Cancer patient makes surprising bucket list as her fate hangs in limbo

February 02, 2021
Claudia Salazar stands outside
Despite an unexpected brain cancer diagnosis, Claudia Salazar is pursuing a doctorate at MUSC to help achieve her dream of making a difference in health care and education for minorities and underserved populations. Photo by Marquel Coaxum

Many thoughts went through Claudia Salazar’s head as she slid into the tube and listened to the metallic clicking and buzzing of the MRI machine.

As a research assistant, Salazar’s goal was to experience what it was like personally to get an MRI so she would be better able to describe the experience and reassure the teens who would be having brain scans as part of a study being done at the Medical University of South Carolina. It never occurred to her that something might show up on the scan. When she started receiving persistent calls, she learned she would need to come back in to repeat the scan.

The second time she slid back into the tube, she sobbed as she lay in the dark, fearing the worst. In May 2017, she learned the suspicious mass could possibly be cancer. Shocked, she entered into a whirlwind of medical appointments, getting multiple opinions, including some that she should have surgery. She had a consult at Johns Hopkins’ cancer center and ended up at MUSC Hollings Cancer Center working with neuro-oncologist Scott Lindhorst, M.D.

The final verdict was to do active monitoring — a painful process of watch and wait — and hope for the best.

Lindhorst said there was a possibility that the mass could be benign or a low-grade glioma, which is a primary brain tumor that starts in the brain and infiltrates normal brain tissue, making it impossible to remove it entirely with surgery. The type of tumor can’t be confirmed without a biopsy, but since the mass is small and not growing or causing her symptoms, they have decided that the risk of surgery, such as bleeding and neurologic deficits, isn’t worth it for now.

It’s a tough position to be in, but Lindhorst notes that Salazar, 25, is a delight. “She is highly intelligent and inquisitive and comes armed to each visit with useful insights about her plan of care. We work together to manage her case as partners.”

Dr. Scott Lindhorst 
Dr. Scott Lindhorst is guiding Salazar through the "watch and wait" process with her tumor and is impressed with her desire to help others in similar situations. Photo by Brennan Wesley

When he learned that she wanted to share her story to help others and shed light on health disparities in neuro-oncology, and in cancer in general, he wasn’t surprised. Salazar knows all too well how research is essential to all fields in cancer care, especially in neuro-oncology.

“While there have been many advances over the last 20 years in understanding the basic biology of brain tumors, of which there are more than 120 distinct types, translating that understanding into new treatments is a long and difficult process that requires a vast amount of resources and often decades of efforts, moving clinical trials forward,” he said.

“Having an ambassador such as Ms. Salazar, with a background in research and health disparities, which also occur in brain tumor patients, is invaluable.”

Champion for the underdog

Salazar’s brain tumor has her focusing on ticking off items on her bucket list, such as her passion for travel, as much as her finances will allow. She’s doing this while pursuing a doctorate in biomedical science with a specialization in neuroscience. Some ask her why, as a first-year graduate student in the College of Graduate Studies at MUSC, she doesn’t just quit the challenging coursework and have fun.

It has crossed her mind, but one of the most important items on her list — her driving dream — is to be a researcher who can make a difference for other minorities like herself. Besides, the one thing Salazar is not is a quitter.

When she came to San Francisco at age 8 with her parents from Ecuador, no one in her family spoke English. Even though her mom had been born in New York, she returned to Ecuador when she was too young to learn English. Salazar remembers growing up with parrots in her backyard, surrounded by an incredible biodiversity. She lived close to Quito, which sits high in the Andean foothills near the Amazon rainforests.

There was the cultural shock of moving to the United States and also economic challenges. Her parents decided to make the move to the U.S. to start a new life with only $400 and the clothes on their backs. She remembers being shocked at watching her dad in a checkout line figure out that he couldn’t barter with eggs to pay for their bill. Her family “couch surfed” for a while and gradually got on their feet, eventually making the move to Summerville, S.C.

Certain experiences made lasting impressions on her. She struggled to keep up with classwork in a language she didn’t initially understand. Her parents took whatever jobs, sometimes multiple, to be able to support the family. She and her brother watched out for each other.

Salazar considers herself a converted Southerner at this point, blessed to have such hardworking parents who never let on to how much stress they must have felt. She worked hard, too, learned English and graduated from Summerville High School. The first in her family to attend college, she pushed through tough times at Winthrop University — times when she doubted herself and felt like giving up. 

“I conduct research through the eyes of a Latino, of an immigrant, of a first-generation college student, as someone who grew up in a low-income household and of someone who has an invisible illness, like my brain tumor.”
— Claudia Salazar

“I had three part-time jobs in college — a supervisor in a social and behavioral research lab that studied policy; a resident dorm night host, where I worked from 11 p.m. to 7 a.m. checking IDs; and a research assistant at the Winthrop counseling center — while I was taking a large load of courses to graduate early to save money. I also was doing extracurricular activities involving research,” she recalled.

“Though this experience was stressful and resulted in many moments of doubt, it is rewarding looking back on this and seeing how the hardship turned into a purpose for my future.”

After graduating from Winthrop, she landed a research assistant job at MUSC, which is when she had the MRI scan and received a cancer diagnosis. She worked through the grief and weighed what was next for her future, deciding she didn’t want her diagnosis to deter her from her career goals. Her curiosity for science brings her joy as does bringing her past experiences to bear on research projects that target reducing health disparities and developing better public health policies to reduce barriers to quality health care to underserved populations.

“I think it's really important to have that interdisciplinary training, especially if I want to ultimately help marginalized populations. I conduct research through the eyes of a Latino, of an immigrant, of a first-generation college student, as someone who grew up in a low-income household and of someone who has an invisible illness, like my brain tumor,” she said.

“That awareness and knowing that everything — society, education and health care — is experienced differently, depending on your nationality, race, sexual orientation and religion, is what propels me to break down all those barriers and ensure that everyone has an equal chance at getting the best and highest-quality education and health care that they deserve.”

It’s why, despite demanding graduate school studies, she still finds time to volunteer to be a tutor at Title I schools, which have large concentrations of low-income students. She relates well to the challenges that these kids face.

“I just love working with the students. I've always loved kids. I know the impact that having a mentor can have and having someone know that you're in their corner and that you're cheering them on because we all need someone to be our cheerleader. I remember how valuable it was when I had a mentor speak with me and sit down with me to teach me or to encourage me. So, I'm hoping that those one-on-one connections make lasting impressions. They're also teaching me a lot, so it's like a two-way street. The kids are just amazing.”

Getting in the trenches

Like many cancer patients, Salazar is navigating a phase of wait and see. Doctors still are advising she hold off on surgery, given the tumor’s location, and the good news is it doesn’t seem to be growing. At some point, she hopes to get a liquid biopsy that wouldn’t require surgery. She’s grateful she isn’t experiencing symptoms, and she’s gotten over the worst part of the shock, she said.

Lindhorst has helped to ground her through the ups and downs of her journey and has been very responsive to her questions.

“I feel like he really takes time to listen. Not only is he brilliant, but I feel like he also does a great job advocating for his patients. Because in that position, I feel like you need to know your stuff, but you also need to be able to relate to patients. Whenever they're having a moment or they're crying in your office, you have to be able to comfort them as well. You can't just ignore that, even if it's a small gesture of just handing them a tissue. It can really go a long way. So, I'm very lucky that he's my doctor.”

Her cancer journey has confirmed for her the amazing power of kindness. “We really never know what someone's going through, what their journey is, what they've been through, what they're currently experiencing. Grace and compassion can really go a long way.”

She recommends that cancer patients find support — through family, friends and support groups — and look for ways to give back so that a cancer diagnosis doesn’t become the focus of their lives.

“A piece of advice that I would give to families taking care of cancer patients, and physicians as well, is to show up as your most authentic selves because the cancer journey — the diagnosis and everything — is terrifying. And it doesn't just stop a couple months after the doctor's visit or after remission, but it's an ongoing journey. And just having someone with them that is willing to get down in the trenches and fight with them and be with them through the highs and lows really, really makes a difference.”

Her cancer journey also has confirmed her career choice.

“As long as I can make a positive impact in people's lives, I'll be happy.”

About the Author

Dawn Brazell
MUSC Hollings Cancer Center

Keywords: Cancer, Research, Education