Keren Clay was 9 years old the first time she was diagnosed with cancer. She was 13 when the cancer returned. Now, a 16-year-old two-time cancer survivor, she will swim a mile across Lake Lanier for Swim Across America to raise money for the Aflac Cancer and Blood Disorders Center, the place where she was treated and where she hopes more children with cancer will be cured.

When Keren was 9, she was a Girl Scout who loved the outdoors, swimming and art, but it was soccer she loved most. She started playing on a recreational team at age 4 and worked her way up to a club team. She was a midfielder, eager for the fall season, when she found the bump over Labor Day weekend.

“My dad was tickling my foot, and something hurt,” said Keren of Atlanta. “It was really small, but it became huge over the next few weeks. I called it the monster.”

Keren felt panicked over the discolored bump that kept growing and caused her to limp. Her pediatrician said it was likely a sports injury caused by all the running from soccer. Over the following months, she had X-rays that showed nothing, was treated for malformation of veins and finally landed back at an orthopedist’s office who did a biopsy. On Feb. 8, 2018, she received the results and heard a foreign, terrifying word: rhabdomyosarcoma.

“It’s hard to describe that moment,” said Kelly Clay, Keren’s mother. “To know how hard we’d been trying to help her all those months and that she’d been getting worse all the while. I felt physically ill, like I was dying right there in that room.”

The doctor said the rhabdomyosarcoma, a type of soft tissue cancer, was Stage 4 and, even worse, it had spread to 11 places in her body, including her shoulder, pelvis and thigh. The outlook was not promising. Keren would require 53 weeks of chemotherapy.

As the shock washed over Kelly and Keren’s dad, Jonathan, they made a decision.

“We were obviously going to take their medical advice, but we felt like we didn’t know what was going to happen, so we wanted to give Keren hope and something to look forward to,” said Kelly. “We made it our focus to ensure she would still have joy in her life.”

This is why they decided to go to Universal Studios and Discovery Cove in Orlando, Florida, for four days before Keren would start treatment.

Keren Clay (left), with her mother Kelly Clay, was diagnosed with rhabdomyosarcoma. After treatment and an amputation, she was declared cancer free for the first time the following summer at 11 years old. (Courtesy of Kelly Clay)

Credit: Courtesy of Kelly Clay

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Credit: Courtesy of Kelly Clay

Six months later, Keren was responding well to the chemotherapy and the cancer was shrinking, but amputation was being discussed.

“If she wasn’t doing great, amputation wouldn’t have been necessary,” said Kelly. “But with rhabdomyosarcoma, it commonly returns to the same place. There was still a tumor in her foot, interspersed with bones, unable to be removed. Amputation was her best chance.”

Keren was in the hospital for less than a week after her leg was removed from below the knee. She began physical therapy immediately and practiced with prosthetics until she could use one full time. Doctors were amazed when she was declared cancer free the following summer. She was 11 years old.

“I always knew I wasn’t just fighting for myself,” said Keren. “I couldn’t leave my family and friends. I tried my best for myself but also for them. I was doing great with my prosthetic leg and got back to normal-ish life. Giving up soccer was really hard, but I couldn’t play with able kids because my prosthetic is dangerous for them and there’s no amputation league. I knew I had to find another activity.”

She began swimming with Blaze Sports, an adaptive sports program for youth and veterans. In swimming, she found joy and met kids who understood her struggles. Life was back on track until her routine appointment just weeks before Christmas in 2021.

“When the doctors said they saw something unusual, we all had a feeling it was cancer,” said Kelly. “So, we planned another Disney trip and went right before Christmas.”

They were in Orlando when they received the call that confirmed their hunches, but with a surprising twist. This time it wasn’t rhabdomyosarcoma, it was osteosarcoma, bone cancer, and it was in her shoulder, the place where she’d received relentless radiation years prior.

Though osteosarcoma has a higher survival rate, Keren still needed 46 weeks of chemotherapy as well as surgery to remove her scapula. It was replaced with a 3D-printed scapula, but Keren lost much of her strength because of the detached nerves and decreased range of motion.

“I could tell the second time was wearing on her and she didn’t understand why she had to go through it all a second time,” said Kelly. “We did our best to be optimistic, reminding ourselves that she’d gotten through it before and could do it again. We came up with things to look forward to, ways to keep her spirits up and made our best effort to believe that she would make it through again.”

Keren did make it through. She was declared cancer free for the second time in May 2022.

Since then, Keren’s life has changed a lot. She’s back in school full time, after missing so much for treatment, and she’s employed. She works as an instructor at Dynamo Swim School, teaching kids from age 3 to 12 how to swim. She still does lots of physical therapy for her arm, she still swims with Blaze Sports and she also trains with the high school swim team. She’s hoping all those hours in the pool will pay dividends on Sept. 21 as she swims across Lake Lanier to raise money for childhood cancer research.

“We continue to advocate because children need and deserve better,” said Kelly. “Some of the cancer treatments we have aren’t good enough. Even when children survive, they have terrible side effects.”

Keren seconds her mother.

“Until Swim Across America, I didn’t feel like I had many opportunities to make change,” she said. “This is an opportunity to do something I love, which is swim, and a chance to advocate for kids who need a better chance of having a good future.”

She’ll be joined in the lake by her prosthetist, Rebecca Hernandez, and her physical therapist, Jilly Cannoy, as well as a couple of her favorite guys.

“My dad and brother are also going to swim. My brother has trained a little and my dad hasn’t trained at all,” said Keren, laughing. “I’m worried about my dad. He’s going to be dead tired. But I’m looking forward to it. I know I can go the distance.”

If you would like to support Keren’s Swim Across America fundraiser, visit tinyurl.com/kerenclayswim.