Doctors thought it was strep throat at first, but her symptoms didn’t respond to antibiotics. For four months the pain worsened as Angela, a beloved Keene Valley resident, walked in and out of several specialist doctors’ offices in the North Country without an accurate diagnosis. A couple of nurses simply said there was nothing to be done, or that Angela would likely have to live with the pain — which had developed into debilitating lesions on her lips and inside of her mouth — for the rest of her life.

But Angela knew something was wrong. In spite of the pain, she learned how to advocate for herself. She refused to give up.

“I had to kiss a lot of frogs to get a diagnosis,” Smith said.

She finally found one with dermatologist Dr. Joseph Pierson at the University of Vermont Medical Center in Burlington. Pearson was the first to run a biopsy of Angela’s lesions, which showed T-cells, indicating cancer — a rare, aggressive form of Non-Hodgkin’s lymphoma that fewer than 2,500 people get per year. At the time, Smith could hardly eat and had to leave her longtime job as a small business consultant. At 47 years old, she was considered a stage IV case.

Beckham, left, holds a razor after Angela Smith’s hair was shaved. (Provided photo —Angela Smith)

The news was hard for Angela and her husband Todd, whose son Beckham was 6 years old at the time. But Angela, always one to look for the silver lining, was also happy to finally know what she was working with — so she could get to beating it.

She went through four months of “grueling” chemo from June through September of last year. But by November 2023, Angela’s cancer was growing again. It had become resistant to chemo, rendering the treatment ineffective.

Angela is now on a drug cocktail of inhibitors, which block the signals cancer needs to multiply. She got some good news a couple of weeks ago after her most recent bone marrow biopsy and endoscopy came back negative for lymphoma. That means she’s headed to remission.

But because blood cancers like lymphoma don’t present as solid tumors that can be removed through surgery or destroyed through chemo, Angela will always have rogue cancer cells floating around in her blood — even when she’s in remission. Her only shot at a permanent cure is a blood stem cell transplant.

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Todd, Beckham and Angela Smith smile outside of their Keene Valley home on Easter Sunday. (Photo provided — Lauren Yates)

A community search

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Cancer sucks, Todd said. It doesn’t care about the family and the future you planned. It doesn’t care if it destroys the career you worked years to build.

“The world comes crashing down around you very quickly,” he said.

Todd was tucking Beckham into bed one night last year when his son said, “I don’t want Mommy to die.” Todd said it’s easy for him to retreat and feel defeated, too.

Keene Central School Kindergarten teacher Kathleen Morse, left, and Angela Smith pose for a photo together at the school after Morse shaved her head to help ease Smith’s son’s worries about his mother’s chemotherapy. (Provided photo —Angela Smith)

But Keene is a small town, where no one can stew on their bad news alone for too long. The Smiths said they’ve felt surrounded by community support since Angela was first diagnosed.

“When people heard, the hugs started coming,” Todd said, “and they’re still coming on.”

Beckham’s kindergarten teacher at Keene Central School, Kathleen Morse, shaved her head last year to help ease Beckham’s worries when Angela started chemo. Todd travels often for his job in Switzerland, and friends and local teachers like Little Peaks Spanish teacher Peg Wilson have provided in-home childcare for Angela as she’s traveled to Burlington for chemotherapy and other treatments. Angela calls them her “magic people.” Sara Posdzich, the owner of Lake Placid-based business With Woman Wellness, organized meal deliveries to Angela’s home when the chemo left her too weak to cook.

And when Angela launched her search for a stem cell donor early this year through the National Marrow Donor Program — or NMDP — the Keene community ran to her side once again.

Last month, the Trail’s End Inn in Keene Valley co-hosted an informational session about stem cell donation with Posdzich for Angela’s benefit. More than a dozen people showed up — many with young families like Angela’s — to learn how they could test themselves as a stem cell match.

Angela Smith (Provided photo —Angela Smith)

An ideal stem cell donor is between the ages of 18 and 33. That’s an increasingly rare demographic among Keene’s aging population, but local residents are already tapping their friends and family in the U.S. and across the globe to join the registry and see if they’re a potential match for Angela.

It’s easy to join the registry. People can sign up at nmdp.org or by texting “ForAngela” to 61474. They’ll get a swab test kit in the mail, swab inside their cheek to test their DNA, and send it back to NMDP to determine if they’re a match for Angela or someone else.

Blood stem cell transplants are fairly painless for the donor. It’s an outpatient procedure with side effects that can be minimized by taking some Claritin beforehand, according to Angela’s experience, and donation comes at no cost to the donor. But potential recipients like Angela face a lot of preparation and recovery time.

To prepare for the transplant, a patient with cancer undergoes rigorous chemotherapy and total body radiation to completely get rid of their cancer cells. That way, when the patient gets their new stem cells — which are essentially a new immune system — they have a better chance at squashing the cancer cells before they can grow again. The catch is that the patient’s new stem cells have to grow and build immunity faster than the cancer cells can. The odds that a stem cell transplant will be effective are typically 50/50.

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Finding joy

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Despite the odds, Angela’s friends and family describe her as a ray of sunshine — the leader of the orchestra that’s working together to find her a cure. Angela’s doctors have told her that she’s one of the most well-educated cancer patients they’ve seen, because she continues to search for her own answers to questions about what’s happening in her body. She keeps her sense of humor, too; she even took advantage of her chemo-related hair loss last year and dressed up as Mr. Clean for Halloween.

Morse believes crises in a person’s life can heighten their existing personality traits, and Angela’s friends and family all say she’s been their rock even though she’s the one going through the difficult time.

“When you share the news that you’re dealing with cancer and you’re so positive, I think it just engenders admiration,” Wilson said. “It is admirable to watch her go through this process and seemingly have such a positive outlook.”

Angela volunteered with KCS’s Four Winds program after being diagnosed, and she got to work with young students at KCS to help them understand the concept of cancer. One book she used was called “Cancer Hates Kisses,” by Jessica Reid Sliwerski, which presented love as an antidote to the sometimes-debilitating mental and physical health effects of cancer. That messaging helped Angela, too, and so did the energy of the kids.

“Kids don’t dwell on stuff,” Angela said. “I just let go of what I can’t control, really.”

But, like anyone else, Angela has moments when fear and anger grab onto her and won’t let go. In those moments, Angela visits her friend, Occupational Therapist Sue Delamarter, who provides Angela with in-home craniosacral therapy sessions to release pain, tension and energy blockages.

Delamarter said she receives messages from her spirit guides during these therapy sessions. She said her guides often talk about helping Angela to concentrate on joy.

“It just kind of guided me to help change her thought process,” Delamarter said.

So much of dealing with cancer isn’t just about physical health, Delamarter added — it takes a toll on mental health, too.

“If she can pull positive energy and bring that to the forefront, I think she can live a very long and healthy life,” Delamarter said.

And with the help of her magic people, Angela said, she’s staying positive and keeping her eyes on the future.