Without warning, cancer intruded on his goals and dreams. It remains difficult for Keith to look back on his battle with cancer. The life a survivor has after cancer is not necessarily the one imagined before diagnosis, he points out.

His memories, he says, are blurry, making it feel almost like an out-of-body experience.

Beyond survivorship, for which he is grateful, Keith prefers not to look back.

“One day you are on the Eastern Shore going to school, and then you’re at Hopkins,” says Keith.

The journey for teens is perhaps one of the most difficult among pediatric cancer patients. There are missed experiences, strained and lost friendships, and other changes that impact the day-to-day life of a teen.

Of the nearly 2 million cancer cases diagnosed each year, only about 5,000 are teens between 15 and 19 years old. Although their cancer treatment may be similar to what older or younger patients receive, the social and emotional experiences are different.

In 1998, Keith described that experience to author Harry Connelly: “When you get cancer, some of your friends become acquaintances. People act differently. My best friend wants to take the pain from me; so does my dad. Some people are scared of me, can’t look at me or talk to me,” said Keith.

Keith’s therapy was very aggressive, including two years of powerful anticancer drugs, ones known as cytotoxic because they kill cancer cells but are also very toxic to normal cells. These are the drugs that cause patients’ hair to fall out and nausea and vomiting in the short term and lasting changes, such as learning impairments and damage to healthy tissues and organs, in the long run. For Keith, the long-term toxicities have included chronic joint damage and pain, depression and memory issues.

“There are brilliant minds at Hopkins. They are incredible, the best in the world, and I would trust them again to treat me, but it was not a fun experience,” he says.

He is aware of the advances that have been made since his diagnosis. He mentions immunotherapy and targeted therapies that are aimed at sparing patients from the toxic side effects like those that plagued him.

It took longer for Keith to heal the mental and emotional scars left by his battle with cancer than to physically overcome the disease. He credits his parents with getting him through the darkest times.

“The reality for me is that the treatments were not as hard as picking up the pieces,” says Keith.

Keith with his dogs on his farm

Ultimately, picking up those pieces required building a life away from Maryland. Keith wanted to put some distance between himself and the memories of his cancer diagnosis and treatment, so in 2016, he moved to a farm in Virginia.

His 8 acres of rolling hills in southern Virginia has been the best medicine. Within six months of moving, he said he could feel the pressure lift, and he slept better. He met his wife Meggin there in 2016, his son Noah was born there last April, and he found faith again.

He says it was divine intervention.

“Prayer works. Have faith. That’s the one thing I missed when I was going through this,” says Keith. He understands that the toxic effects of the treatments that saved his life were what they were going to be, but he is confident the mental anguish that gripped him for many years could have been alleviated if he had faith then.

When he first moved to Virginia and was renovating his home, he found a New Testament pocket Bible in a pile of trash. He was rewiring the home, so there was no electricity. He couldn’t watch television, and to occupy his time when he needed a break from working on his house, he read the Bible.

“I realized I had been disconnected from God, and that I was bitter. I remember fighting with God when I was at Hopkins,” says Keith. “I guess I was mad at God. You think, why did I deserve this? You feel slighted. Then I realized, it was not God that abandoned me, it was I that abandoned God.”

Now, through his suffering, he has gained hope, and faith remains an important part of his life. He wishes it for everyone.

“At 16 we listen to the world, which says we do not need God. Through life experience, we learn we do need God regardless of what the television, media or educational institutions imply,” says Keith.

It is the experiences of patients like Keith that drive the Kimmel Cancer Center to become better. In the early years of the Cancer Center, the primary focus was on saving lives, with cancer taking the lives of nearly 70% of pediatric patients diagnosed. As research led to improved therapies and longer survival, another focus was added. Clinicians and scientists worked together to decrease toxicities of cancer therapies and added a long-term survivorship clinic to monitor patients for late effects and develop ways to prevent and treat them.

Today, Keith says his cancer experience has made him a more understanding and empathetic person. It most certainly has made him insightful.

“Life moves on, but you are too busy looking over your shoulder to notice,” he says.

Part of the challenge is letting go of what the cancer takes — the stolen or altered experiences of his teenage years, not to mention the lasting reminders of the cancer that come in the form of treatment toxicities. Added to that is the looming threat of cancer returning.

Keith can’t go back to the way it was before cancer. No cancer survivor can, but now having a family of his own and immersing himself in his farm, for the first time in many years, he feels like he can finally look ahead.