From patient to intern: Cancer experience inspires career in sonography

At 17, Nathan Eller was a competitive athlete who dreamed of running Division I track in college. But during his junior year of high school, feelings of fatigue and weakness began to interfere with his race performance and at times left him falling asleep in class.

Eller was eventually diagnosed with T-cell lymphoblastic lymphoma, a rare cancer, and received treatment at MultiCare Mary Bridge Children’s Hospital.

The experience later inspired him to pursue a career in diagnostic ultrasound — and led him right back to the place and health system that helped him heal.

“When I found out I was coming back to Tacoma for my clinical internship, I was over the moon,” Eller says. “It was amazing to think that my experience was coming full circle.”

The road to a diagnosis

In high school, Eller had a plan. His brother had received a full-ride scholarship to run track in college, and Eller intended to follow in his footsteps. To get there, he trained six days a week and competed in a variety of events, from the 800-meter dash to 5K cross-country races.

When Eller’s health and strength began to decline, he grew concerned. One night his symptoms became so severe he went to a local emergency department, but after a chest X-ray cleared him of pneumonia, he was released.

At the urging of his family, Eller made an appointment with a specialist at Mary Bridge Children’s, where an echocardiogram — a diagnostic imaging test that uses sound waves to evaluate the functioning of the heart — found a tumor in his chest.

According to the American Cancer Society, T-cell lymphoblastic lymphoma often originates in a gland called the thymus. This gland makes T cells — a type of white blood cell that fights infection. Because the thymus is situated in the chest near the heart, this fast-growing lymphoma can cause difficulty breathing, fatigue and weakness — many of the symptoms Eller had been experiencing.

Two weeks after his diagnosis, Eller began receiving chemotherapy under the care of Rebecca Johnson, MD, a medical oncologist and hematologist at Mary Bridge Children’s.

“Looking back, I know what a blessing it was to start treatment that quickly,” Eller says. “But it was also a difficult time. We had to cancel vacation plans. I missed a lot of school, and worst of all I couldn’t run for almost a year.”

Reaching a crossroads in his care

By February 2020, Eller was approaching the maintenance phase of his treatment plan — a less intense phase of treatment designed to prevent cancer from recurring. A senior in high school at that point, Eller planned to return to track that spring. But Dr. Johnson shared news that would require Eller and his family to make an important decision.

A new chemotherapy drug called nelarabine had recently shown promising results at effectively treating T-cell lymphoblastic lymphoma in a phase 3 clinical trial. Mary Bridge Children’s was one of several clinical trial sites across the country testing the drug, and one of five in the state of Washington.

“Most patients who get treated for T-cell lymphoblastic lymphoma do achieve remission,” Dr. Johnson says. “But if the cancer recurs, it can be hard to control. Adding nelarabine to Nathan’s treatment regimen — a drug that’s now part of the standard of care for this cancer — would increase his chances of staying in remission.”

Naturally, Eller wanted to do everything he could to keep the cancer from recurring, but adding nelarabine to his treatment plan would affect his ability to compete in track events at the level he was used to, due to the drug’s side effects.

“It was a hard decision,” Eller said. “My family and I talked it over, and we decided I should take the drug. I remember my mom told me, ‘It’s better to be alive than fast,’ so I thought OK, why not be a part of trying something new?”

Better outcomes through research partnerships

A member of the Children’s Oncology Group (COG), Mary Bridge Children’s partners with the MultiCare Institute for Research & Innovation to provide pediatric patients access to a variety of clinical trials.

These trials investigate new and emerging cancer therapies, supportive care treatments, as well as the long-term effects of cancer therapy that may arise in children and young adults.

A new career path emerges

Trying an innovative cancer treatment strategy was not the only new development on the horizon for Eller. Following his high school graduation in 2020, he began to set his sights on the future. His dream of running Division I track in college ultimately did not come to fruition, but his cancer was in full remission and it wasn’t long before a new path began to emerge.

“At first, I wasn’t sure what I wanted to do with my life,” Eller says. “But I thought back to that echocardiogram procedure that first uncovered the mass in my chest, and after looking into it, ultrasound seemed like a good career path for me.”

Eller enrolled in a bachelor’s program for diagnostic ultrasound (sonography) at Seattle University — the first of its kind in Washington — and became part of the program’s largest-ever cohort: 42 students.

The curriculum includes an internship where students gain hands-on experience as ultrasound technologists in a clinical setting, such as a hospital or ambulatory clinic. By chance, Eller was assigned to MultiCare Tacoma General Hospital, where he is currently completing this portion of his education, specializing in cardiac sonography.

“I feel really fortunate to be here, where I already know some of the doctors because of my treatment,” Eller says. “Plus, the team at Tacoma General is great. I have a lot of opportunities to learn and try new things — my mentors give me the freedom to grow into the kind of sonographer that I want to be.”

While Eller, who will complete his internship at Tacoma General in August 2024, has not yet had the chance to work with Dr. Johnson directly, he does see her routinely for his follow-up care. All he has to do is walk across the street to the Mary Bridge Children’s Outpatient Center after his shift for his appointments.

Once his internship is complete, Eller will start a position as a full-time cardiac sonographer, floating between Tacoma General and other MultiCare hospitals in the Puget Sound area.

“One of the most heartwarming parts of my job is getting to see how people grow up and incorporate their cancer story into their lives,” Dr. Johnson says. “Nathan is a very bright light, and I have no doubt that interacting with him will be a highlight for his patients — just as it is for our staff.”