Ready to run

Emily Knerr has blown the air horn to start the Head Over Teal race, benefiting ovarian cancer awareness, for the past seven years. When the 13-year-old Ross Bridge resident started the race in September 2015, she had no idea she was less than two months away from her second fight with ovarian cancer.

The Knerr family, including parents Ryan and Amanda and Emily’s sisters Anna and Casey, moved to Ross Bridge from Miami in 2009. When then-6-year-old Emily started to have body pains and weight loss, the family attributed it first to anxiety about the move, then to appendicitis.

Instead, they found a nearly 10-centimeter tumor on Emily’s ovary.

“I never heard of ovarian cancer in a 6-year-old. It was very scary. She had a 96 percent mortality rate,” Amanda Knerr said.

As a former nurse, Amanda Knerr said she felt like she should have recognized the signs in Emily sooner. The October 2009 diagnosis — ovarian small cell carcinoma with hypercalcemia — was rare and kicked off five rounds of chemotherapy as well as stem-cell treatments, radiation and surgery over 15 months.

Amanda Knerr said she can remember everything about that first battle with cancer, from the number of treatments to the way her daughter’s mood would get worse on the days when treatments were affecting her. Emily, on the other hand, said her main memories are of little things like her friendships with nurses at Children’s of Alabama or painting for the art wall in her ward. 

“I remember the major things, but I mostly remember the good times. I don’t remember much of the bad stuff,” Emily said.

After finishing treatment, Emily was cancer-free for five years. Her parents tried not to let the cancer diagnosis in her past affect the way they raised Emily compared to her sisters.

“Except, the only thing is I’m probably a little bit more mature than everybody else,” Emily said. “And I hang out with adults more, too. But other than that, I’m completely normal.”

“I don’t know how normal you are,” Amanda Knerr teased.

But in November 2015, things changed.

“Two days before her 13th birthday, she was having some symptoms, and we went in and had an ultrasound, and she had another tumor,” Amanda Knerr said.

Though the second ovarian tumor was smaller, Emily had to be pulled out of classes for the rest of the school year to treat the relapse with surgery and more chemo until her small body could no longer handle it. Other than a brief scare in June due to spots on her liver, which turned out to be benign, Emily is on a maintenance treatment plan and is showing no signs of the tumor returning.

Unlike the first time, when the Knerrs had just relocated, Emily’s second battle with ovarian cancer triggered an “overwhelming flood” of support from friends and neighbors, her mother said. Among them was Bumpus school nurse Melanie Schmith, who had heard Emily’s story even before she entered middle school.

“I know from a mother’s heart how hard it is to have a chronically ill child, as I have one as well. Then I saw Emily’s fighting spirit come through. She faced her challenges with such a ferocious tenacity and never played the victim or pity role. Watching her inspired me beyond measure,” Schmith said.

Schmith decided to run in Emily’s honor in the recent Save the O’s race, another run in support of ovarian cancer, over the summer.

“[It] seems like such a small way to show how much you admire someone’s courage and bravery, but it was the least I could do. After all, she loves to run, and she runs her race well,” Schmith said.

When she began treatment again, Emily was concerned she would lose some of her friends by being homebound the rest of the year. But there was nothing to worry about.

“They have just stood by her. It was incredible to see,” Amanda Knerr said.

Once she returned to school, Emily said the question she heard from classmates wasn’t about why she had lost her hair; it was why she wasn’t taking the opportunity to wear a mohawk instead.

“The first time I walked into school, like for the first time back, it was during the changing period and everybody ran up and gave me a hug. It was like I didn’t even know what was going on, all I knew was everybody was up against me hugging me,” Emily said.

 “She had no hair and no lashes or eyebrows. She looked very sick, but the kids were great. The kids were like the best part,” Amanda Knerr said.

Emily has since joined the cross-country team and is building up her strength. She started the season unable to run a full lap around the football field track, but now can complete a 2-mile course.

“I have a bunch of friends on the cross-country team. It’s just a fun environment to be in,” Emily said.

She keeps an undaunted, cheerful attitude for a young person facing such a rare diagnosis. Emily and her mother can laugh about the times they went to the grocery store during treatment, and Emily would forget why people were staring at her.

“Oh, wait. I don’t have any hair. That’s probably why,” Emily remembers thinking.

Amanda Knerr said they don’t have a lot of answers for what Emily’s future might look like. Having been diagnosed so young, Emily said she’s a sort of a “guinea pig” for the doctors who have treated her.

“Her tumor’s so rare, and it’s such a late relapse, and she’s so young, and there’s just so little research done on this tumor. Like our doctors say, ‘We’re writing a book on this,’” Amanda Knerr said. “There’s nothing telling us what to do right now. We’re making the best choices with the best information we have.”

Amanda Knerr works as the executive director for the Hope for Autumn Foundation, which raises funds to support pediatric cancer patients and awareness, and Emily continues to be involved with the Laura Crandall Brown Foundation’s Head Over Teal race.

After two rounds of cancer, the Knerrs say the biggest change in their family is that they don’t put off things they want to do for another day. Emily said when she sees something she wants to experience, the Knerrs think, “Why not?”

“You never know what’s going to happen tomorrow, so you have to live for today,” Amanda Knerr said. “I’m still struggling with that. She [Emily] has it down pretty well.”