Identical twins Emma and Sofia Ego of Clarkston, Michigan, were each diagnosed with Hodgkin's lymphoma years apart, endured the same grueling treatment, and are now both cancer-free as they head off to their freshman year at the University of Michigan in Ann Arbor. Sofia was the first to get sick, noticing symptoms when she started sixth grade. Five years later, Emma found a lump and received the exact same diagnosis.
Sofia's illness announced itself through persistent tiredness and substantial weight loss, and her diagnosis landed the day before her 12th birthday in 2020, according to ClickOnDetroit | WDIV Local 4. She underwent surgery and chemotherapy during those first pandemic months, when COVID-19 restrictions meant only her father, Alan Ego, was allowed to accompany her to treatments. Sofia leaned on music to get through it, while her twin sister stepped in as a steady source of support throughout the ordeal.
A Second Diagnosis, Five Years Later
Emma's turn came later, when she found a lump and was diagnosed with the same Hodgkin's lymphoma her sister had already survived. The station's report notes that both sisters ultimately received the identical course of treatment, completing eight chemotherapy sessions over four months. Emma kept up with her schoolwork through the ordeal and found outlets in theater and jewelry making, mirroring the way Sofia had turned to music years earlier.
Dr. Kate Gowans, an oncologist at Corewell Health who treated both sisters, called the twins' shared diagnosis unusual. The Ego family underwent genetic testing to try to understand why both daughters developed the same rare cancer, but per the same account, the testing found no explanation. The family has thanked Dr. Gowans for guiding both daughters through their treatment, and she is retiring just as Emma and Sofia head off to college.
What the Science Says About Twins and This Cancer
Medical research offers some clues, even without a clear answer in the Ego family's case. A landmark twin study published in the New England Journal of Medicine found that identical twins of Hodgkin's disease patients face a dramatically elevated risk of developing the disease themselves, with a standardized incidence ratio of 99. That same research, which tracked 432 sets of twins affected by Hodgkin's disease, found that 10 of 179 identical-twin pairs both developed the illness, compared with none of 187 fraternal-twin pairs. The study's authors concluded that genetic susceptibility underlies Hodgkin's disease in young adulthood.
More recent work has tried to pin down which genes might be responsible. Researchers at St. Jude Children's Research Hospital performed whole-genome sequencing on 234 members of 36 families and identified 44 inherited variants linked to increased Hodgkin lymphoma risk. As the researchers put it, “Inherited variants can be an important missing piece of the puzzle” in understanding why some people are more likely to develop the disease. St. Jude also notes that Hodgkin lymphoma, which affects the lymphatic system, carries a five-year survival rate of 90 to 95 percent.
Looking Ahead to Ann Arbor
Sofia and Emma have both said their fight with cancer was mental as well as physical, and they've advised others facing a cancer diagnosis to feel their emotions rather than push them aside. Sofia now plans to pursue a career in genetics, while Emma plans to study anthropology once classes begin at the University of Michigan. More than 15,000 families in the United States receive a new childhood cancer diagnosis every year, a statistic that carries extra weight given that September is Childhood Cancer Awareness Month.
