A backache quickly became more serious

In November 2018, Maria Morales, who was 26 at the time, began to experience backaches. At first, she attributed the pain in her back to her job as a therapist for children with autism, which often involved lifting children and twisting on the floor.

After a week of back pain, Morales started to feel like she had the flu, though a test for influenza returned negative. The next day, she woke up with abdominal pain, and it seemed like her stomach kept growing.

When Morales' boyfriend checked on her later that day, her abdominal pain had worsened. "He put pressure on my stomach, and I yelled out in pain," she said. The two of them quickly went to the ED, where a scan showed a mass on her right kidney surrounded by blood.

Morales was admitted to the hospital, and after reviewing additional scans, doctors said her growth was likely an angiomyolipoma, a type of noncancerous tumor that is made of fat cells, muscle tissue, and blood vessels. These types of tumors are somewhat common and usually found in middle-aged women.

At the time, doctors assured Morales that the tumor wasn't serious. "They said it was a very vascular tumor that burst, but it's nothing to be concerned about," she said. "We trusted them."

At the hospital, doctors performed an embolization, inserting tiny beads of gelatin into blood vessels to reduce the risk of additional bleeding and reduce the mass of the tumor. Morales was discharged five days after the procedure.

A month later, she met with two urologic oncologists at separate health systems to discuss her condition. Both doctors agreed with the diagnosis of an angiomyolipoma and ordered another CT scan in three months to check on her progress.

The surprising diagnosis that was almost missed

In March 2019, Morales underwent a new CT scan, which showed that the mass was growing instead of shrinking. The first urologist said he would continue to monitor the likely angiomyolipoma. He also considered doing a biopsy to determine if the tumor was cancerous, but it was never performed.

Morales then met with the second urologic oncologist, Mark Gonzalgo, from the University of Miami's Sylvester Comprehensive Cancer Center. After seeing the large size of Morales' tumor, Gonzalgo suspected that it could be cancerous and recommended that Morales have her kidney removed. Doing so would remove the root cause of the problem and allow for confirmatory testing to be performed.

Gonzalgo referred Morales to an interventional radiologist for next steps. In April 2019, the interventional radiologist performed two embolization procedures, like the one Morales initially received. Another doctor later performed another embolization in June 2019 after another CT scan showed continued growth.

A difficult journey to remission

Following her diagnosis, Morales received two weeks of radiation treatment and underwent an intense regimen of chemotherapy for over a year.

During her treatment, Morales experienced severe complications. After a few weeks of chemotherapy, she developed veno-occlusive disease of the liver, a potentially fatal side effect of chemotherapy and radiation. The condition blocks small blood vessels in the liver, which causes jaundice and fluids to build up.

Because of this, she spent 10 days in the ICU, where she wasn't allowed to leave her bed due to concerns about her low platelet levels and potential bleeding.

The cancer treatments also triggered early menopause and ultimately left Morales infertile, with ultrasounds showing no eggs or follicles. To manage her menopausal symptoms, she currently wears an estrogen patch and has an intrauterine device that releases progesterone.

According to Morales, she wonders if she could've avoided the complications of her aggressive chemotherapy treatments if the cancer had been diagnosed earlier. "What would my life had been like if they'd done the biopsy right away and took it out then?" she said.

In October 2020, Morales finished chemotherapy, and her cancer has officially been in remission since then.

"The five-year mark was a good celebration point," said Aditi Dhir, a pediatric oncologist at the Sylvester Comprehensive Cancer Center who treated Morales. "The further and further she keeps going on, the lesser chances of it ever coming back."

Since her cancer went into remission, Morales married her husband, Octavio Goren, and relocated to Denver, Colorado, from Miami — something that she promised herself she would do when she was struggling with her cancer treatments.

Morales, now 34, focuses on spending more time doing what she loves: appreciating nature. "You can be on the highway and there's a hike right there, so we'll just stop and do it," she said. "Everything is breathtaking, no matter what angle you look at it."