In February 2023 Madison Barnett was a 21-year-old junior and pitcher for the softball team at Lee University in Cleveland, Tennessee, when she noticed a painless dime-sized cyst on her right rib cage.
“It was very surface level, very mobile. I could move it around,” she remembers.
Four months later, at her physical before returning to school as a senior, her primary care doctor said it was more than likely a lipoma, a benign tumor of fat that forms between the skin and underlying muscle. She told Barnett to schedule a time to have it removed during an office visit.
Barnett talked to her coach about the best time to have it removed, and when she went back in November 2023, it had grown to about a half-dollar size. Her doctor said it was too large to remove in the office and referred her to a surgeon.
Expecting the cyst to be benign, Barnett and her family were devastated when the biopsy revealed Ewing sarcoma, an aggressive and highly malignant type of cancer that often occurs in bone but may arise anywhere in the body. It mostly occurs in teens and young adults (and slightly more often in males), although it can happen at any age. There are about 500 cases of Ewing sarcoma in the U.S. each year.
She was referred to Monroe Carell Jr. Children’s Hospital at Vanderbilt, a leader in the treatment of sarcomas, and eventually to Scott Borinstein, MD, PhD, Scott and Tracie Hamilton Professor of Cancer Survivorship and professor of Pediatrics in the Division of Hematology and Oncology.
They came up with a plan — removing more of the area around the cancer on Dec. 27, 2023, where a few more cancer cells were found, followed by several months of chemotherapy.
“The day Dr. B told me I was going to have chemo and miss my season I told him I had two questions: ‘Can I not (have chemotherapy)?’ and ‘Am I going to die?’ His response was ‘I don’t recommend that you not.’”
There was no evidence that the cancer had spread at diagnosis — about 15%-20% of patients with Ewing sarcoma will have metastatic disease when they are diagnosed, said Borinstein, medical director of Pediatric Hematology and Oncology and associate director of the Pediatric Hematology Oncology Fellowship Program.
Barnett began chemotherapy — 14 rounds and five different medications — on Jan. 18 and ended on July 20. She took one online class in the spring while she was undergoing chemotherapy and two classes in the summer.
By the third week of August, Barnett, still battling fatigue, was back at school. By the second week of September, she began preseason softball training. She will graduate in December but is still eligible to pitch for her final season, beginning in late January 2025.
“I was ready to be back,” she said. “You kind of catch a second wind when you realize your life is coming back to you.”
Barnett, who began playing softball at age 6 and pitching at 7, said her pitching ability is not fully back to where it was.
“A lot of pitching is muscle memory based — it’s like riding a bike,” she said. “I lost a lot of muscle. I’m pretty strong physically. I can lift heavy weights, but I couldn’t do any of that during treatment. It’s been hard to gain my muscle back, to get all my patterns back the way they’re supposed to look, making sure I’m sleeping enough and eating enough while also working through all the body changes that happen. It’s been a process, but I feel like I’m getting there.”
She credits her strong faith with her ability to get through such a difficult time.
“I can’t imagine what it would have been like to go through that if I didn’t have faith. I grew up in a very faith-based household. When I found out I had cancer, it was a generally warm day for December. I remember a gust of wind blowing, and I got chills. I felt the Lord in my spirit and knew I was going to be OK.”
Barnett said she was lucky to have “an amazing support system” — her family, friends and teammates.
“I’m lucky to have been surrounded by people who are going to pray for me, hold me, carry me and fill me with joy. All of those things are so important in these situations,” she said.
Barnett, now 22, is graduating with a degree in special education and will begin working toward a master’s degree in marriage and family therapy next spring. She hopes to use her degree to counsel children who have gone through trauma.
“I did my observations in the school system and realized I wanted to work with children with special needs, helping them work through their emotions, all of their questions, and questions their friends may have. Then when I got diagnosed in 2023, being around all of those families of children with cancer and seeing their similar question marks — siblings who don’t know how to tell their friends that their younger brother or older sister has cancer, wondering how to feel, how to respond, I felt like the Lord was telling me to broaden what my purpose was,” she said.
“Mentally I learned a lot. It was challenging, but also rewarding because those are lessons I’m going to use for the rest of my life. Walking through a cancer journey, or any massive change, can reset your perspective. Now I find so much more joy in the little things — like getting to play softball and being around my people.”
Borinstein, who Barnett calls “the best,” said seeing Barnett do so well with her treatments and being able to return to playing softball is very rewarding.
“She’s doing great. We will still monitor her very closely for the next five years for recurrence (every three months for the first year, then every six months for four years after that), but we are very optimistic she will be cured of her cancer.”
