Late last summer, as a brand-new freshman at the University of Maryland, College Park, Kathryn Brown got some exciting news: She'd made the Maryland Spirit Squad, a cheer team for school sporting events like women's volleyball and basketball games.
Brown was thrilled — she's loved cheering and tumbling since she was a little girl. But unlike many college cheerleading hopefuls who hone their skills in high school, Brown spent her teenage years facing a more serious challenge than opposing teams. She battled hepatocellular carcinoma, a rare form of liver cancer, undergoing chemotherapy and a liver transplant, followed by doctors' orders that she forgo any physical activity.
For Brown's family, watching her cheer after that struggle is nothing short of a miracle.
"Most kids when they have this ... we meet other families, and within two months it spreads to their lungs, and that's it," said Brown's mother, Leslie Savary. "She's like a miracle child. Every time I see her, I get chills."
As an outgoing and hardworking young girl, Brown was a natural fit for cheerleading. "I like cheering on other people and making them smile," she said.
She grew up cheering competitively, and in the summer of 2011, before her freshman year at James Hubert Blake High School in Montgomery County, she made the school's varsity cheer squad.
But before she ever had the opportunity to take the field at a football game, Brown got sick.
"I was just not feeling well and couldn't stop throwing up," she said. "I went to my pediatrician, and they thought I had a virus. Those tests came back negative, so they did a parasite test. Before those [results] came back, I was laying in bed and felt on the right side of my body. It was hard. That wasn't normal."
That was the beginning of a battery of tests, first at Shady Grove Adventist Hospital, then at the Children's National Medical Center in Washington. She was ultimately diagnosed with liver cancer on Labor Day weekend 2011, just as her freshman year was starting. She was 14.
According to the National Cancer Institute, hepatocellular carcinoma mostly occurs in people 65 and older. Incidence among 10- to 14-year-olds, was just 0.1 per 100,000 between 2008 and 2012.
Brown began chemotherapy right away, a course of treatment that is typical, according to Dr. Anurag Maheshwari, a hepatologist and gastroenterologist at Mercy Medical Center and assistant professor of medicine at the University of Maryland School of Medicine. "Most of the time, we try to perform chemotherapy in an effort to shrink the size of the tumor."
But chemotherapy alone isn't enough, Maheshwari said. "What we know about liver cancer is that surgery — just cutting out the portion of the liver that has the cancer — or chemo or radiation are not curative treatments. The risk of recurrence is very high. The only cure is a liver transplant, so early detection is critical."
Brown was told she needed a liver transplant after eight months of chemotherapy.
Liver transplant decisions are made using MILAN criteria, a set of global guidelines based in part on tumor size, Maheshwari said. "The chance of recurrence after liver transplant comes down dramatically" after shrinking the tumor.
At one point, Brown was turned down for a transplant by a group of physicians in Pittsburgh and told she had just months left to live.
"The whole way home, my family and I cried," says Brown. "Being told a transplant would be pointless for me, and that my cancer would come back, was devastating."
By then, Brown had missed much of her freshman year of high school. Though her determined nature helped her keep up with her studies, she was physically exhausted, she felt self-conscious as a result of her chemo-induced hair loss, and she kept many of the details of her disease and treatment to herself. Her close friends knew she was sick, but even they didn't know exactly how challenging each day was.
"My going-to-school experience was really difficult," she said. "I missed that window where people became friends. I came into school with my friends I knew beforehand and felt that anyone that didn't know me didn't know what to say to me."
In April 2012, Brown received good news; after chemotherapy further shrank the tumor, she was deemed eligible for a transplant at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del.
The transplant was successful, though her recovery wasn't easy. Following the transplant, she was placed on steroids that made her feel bloated, and she wasn't allowed any physical activity.
Even with those setbacks, Brown made the most of her life outside the hospital. To stay involved in sports, Brown managed the girls' field hockey and lacrosse teams at her high school. But the cheerleading bug never quite left her alone.
Brown also became involved with the Baltimore-based Casey Cares Foundation, an organization that helps children with life-threatening illnesses and their families enjoy their time together in spite of the emotional and physical rigors of treatment.
Through Casey Cares programs, Brown stayed immersed in sports, going to college-level games and even doing a modeling shoot at Under Armour.
"My personal favorite [Casey Cares event] was a mother and daughter spa day in Fulton," Savary said. "This was when Kathryn was doing chemo. She was as sick as a dog, but said she really wanted to go. She had a facial and got her nails done and had the biggest smile on her face. And all I needed was to see the smile."
Today, as a cancer survivor, Brown is still involved with Casey Cares but in a different way. Last year at the organization's Coaches vs. Cancer golf tournament, she shared her story with the crowd, opening up about what she went through and the lessons she took away from her battle. "I talked about never giving up hope," she said.
"To see her transform into the amazing woman she is today is just beyond belief," said Casey Cares founder Casey Baynes. "It's incredible to know we were a little piece of that journey."
Following her transplant, Brown worked hard to get back into shape, running and lifting weights to regain muscle mass and endurance, and doing physical therapy for nerve damage in her right arm that resulted from a blood transfusion during transplant surgery.
"She's tough," her mother said. "After she was sick, it took her about two years to get back physically."
"Getting my strength back has been the biggest obstacle in the recovery process for me," Brown said. "Before I was sick, I was in the best shape of my life, with lots of muscle. I still am not where I would like to be, but I feel so good when I am sore after a workout."
Last summer, she finally felt ready to get back into cheerleading.
"She said she wanted to go to a cheer camp 'just to see if I still have it,' she said," according to Savary, who signed her up for a session at a Rockville gym where Brown used to cheer. "She went and said, 'Mom, I'm not as rusty as I thought! It was like riding a bike!'"
Then Brown started figuring out how to get involved with cheering at the collegiate level. She and her mother contacted the coaching staff at the University of Maryland and found out she could try out for a walk-on spot.
After four years of fighting the disease that kept her from cheering, making the team was a major triumph.
"I was with my best friend because she made the team, too, and once we got outside, we screamed and jumped with joy," Brown said.
Brown is a back spot, a member of the squad who stays on the ground during stunts, stabilizing and watching out for flying teammates. When she's wearing her uniform, the inverted T-shaped scar on her exposed midriff is a reminder of how far she's come.
"I don't really think much of it when I look at it," she said of the mark made by her liver transplant. "A lot of times, I forget it's there. Sometimes I can tell when people notice it, which makes me feel a little awkward, but it doesn't bother me. It makes me me."
Brown's cheerleading coach, Courtney Johnson, said that despite the cheerleader's medical history, she consistently gives cheering her all. "She disclosed her battle with liver cancer with the team during the first week of practice, but we haven't looked back since. I know some days are harder for her than others, but she's always giving 100 percent and pushing forward. After beating cancer, I'm sure pushing through college cheerleading is a walk in the park."
For Brown, being on the team has been a dream.
"I missed the team dynamic," she said. "You have all these people who want the best for you and support you, and you're all in it together."
After graduation, Brown hopes to make a career in broadcast journalism. But first she has a more immediate goal in mind: make the varsity squad.