MARION TWP. - If you go to the McDonald's in Marshall Township, chances are, Brandie Schramm will be working. You'll recognize her. She's got chin-length, brown hair. She wears wire-rimmed glasses. Two bracelets and a watch wrap around her left wrist. Her jeans are held up by a studded belt.

She's 28 and has two bachelor's degrees - one in English and one in fine arts - but she's still looking for that just-right job in her field.

Oh, yeah, and she has a rare form of cancer called malignant peripheral nerve sheath tumors, or MPNST. It's easy to overlook because Schramm, of Marion Township, doesn't look sick, she doesn't act sick, and, when she talks about her illness, it's in the same voice most people would use if you asked them what they had for lunch that day.

For as long as she can remember, Schramm's been saying, "neurofibromatosis." That's a genetic disorder she inherited from her mother and grandmother. It causes noncancerous tumors to grow on her skin and her peripheral nervous system. It's fairly common - about one in every 4,000 people have it.

Sometimes doctors remove the skin tumors for cosmetic reasons and take out the tumors deep within the body if they're painful or too close to organs, but they usually grow back.

But Schramm is different. She is one of the 10 percent, that small group of neurofibromatosis patients whose noncancerous tumors turn cancerous.

Five years ago, on a snow-covered road in Zelienople, Schramm's car slid into the back of a truck. Her air bag deployed, snapping her neck back.

When the pain in her neck wouldn't go away, Schramm went to Ellwood City Hospital's emergency room. CAT scans and X-rays showed her neck was all right, but there was a tumor in her chest, underneath her rib cage, resting on top of her left lung.

Schramm thought little of the tumor, assuming it was just another one caused by her neurofibromatosis. For five years, she obeyed doctors' orders to have occasional CAT scans to see whether it grew. It didn't, until January of this year.

By July, when the biopsy was scheduled, the tumor had grown another 3 centimeters, and when doctors removed three ribs to take it out of her chest on Aug. 10, it was the size of a baseball. It was MPNST, doctors decided once they had examined it and rebuilt her ribs.

Medical Web sites call MPNST "one of the most difficult and elusive diagnoses in soft-tissue diseases." It's also one of the most aggressive forms of cancer with the worst prognosis for patients.

But doctors caught it early enough that it hadn't spread. To Schramm, that meant two important things: a better chance of survival and no chemotherapy.

Barbara Schramm said when visitors stopped by her daughter's hospital room and, later, the living-room couch, she sent them away if they cried.

"Take your bad vibes away," she'd tell them. Then she'd go back to her knitting. She was making hats and scarves for people who couldn't afford their own.

For 15 minutes a day, for 35 days, Schramm had to lie under a machine and let its light concentrate on the left side of her chest. It didn't hurt, but it made her skin red and dry, like a midsummer sunburn.

While the machine hummed, she silently made her shopping list and thought about how annoying it was to drive to Jameson Hospital in New Castle every day to get this treatment and how she couldn't wait for it to be over.

Her health insurance doesn't cover all of her expenses. She calls it her "bargain basement insurance." It paid a portion of her CAT scans and covered a small part of the surgery. But the rest is her financial responsibility.

But she's trying to juggle her money the best way she knows how. Her student loans have been deferred. She's living with her mother and brother to save on rent. She's working with the hospital's "patient navigator" who is helping her find a way to pay for medical expenses.

And she's getting ready for that next CAT scan, when doctors will tell her whether she'll need more radiation or whether she'll be freed from her once-a-day trips to New Castle.

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