Chasing Life (2014): Leukemia at Twenty-Four

April Carver is a 24-year-old aspiring journalist at a Boston newspaper, juggling a career break, her widowed mother, a rebellious sister and her grandmother. Then her estranged uncle George, an oncologist, tells her that her bloodwork is abnormal and that she has leukemia.

The first season runs on two decisions. April hides the diagnosis from her family and her colleagues while chasing the story that will make her name. And she lets her uncle treat her. The search for a marrow donor turns up Natalie, a half-sister born of her late father's affair. April reaches remission, then relapses in the second season, then decides against further trials and goes to Italy to spend the time she has as she wants.

Spoilers below. This page says where April Carver's storyline stops, which is mid-air: the series was cancelled after two seasons.

The show treats this as a quirky premise. It is the one thing here that professional guidance addresses head-on.

The AMA Code of Medical Ethics is direct: in general, doctors should not treat themselves or their own family. The reasons it gives read like a summary of the show's own plot. A doctor's own feelings may sway their judgement. A doctor may skip sensitive questions, or skip parts of an exam. Patients may feel awkward being cared for by a relative. They may hold back things they would tell a stranger. And they may find it hard to say no to a plan.

The code allows exceptions for emergencies, isolated settings with nobody else available, and short-term minor problems. A course of treatment for an aggressive blood cancer is none of those.

This is worth knowing because a version of it happens in real life. A relative, a family friend or a colleague offers to handle your care, and it feels rude to decline. It is entirely reasonable to ask for someone else, and asking is not an insult.

The show names leukemia in the pilot and uses the word repeatedly. It never names a subtype, and no subtype should be attached to it from outside.

That gap matters more than it looks. NCI calls leukemia a broad term for cancers of the blood cells. The type turns on two things: which blood cell has become cancer, and whether it grows fast or slow. Those two questions split the word into diseases that are treated in different ways, on different clocks. NCI writes a separate treatment guide for each one.

So "I have leukemia" is the beginning of an answer. Acute and chronic leukemias covers the difference. If your own paperwork stops at the word, ask for the rest of it in writing.

April is 24. She goes through treatment across two seasons and the subject of fertility never gets a scene.

For a woman in her twenties that is a serious omission, and it is the kind that cannot be fixed later. NCI puts the sequence plainly. If you choose to protect your fertility, your cancer team and a fertility specialist plan it together. They also advise on timing, and on what any delay to starting treatment would mean.

NCI also records a finding worth repeating to anyone hesitating. Survivors were less regretful if they had met with a fertility specialist, regardless of whether they went on to preserve their fertility. Seeing someone is not a commitment.

The methods NCI lists for women include freezing embryos, freezing eggs, and freezing ovarian tissue. NCI lists that last one partly for people told not to delay treatment. It is also for people who cannot have the hormone drugs the other methods need. Both are common in a fast-moving blood cancer. Fertility preservation before treatment begins goes through the options. If nobody has raised it with you, raise it yourself.

One thing the show cannot be blamed for, but which the storyline invites people to ask about: could this have been caught earlier?

NCI states it directly. It does not have PDQ evidence-based information about screening for leukemia. There is no test recommended for people with no symptoms. The route in is the unglamorous one the show actually uses: a blood test done for another reason, or symptoms that do not settle.

Where the series is genuinely good is the social side. The impulse to hide a diagnosis. The fear of being redefined at work as the sick one. The way a serious illness lands in the middle of a career and a dating life rather than replacing them. And the way a donor search drags family secrets into daylight.

Where it is weak is the pace. April absorbs her diagnosis and moves through her life on a plot-friendly rhythm, looking well through bar fights and shopping trips.

Cancer Explained has no advertising and no sponsors. If this page put the fertility conversation on your list before treatment starts, it has done its job, and you can help keep it available to the next person. Support our work.

Chasing Life is honest about what a diagnosis does to a twenty-four-year-old's job, family and dating life, and careless about almost everything clinical. Two things to carry out of it. Ask which leukemia you have, not just whether you have one. And if a relative offers to be your oncologist, say no.

• NCI — Fertility Issues in Girls and Women with Cancer
• NCI — Leukemia, Patient Version
• AMA Code of Medical Ethics — Treating Self or Family

This page discusses Chasing Life for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].