you're up against a cancer treatment timeline, they're really trying to stimulate you quickly and as quickly as possible to get as many eggs as possible. And so, there's a lot of just extra side effects that come with that. And so, I think again, like at this young age, you know, people in the early 30s definitely might be thinking about starting a family or like planning for like that's in a few years or we're not there yet. And now it's like, no, you have to plan now. Like you have to do this now before the next step. Did that impact you in any way, or was it just kind of part of the bigger plan anyway, so it wasn't anything different?

 Hannah Kahn, Astrocytoma survivor Part of the bigger plan anyways. I wanted to fertilize the eggs because I knew, because I'm married and like my husband was with me, so I knew it's going to both of ours. But he was also so overwhelmed with the whole process. So, he was just like, no, I can't think like that far in advance. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Absolutely. And I think that's one of the challenges upon diagnosis is you do have so much information being thrown at you. It's just, it's the diagnosis. It's the treatment plan. It's the side effects. It's the prognosis. And then especially for young adults, it's work and school. It's your relationships, your marriage. Some people are still dating. It's the friendships. It's the family planning. It's the even just mental, emotional sort of, aspect of planning all of these things while you're also planning a lot in your life. It's like life is busy anyway. And then you add all of these layers on top of that. Will you talk about that experience a little bit of what it was like to kind of juggle all of those different aspects and what that felt like?

Hannah Kahn, Astrocytoma survivor I would say, like, I'm lucky to have friends that have gone through the process. So, I didn't feel truly alone during that. And even my first day of injections, I had one of my best friends on FaceTime showing me because she had leftover needles from hers, showing me how to mix the needles, and she even watched my first injection, and she was just cheering us on just to make sure. And even my friends, during that two-week process, they were all just checking in to make sure I was OK and just everything. And I will say, like, I've truly felt the love during this whole entire journey with cancer. But the whole egg retrieval, I truly felt it. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor I didn't feel alone. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Obviously you said earlier, you're an open book and so you felt comfortable sharing that, which I think probably helps make you feel more supported because then people know what you're going through, then they have the opportunity to support you. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And I know you're pretty active on social media, so tell me how that came into play after your diagnosis in terms of connecting, getting support from people. 

Hannah Kahn, Astrocytoma survivor So, I kind of waited till, I don't know why I waited till May 1st and like May, is Brain Tumor Awareness Month. And I think that's why I want to like make my post in May to be like kick it off. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Yeah, like say hello to the world and say, this is what's going on. Even like people knew what was going on, but I wasn't very open about it how I am now. But with me posting, I actually got connected with someone who went to the same college as me. I went to Alabama. Roll Tide. I immediately felt a sense of relief, just like having someone who walked in those shoes. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor But also, I was connecting to other cancer patients. The whole mentality of we're all going through the same thing, it doesn't matter if it's a different type. We all understand on that level. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor What other people can't understand. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Right. Exactly. Because kind of what you were saying earlier is so many young adults feel like they're the only young one of that age group. It's either you're the oldest one in the waiting room or the youngest one. And so, it is nice to be able to connect with other people your age, whether it's the same cancer or not, same treatment or not, whether you live in the same state or not. Sometimes it is just nice to have other people that like, look like you and feel like you to kind of connect with whether or not it's exactly the same. 

Hannah Kahn, Astrocytoma survivor Yeah, because I also don't scream stereotypical cancer patient too. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. No, I mean, I think that's another really important topic is that it's the perception of what people see. So, there's this stereotype of what a typical cancer patient looks like. And so, it's not typically someone that's younger that has hair that is active, that's laughing and joking and still going out and spending time with family and friends. Like it's very much a different picture. And so, that's probably not what people assume. And and even though sometimes, yes, you may feel great and look good and have a great attitude, but also you can still be struggling with fatigue or anxiety or just healing. Your scars hurt. Like there's just so many physical side effects from treatment. 

Hannah Kahn, Astrocytoma survivor Or even the hair growth. Like, yeah, I look like I have hair. But underneath I lost majority of my hair with radiation. So, I'm in that hair growth stage. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program The awkward grow out. 

Hannah Kahn, Astrocytoma survivor And that's why I'm wearing the headband. Because it's like, I call it my toddler hair, that the hair just popped out like this and I have to glue it down, or even wear a headband. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah, and it's hard because when people see you who don't know you, they probably just think, oh, she's so cute. Like. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program That looks great. They don't know that that doesn't feel like you. That when you look in the mirror, this isn't you, and whether you hate it or not. But just like, that is not you to you. Whereas people who don't know you feel like that's just Hannah. That I met this girl. She was so great. She had so much energy about her. Like, I really liked her energy. And so, they just don't know that it doesn't feel like you. And there's such a disconnect sometimes between what people assume when they look at someone versus what's really going on underneath. 

Hannah Kahn, Astrocytoma survivor Even I have to like be vocal, especially to my husband, because he'll see me days when I'm feeling good. I'll go to SoulCycle, which I call my physical therapy, because it just feels like physical therapy when you're in that room. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Very difficult! Yeah. 

Hannah Kahn, Astrocytoma survivor Very difficult, but like, it just feels like very therapeutic in the room. And then I'll be lying on the couch the next day, and he's just like, wait, but you were just, went to spin class yesterday. I'm like, yeah, I'm exhausted today. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Or maybe hours later it'll hit me too. And I'm like, yeah, I don't feel like doing anything. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I'm sure it's also nice you go to a class because then you're also, again, connected with people. So, like, you're getting that physical activity. You feel like you're accomplishing something. It feels motivating and you're able to just be in person, like with other people and connect, which it sounds like for you is also really just an important thing is to feel connected and supported. 

Hannah Kahn, Astrocytoma survivor Yeah, and even the instructors know about me too. So, like one time I did it like right after chemo, just because I just wanted to move my body. And I told the instructor, so I'm like, I'm just here to move. I'm not giving you 100% today. I just finished chemo. I'm just here. She's like... 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I showed up. 

Hannah Kahn, Astrocytoma survivor She's like, I don't care. I'm just happy if people are here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah, it's like I just showed up. You could just sit and like it's nice that you showed up and like, your brain is thinking about spinning, you know? It's so nice. So, I think something you touched on earlier was the connection and the social support. And one thing I hear from patients a lot is that even when they have very solid support systems. They have great family. They have great friends. They have great colleagues. And like A-plus, they get a lot of support. They still feel like there's so much benefit and having their cancer friends because they just get it. Has that been your experience? 

Hannah Kahn, Astrocytoma survivor For sure, because I also connected with a girl who's my age with a different type of cancer. And like, we talk also about like, oh, I'm so tired. I'm exhausted. Just the things that people don't understand. My family understands, but like it's not the mental part. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. They understand. They empathize. They love you. They support you. Like whatever they can do to help. Absolutely. And there's just nothing comparable unless you have been through it. 

Hannah Kahn, Astrocytoma survivor Exactly. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And so, I think patients often say that their cancer friends are the ones who don't feel the need to fix it either. When you just say like I'm tired. They're like, yep. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program That kind of day. What are you doing? 

Hannah Kahn, Astrocytoma survivor Or I'm like, brain fog. I walked into a room. I don't know why I'm there. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. And they're like, yeah, me too. You know, it's like there's no judgment about it. There's no fixing. They just kind of allow it to be what it is. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And I think that can be so valuable and something that really can come out of social media. Right? Like sometimes we see the downsides of it. But there are definite upsides of when you do share your story. You do get to connect with people. And I imagine the people in your comment section are probably then connecting with each other.

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And they'll see like, oh, I saw this person on this one page, or I came across this girl, and she mentioned this thing and then I followed them. And so, it just inevitably kind of creates this community. 

Hannah Kahn, Astrocytoma survivor Yeah. And then I also like have been seeing other Instagram accounts that are dedicated to cancer patients. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Oh yeah. 

Hannah Kahn, Astrocytoma survivor And I'm just like, oh yes, I love this because they'll post a million memes. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yes. 

Hannah Kahn, Astrocytoma survivor And like even this one, I hate to call her an influencer, but her content is hilarious. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Because it's like, this is a mind of a survivor, or this is a mind of someone going through treatment and the things that she says is so spot on. And even friendships. You may lose some friends because I have noticed, like some friends may constantly be inviting me to places and I just can't go because I'm either exhausted or during chemo or I'm here. Then they kind of just stop inviting and like, she even like put that out there too, of like, you know who your real friends are. The ones that are still with you. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And that is kind of an aspect of cancer that doesn't often get talked about also is even when you do have friends who, who, let's just say they mean really well and they want to help and they invite you for a while and then they think, "Well, I don't want to bother Hannah. So, I'm just going to, like, let her be. I don't want to be a bother." And so, then they just fade and fade and fade. And I hear this a lot, especially when people finish treatment, is that like during treatment or like when the surgery is planned and they need someone in the waiting room or people are delivering things or offering food, whatever, right, in that acute phase. But then as they get further and further from that acute treatment, just kind of fades out because people just assume, well, she must be doing fine. She's good, like the surgery is over. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And or the radiation is over. And so, she probably doesn't need that much. I'm not going to bother her, when in reality, sometimes it's when, like, you need people the most, or when you really want to connect and actually realize, no, I was in the weeds then and I didn't know what I was going through. Now I know what I'm going through, and I want to talk about it. When people talk to you about what your cancer experience was, so what do you feel like, kind of, the tenants were? So, you mentioned, like, fertility, planning for that. Social connection, the social media. And you've also mentioned staying active. So, like were those kind of the things that were really important to you? 

Hannah Kahn, Astrocytoma survivor For sure. My biggest thing is after my seizure, just before my surgery, I'm like, "Will I be able to run again?" So, I've, back story of me: I've done four full marathons. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Wow. 

Hannah Kahn, Astrocytoma survivor Seventeen half marathons. That's why I'm like, why do I have cancer? 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yes. Then what was it like physically to go through all of this? Were you able to still run? Like, what was your activity level? 

Hannah Kahn, Astrocytoma survivor So, after surgery at my two-week follow-up with my surgeon, they said I can run again, but just make sure I have water. Very light runs. And where my parents live, there's not much shade over there. So, I didn't feel that comfortable running over there. We just did a lot of walking. When I started radiation, we stayed in a housing situation. I felt more comfortable running over here because there's a lot more shade. So, I felt comfortable, like trying to run again. So, my goal was to run one mile, then walk two or three miles. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. That's awesome. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And it sounds like your team really encouraged you to do what was right for you. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program So, and I think there's this spectrum, right, of you're used to being active. So, being active feels good to your body. It's like you almost need it, I feel like is what people will say. Especially, like, if you're running marathons, like, you're used to a lot of activity. And so, if someone had told you like, "No, do, nothing." Like that would be so, probably mentally and physically really difficult because it's also probably a coping mechanism. And so, there is this ability of be active, like push yourself a little bit, get out there, do some walks. You know, you did all the safety kind of planning around it but do some activity. But then also, were there are times, and I don't know if this happened after radiation or even now in chemotherapy, where it feels like, OK, no. Today I need to rest. Like, there's a kind of a balance? 

Hannah Kahn, Astrocytoma survivor I definitely feel that with chemo. Not with radiation. I felt no fatigue with radiation. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program OK. Awesome. 

Hannah Kahn, Astrocytoma survivor I was fine because I worked out. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And that's a major factor too. But with chemo, there's days I just lay on the couch, but I know my body's recovering. And I've really learned the lesson of listen to your body. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And I think that's the important part of, yes. Push sometimes. 

Hannah Kahn, Astrocytoma survivor Yes. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program But it is important to know because your body is working very hard to heal itself. And so, it is important to rest and take care of yourself. And there's just this wide spectrum of kind of having to know your body. 

Hannah Kahn, Astrocytoma survivor And that's one of the topics that covered with my therapist. She's like, "Yes, you are on the couch chilling, but your body is doing so much." So, like, you are being active without being active. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Absolutely. And so, you got connected to her through AYA, right? She's one of our away therapists. Awesome. 

Hannah Kahn, Astrocytoma survivor She's awesome. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program So, what got you interested in, "I need to tackle my mental health in this and make sure I'm covered?" 

Hannah Kahn, Astrocytoma survivor Maybe because, like, everything was just so like, oh my gosh, I'm going through cancer. Maybe to talk to someone who is trained to talk to cancer patients. Because there are things I think about when I'm not here, when I'm back at home, I'm like, "Oh my gosh, I need to ask her about this. I need to talk to her about this situation." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And it's just a normal, like, I just need to run this by someone. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And I feel like it can be such a protective factor. Like, I think a lot of people feel like, "Oh, I have to wait until I feel really terrible before I go see a therapist or a counselor of any kind." And they wait until it's bad, whereas, like, it's OK to go when you actually are feeling kind of OK. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program But it just gets you a plan, and it makes sure, you know you have someone to talk to, and it keeps you, I think, at a solid level. 

Hannah Kahn, Astrocytoma survivor In one of my sessions, I was telling my therapist I was like, "I just hope to make it to 40." I know most people don't want to turn 40, but I look at that as a huge celebration. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program And that's the reality of it, right? Like. 

Hannah Kahn, Astrocytoma survivor Yeah.

Wendy Girbach, Program Director, Adolescent and Young Adult Program I want to because every birthday is a blessing. Like every birthday is a privilege. You get to turn 40. 

Hannah Kahn, Astrocytoma survivor Exactly. Like, even like this past birthday, I was like, "Yeah, I'm turning 33, but I'm so happy to be turning 33." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. It's definitely a different perspective. 

Hannah Kahn, Astrocytoma survivor Yeah. And I've been seeing her for over a year at this point. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Awesome. 

Hannah Kahn, Astrocytoma survivor I mean, there are days where I'm like, "I feel good enough." Like, I don't need to see her, but, like, I do want to see her. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. It's just like the maintenance part of it. Yeah. And so, as we use this label survivor, do you consider yourself a survivor? 

Hannah Kahn, Astrocytoma survivor Like I'm still in that, like, I don't want to call myself that yet. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor More of a thriver. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor How I view it is like, because I'm still in the thick of treatment, I view it as, let's celebrate each treatment being done. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Like the treatment milestones. 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Which I think is another very important aspect that I'm glad you brought up, because a lot of people also think just, it's ringing the bell at the very end of treatment and like it's that or nothing. And so, I love when people incorporate like every part of that as a milestone going through surgery. 

Hannah Kahn, Astrocytoma survivor Oh my gosh. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Weeks of radiation. Honestly, like, you could ring the bell every week that you're completing. But every different, you know, chemo regimen, every different clinical trial, those are all huge milestones. And I think we sometimes celebrate milestones in our life, but like, not in the cancer treatment world. And so, I love that you mentioned that and that you do see those as the milestones to kind of celebrate and mark what's going on. 

Hannah Kahn, Astrocytoma survivor Like, I kind of, also even with chemo. So, my chemo treatment is a pill. Perks of my cancer, it's a pill form. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And it's for five nights, every 28 days. And after each treatment, I'm kind of like, "I deserve a little treat." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yes! Oh my gosh, absolutely! 

Hannah Kahn, Astrocytoma survivor I just finished chemo! 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah! Absolutely! Because like, those are the things that, it's not the race, I guess. But it's like you've run a marathon, right? So, it's like, you still have to get to every mile, right? And so, it's like these are the mile markers that are kind of getting you there. So, thriver feels good to you. So, not quite at the survivor yet. So, thinking back, big picture about your cancer experience. What advice would you give to other cancer survivors or cancer patients who are still in the thick of treatment or survivorship? 

Hannah Kahn, Astrocytoma survivor Do whatever makes you happy. You still got to live your life. Like if you want to lay in bed and watch Bravo all day, do it. That's what I did when I was exhausted. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And I still do it. I'm obsessed with Bravo. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Also, like, still like, try to live your best life by going out to dinner, seeing your friends to like, the limits that you can do. Go to that football game. Go to that concert. My biggest thing was I want to make it to an Alabama football game, which I did, and I did cry at my first one, just knowing that's what I wanted to do. And then I also saw Beyonce "Cowboy Carter." Listening to her, to that album has helped me through my treatments. I would listen to that on the way to radiation. I'll still listen to that during my MRIs. It's just kind of that feel good moment. Another thing is, I like to dress up for my appointments. I just want to bring sparkle and sunshine here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. What do they call it? Like dressing in dopamine or. it's like the dopamine of like, even if you don't feel it, like you fake it. And just like, put a headband on. Put an extra scarf on. Put your favorite shoes on. Like, whatever it is to just like get you to that next point. Which kind of makes me think big picture, of like, goal setting. Like it sounds like you just had these very certain things of like, "I want to get to an Alabama game." 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program "I'm going to get to a SoulCycle." 

Hannah Kahn, Astrocytoma survivor Yeah. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program It was the goal setting of like, "OK, I know I got there." And that's what made you feel maybe joy in a sense at a time when you... 

Hannah Kahn, Astrocytoma survivor It also made me forget about what my real reality is. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Is that also where social media is helpful to sort of, not forget and not distract from, because I actually think some people use social media to process what they're going through. But so, is that kind of what came into play for you? 

Hannah Kahn, Astrocytoma survivor Yes. To kind of process and just to like put it out there because I knew a lot of people are reaching out to me, and I also figure that was just the easier platform for me just to get everything out there. And I have heard from a lot of people from my high school, from my hometown in Birmingham and just people in Atlanta just reaching out saying, "Hey, I've been seeing your post and just want to let you know I'm thinking and praying for you.". 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor And that just makes me feel really good. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. Because is that kind of the hope and the goal for the content that you're putting out there? 

Hannah Kahn, Astrocytoma survivor That and just educating people on brain cancer too. Especially if someone who gets diagnosed with cancer and they look at me, "They're like, OK. She's fine. Like, I know I can get through it." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor That's why I put a lot of stuff out there too. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Because, I mean, it is scary to hear the word brain surgery. The main thing I was concerned about was my hair. My husband had all the questions to ask my surgeon and same with my parents. And then it goes, "Do you have any questions for me?" And I go, "How, what's my hair situation going to be like?" 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah! But I think that's a very appropriate question for a young adult to ask. It's like it's not superficial like this really is the concern of like, this could impact me. And I think people will talk about this about like, "Well, I have to go on job interviews." Or like, "I am still dating." Or "I just want to look like myself." And so, you know, I can get through anything, but I want to be able to recognize myself in the mirror. And so, you know, I guess the big concept here is body image, but knowing how it will really impact, like your day-to-day life and what your body image is like, your hair is a huge part of that. And so, I don't think it's an insignificant thing, like it really does matter to people. And I know sometimes the response is like, "Well, you can wear a wig. Well, you can wear a headband. Well, you can go bald. You look great." But like, none of that at the point. The point is it's not you. And it doesn't look like you and it doesn't feel like you. And so, it's helpful to know what do I expect and what can I prepare for? 

Hannah Kahn, Astrocytoma survivor Even like, the day of my surgery, my hair was down to here. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Wow. 

Hannah Kahn, Astrocytoma survivor And then after surgery, I had a haircut and I was like, "Screw it." That post-wedding cut. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor I cut it to here. And then I kept getting shorter and shorter. And my surgery, I call it my surgery hair was growing in. It's still like long. And I was like, "Screw it. Let's just like, chop my hair to kind of make it a little more even." But now my radiation hair is growing in. It's all crazy. But that's also another reason I like to dress up for my appointments. Got to look good to feel good. And it's just that sense of internal feeling of like, "I may not feel good, but I want to look good." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program It's an internal satisfaction because I think there is this point of like hair comes in different colors, hair comes in different textures. And I don't mean like people have those. Yes, different people have different hairstyles, but no, the same person can have different hair colors, different hair texture. Sometimes they go from straight to curly and then sometimes it's just thin or it breaks and it's wonky and it's uneven. So, all of those things that like, one patient can experience. And so, they've spent their whole life figuring out how to do their own hair, only for the color to change or the texture to change. And so, again, like, it doesn't feel like them. And it's a whole new learning curve on top of like, I'm still learning how to live in my body. I'm still learning how to get back to running half marathons. And now I'm like, figuring out my hair again. 

Hannah Kahn, Astrocytoma survivor I was in a wedding in August. It was my cousin's wedding. I was her maid of honor. That was the first time I felt myself/pretty since my own wedding. I think that's also why I've been buying a lot more makeup at Sephora, just to make me feel even better too. My husband's like, "You've got to stop it at Sephora." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program But sometimes, like, you control what you can control, right? And so, it's like, sometimes if it's skincare, if it's clothes you're wearing, if it's makeup you're putting off, if it's way you're doing your hair, like, if it makes you feel good, like, and you have to hang on to those things that make you feel good and it sounds like you've been... 

Hannah Kahn, Astrocytoma survivor And that's what's on those cancer Instagram accounts. They're like, "If you want to do something to make you feel good, do it." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. Absolutely. Like those little pieces of celebrating every milestone of the treatments, of taking care of yourself the best you can or not taking care of yourself if you can't at that moment, but just kind of knowing what that looks like for you and adapting accordingly because it is a roller coaster and things change so much throughout the entire experience. 

Hannah Kahn, Astrocytoma survivor Because even when I'm doing chemo, I'm either in my pajamas or in a sweatshirt and sweatpants. So, like out of the 21 days of the five days, I just want to look good. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah, yeah, yeah. Awesome. OK, Hannah, anything else that you would want people to know or any advice that you would give to other survivors? 

Hannah Kahn, Astrocytoma survivor Use the AYA sources. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. I love that. 

Hannah Kahn, Astrocytoma survivor Especially if you're a young adult. Take that to full advantage. I just remember after my surgery, maybe two weeks later, I was getting all these appointments set up through the AYA system, and I was just like, "OK. I'll do therapy. I'll take this genetic call." 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Yeah. 

Hannah Kahn, Astrocytoma survivor Because, like also genetic, like to go through the whole genetic process is also a big factor. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Obviously I'm very biased because it's the program I work with and I love it so much, but that really is the goal. It's like when patients come in, they don't always know what they don't know. They don't know what questions to ask, they don't know what's available and what's not. And so, ideally, when they're coming through the young adult clinic, we can say, "We got you, and here's what we're looking at. Here's all the services." And so, patients can start from the beginning, or they can say, "I don't know. I got a lot going on right now. Like let's, you know, punt this down the road a little bit." But the goal is to talk about fertility very early on, to talk about work in school. Talk about the mental health, the relationships, the genetic aspects. Nutrition, just all the components that go into it. And so, wherever people are in that process and whatever they're ready for, obviously, like, the goal is to just get patients connected. 

Hannah Kahn, Astrocytoma survivor For sure. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Well, Hannah, this was such a good conversation. I feel like we could just... 

Hannah Kahn, Astrocytoma survivor So fun! 

Wendy Girbach, Program Director, Adolescent and Young Adult Program Keep talking about all the elements forever. So, just thanks for joining us today and thanks for being vulnerable and sharing all your experiences. 

Hannah Kahn, Astrocytoma survivor Thanks for having me. And again, I'm an open book because I just want to help the person behind me. 

Wendy Girbach, Program Director, Adolescent and Young Adult Program I love that. And thank you for tuning in today. If you enjoyed this episode, be sure to follow or subscribe on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. And don't forget to comment or review. For more information or to request an appointment, call 1-877-632-6789 or visit MDAnderson.org. Thanks for listening to the Cancerwise podcast from UT MD Anderson.