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|Ashley Anne Kirilow|
|Born||1987 (age 29–30)|
|Known for||claiming to have cancer to defraud sympathetic donors|
Ashley Anne Kirilow is an Ontario woman who raised money to aid cancer sufferers, while pretending herself to be a cancer sufferer. When Kirilow's fraud was made public, her story was republished around the world.
Since her case became public Kirilow's fraud has been cited as a cautionary example of the dangers posed by online fund-raising campaigns.
In 2008 or 2009 Kirilow discovered a lump in her breast. Although a biopsy showed the lump was benign, she told people she had cancer.
According to the Toronto Sun, psychotherapist Marc Feldman, a professor of psychiatry at the University of Alabama, suggested the kind of lies Kirilow told were often a sign an individual was manifesting Münchausen Syndrome by internet.
Kirilow was one of the examples of a mentally ill suspect offered in the textbook Criminal Profiling: An Introduction to Behavioral Evidence Analysis.
In November 2010, Kirilow pled guilty to defrauding Donna Michalowski, a woman who had raised almost $7,400 for Kirilow.
Kirilow surrendered to the police on August 6, 2010. Kirilow's father described growing suspicious of his daughter's cancer claims, and when she wouldn't supply details of her treatment, he told her he no longer believed she had cancer, and that he would report her to the police if she didn't surrender herself first.
Kirilow appeared several times in bail court, during her first weeks in custody. Newspapers quoted former friends who explained that no one would post bail for her because everyone was too hurt and angry. Kirilow's father explained that he had considered posting her bail, but decided that she had lied too many times. On August 20, 2011, bail of $5000 was paid, and she was given a temporary conditional release into the custody of the John Howard Society.
Kirilow's conditional sentence
The Winnipeg Free Press reported that Kirilow received a conditional sentence, no jail time. Kirilow had not spent the year between her arrest and her sentencing in jail. She spent that time in half-way houses and mental health facilities. When explaining the conditional sentence the judge said sentences were ""not an instrument for the acting of public vengeance and retribution,"
Kirilow was sentenced to 10 months of house arrest, followed by five months where she would have a curfew. During her ten months of house arrest she was to be allowed three hours a week for shopping for "necessities". During her five months of curfew she would have to be at home between 10pm and 6am. After her fifteen months of house arrest and curfew her sentence required her to do 100 hours of community service. Her sentence explicitly barred her community service from including any duties connected with fund-raising for charities. Kirilow was not fined, and did not have to pay restitution.
October 2011 shoplifting conviction
Kirilow was arrested by a grocery store security guard, on October 7, 2011, for attempting to steal $11 worth of cold medicine. She pleaded guilty two weeks later to theft under $5,000. She was sentenced to one further day in jail. Kirilow was still serving her conditional sentence from her fraud conviction when she stole from the grocery store.
On November 10, 2011, she received an additional 30 days in jail for breaching terms of her conditional sentence. Both the Toronto Sun and The Hamilton Spectator speculated that Kirilow's last conviction was a sign that underlying mental health issues were not being addressed.
Second accusation of parole violations
The Hamilton Spectator and CHCH TV reported that Kirilow appeared in court on February 8, 2012, for a second breach of her parole conditions. The Hamilton Spectator speculated that Kirilow was risking having her parole revoked.
On March 2, 2012, The Hamilton Spectator confirmed that her conditional sentence had been revoked. Ashley Kirilow was jailed for breaching her house arrest conditions by visiting her boyfriend.
Kirilow's Facebook page described a charity she said she set up, entitled Change for the Cure. Kirilow appeared at benefit concerts, organized on her behalf. Kirilow visited children in hospital, receiving cancer treatment.
On October 13, 2010, Linda Nguyen reported on the efforts to raise funds for experimental treatment for Alexis Wronzberg, a young Toronto area woman who suffers from a rare form of Leukemia. Wronzberg needed $300,000 for haplo-identical stem-cell therapy. Wronzberg's father described concerns that Kirilow's fraud would discourage donations to their fund. He said their fears did not materialize. Nguyen also quoted a spokeswoman for the Canadian Cancer Society, who "could not say" whether donations had lagged for anti-cancer charities, due to Kirilow.
Kirilow has offered the explanation that she pretended to have cancer to make her family pay for an unhappy childhood. Kirilow's parents divorced when she was young. She lived with both parents, and her grandparents, switching custody multiple times. Kirilow told her donors both that her parents were dead, and that they were drug addicts who had disowned her.
In addition to the funds she solicited, she accepted a vacation at Disneyworld from a charity that sponsored visits to the resort from those who were at risk of dying. Skateboard personality Rob Dyer's organization Skate4Cancer financed Kirilow's trip to Disneyworld.
According to reports, Kirilow was working as a receptionist at the Sutton Group Results Realty Inc. office in September 2008. She later revealed to her co-workers that she had been diagnosed with cancer. Hence, Michalowski organized a fundraiser in February 2009 at the Burlington bar Club 54. The fundraiser collected $7000.
Kirilow is also accused of further raising thousands of dollars for her own benefit through a charity called "Change for the Cure" on Facebook. She had supposedly created the charity to fund cancer research. Kirilow told Toronto Star that she had lied about being terminally ill.
Kirilow faced three additional charges of fraud under $5000 at her November 1 appearance. She pleaded guilty to the one charge of fraud over $599.
After her court appearance, while trying to explain the scrutiny which the Kirilow′s case triggered, the lawyer said:
“It's the perfect storm. You've got social networking... you've got an insidious disease, which almost everyone in our society is touched with. When you put all those factors together there's a public outcry.”
Kirilow mentioned in the context of similar frauds
On November 5, 2010, the week that Kirilow pleaded guilty, Ontario Police announced the arrest of Jessica Ann Leeder, a 21-year-old Huntsville, Ontario woman, who is also accused of using Facebook to solicit funds to treat a non-existent cancer. According to the Winnipeg Free Press Leeder too had shaved her head.
In December 2011 Maclean's magazine listed Kirilow in a year-end summary article subtitled, "From Norway gunman Anders Behring Breivik to cancer fraudster Ashley Kirilow: portraits of evil". Maclean's called her the "photogenic queen" of cancer fraudsters, when it included her in a list that included Osama bin Laden and Russell Williams, a notorious sexual sadist and serial killer.
- Stephanie Dearing (2010-08-09). "Ashley Kirilow vilified for alleged cancer charity scam". Digital Journal. Archived from the original on 2010-08-18. Retrieved 2010-08-18.
Those in the know allege Kirilow made off with at least $20,000, an amount that under different circumstances would only merit the young woman a mention in the local newspaper after she'd been found guilty. But because Kirilow claims she faked cancer to get the money, her story has gone around the world.
- Kim Carolco (2010-08-12). "Are Cancer Fraudsters Desperate or Psychopathic?". ABC News. Archived from the original on 2010-08-18. Retrieved 2010-08-18.
In an interview with the Toronto Star, she admitted to the hoax and said she did it to get attention and to get back at her family for her unhappy childhood.
- Lietuvos rytas (2010-10-10). "Apgavikų arsenale – ir mirties šešėlis". lrytas.lt. Retrieved 2010-10-20.
- "Crowdfunding for medical expenses". Canadian Medical Association Journal. 2012-01-05. Archived from the original on 2012-01-30. Retrieved 2012-01-30.
There is always the possibility of abuse of Internet fundraising, as evidenced by the case of Ashley Kirilow of Burlington, Ontario, who in 2010 faked having cancer and used a Facebook page to help raise thousands of dollars.
- Ciara Byrne (2010-11-02). "Ontario woman who faked cancer pleads guilty to fraud". Globe and Mail. Archived from the original on 2010-11-07.
More than a year ago Ms. Kirilow found a lump in her breast and, suspecting the worst, had it removed, court heard Tuesday. The lump was benign but Kirilow began telling people she had cancer in an effort to make her parents feel bad, the Crown said.
- Joanne Richard (2010-08-18). "Accused cancer faker isn't alone". Toronto Sun. Archived from the original on 2010-08-19. Retrieved 2010-08-18.
“Although there is clear evidence in the Kirilow case of malingering - lying about illness to get money – I would bet that the principal motive was an intangible one: to get attention, nurturance, care and concern that she felt unable to get in other ways.”
- "Martha Nicholas, 42, Arrested After Allegedly Faking Cancer To Raise Money (VIDEO)". Huffington Post. 2011-12-11. Retrieved 2012-06-10.
Nicholas isn't the only person to have allegedly faked cancer for financial gain. In 2010, Ashley Kirilow, a Canadian woman, pleaded guilty to one count of fraud after she lied about having cancer to raise money, according to CBC News.
- Brent E. Turvey (2011). Criminal Profiling: An Introduction to Behavioral Evidence Analysis. Academic Press. p. 239. ISBN 9780123852441. Retrieved 2014-01-22.
Ashley Anne Kirilow, a Canadian woman who faked cancer and defrauded hundreds of charitable donations in the thousands of dollars, shaved her head, plucked her eyebrows, and starved herself to mimic the effects of chemotherapy. She also had the words "Won't Quit" tattoed across both of her knuckles.
- "No jail time for cancer-faking woman". Inside Halton. 2011-04-08. Archived from the original on 2014-01-22. Retrieved 2014-01-22.
Following 10 months of house arrest Kirilow will have five months of imposed curfew, from 10 p.m.-6 a.m., wherever she is living at the time. She also received 100 hours of community service and two years of probation, the latter of which begins after the 15-month conditional sentence.
- "Cancer faker gets new charge: Kirilow's former co-worker says charge relates to fundraiser in Burlington, Ont.". CBC News. 2010-08-11. Retrieved 2010-08-18.
An Ontario woman accused of faking cancer in order to elicit donations for herself has been charged with an additional count of fraud over $5,000.
- "Ganó miles de dólares tras fingir cáncer" (in Spanish). El Universal. 2010-08-17. Archived from the original on 2010-08-19. Retrieved 2010-08-18.
- Mikkel Selin (2010-08-10). "Løj sig kræftsyg og scorede kassen: Canadisk kvinde, der lod som om, hun havde kræft, snød folk for over 100.000 kroner" (in Danish). Ekstra Bladet. Archived from the original on 2010-08-19. Retrieved 2010-08-18.
Ashley Kirilow, 23, fra Canada gik til yderlighederne for at narre penge fra godhjertede mennesker, som troede, hun var døden nær af kræft.
- "Na Facebooku vylákala z lidí tisíce: Lhala, že má rakovinu!" (in Czech). Blesk. 2010-08-15. Archived from the original on 2010-08-19. Retrieved 2010-08-18.
Chtěla si přivydělat, tak předstírala závažnou nemoc. Kanaďanka Ashley Kirilow (23) si vytvořila profilna Facebooku, oholila si hlavu a obočí a svým přátelům na síti tvrdila, že má rakovinu.
- 末期がん偽る募金詐欺、頭剃ってフェースブックに カナダ (in Japanese). AFP BB News. 2010-08-12. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
- "Facebook-Schwindlerin verhaftet: Ashley (23) hatte gar keinen Krebs" (in German). Blick. 2010-08-12. Archived from the original on 2010-08-19. Retrieved 2010-08-12.
Sie rasierte sich den Kopf und die Augenbrauen, schrieb immer wieder traurige Botschaften auf Facebook. Die Masche zog: Ashley Kirilow soll über das Online-Netzwerk Facebook das Mitleid ihrer Mitmenschen ausgenutzt und sich nach Polizeiangaben mindestens 5000 kanadische Dollar erschlichen haben. Bisherige Unterstützer der Frau schätzen die erschwindelten Einnahmen sogar auf 20´000 kanadische Dollar!
- "A strâns mii de dolari după ce s-a ras pe cap şi şi-a smuls genele" (in Romanian). Libertatea. 2010-08-10. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
Ashley Kirilow, 23 de ani, realizase o pagină pe Facebook şi a folosit reţeaua de socializare pentru a forma grupuri de susţinere, care i-au trimis bani, fără a cere şi primi chitanţe. Tânăra s-a prezentat vinerea trecută la poliţia din Ontario, care o investiga de peste o lună, pentru a fi închisă în urma acuzaţiei de fraudă, aproximativ 20 000 de dolari.
- "Păcălea oamenii spunând că are cancer" (in Romanian). Cancan International. 2010-08-08. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
Ashley Kirilow în vârstă de 23 de ani a organizat strângeri de fonduri ajutată de alte două persoane care erau convinse că tânăra avea cancer în stadiu terminal.
- "Les femmes de la semaine" (in French). Elle magazine. 2010-08-13. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
Ashley Kirilow. Parce que cette jeune Canadienne est à l’origine d’une énorme escroquerie. Elle s’est faite passer pour une malade du cancer, allant même jusqu’à se raser le crâne et s’épiler les sourcils, pour récolter des fonds. Cette mascarade morbide lui a permis de recevoir jusqu’à 20 000 dollars de dons. Depuis que la vérité a été révélée, ses amis et même son propre père se sont retournés contre elle.
- "Acusada de fraude una joven que ganó miles de dólares tras fingir que padecía cáncer" (in Spanish). 20 minutes International. 2010-08-16. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
Sólo quería dar una lección a sus padres, pero la cosa se le fue de las manos. Así justifica Ashley Kirilow, una joven canadiense de 23 años, que fingiera padecer cáncer y recaudara fondos para tratar su falsa enfermedad, un dinero que aprovechó para, entre otras cosas, viajar a Disney World.
- Kevin Gallagher (2010-08-19). "Ashley Kirilow, accused cancer faker, allegedly fielding death threats". National Post. Archived from the original on 2010-09-05. Retrieved 2010-09-04.
The number of threats in the community have raised concerns for everyone involved.
- "Woman pleads guilty to faking cancer to raise cash". ctvnews.ca. Canada: CTV News. 2 November 2010. Retrieved 25 May 2016.
- Jennifer Yang (2010-08-09). "No bail yet for woman who faked cancer". Toronto Star. Archived from the original on 2010-09-04. Retrieved 2010-09-04.
With no one willing to post her bail, Kirilow was remanded back into custody until her next court appearance on Wednesday. A publication ban has been placed on the proceedings.
- Rob Lamberti, "Ex-pals angry at accused cancer scammer". QMI Agency, via the Ottawa Sun, August 10, 2010, p. 16.
- Jim Wilkes (2010-08-20). "Bail granted to woman who admitted faking cancer". Toronto Star. Archived from the original on 2010-09-05. Retrieved 2010-09-04.
She is to be supervised by the John Howard Society and stay at the undisclosed location where the organization has arranged for her to live. She must also report to police and the John Howard Society weekly and she is not allowed to use and or possess a computer or cellphone.
- Kevin Gallagher (2010-08-20). "Accused cancer fraudster Ashley Kirilow granted bail". National Post. Archived from the original on 2010-09-05. Retrieved 2010-09-04.
Kirilow has said she has been diagnosed with bipolar disorder and suicidal tendencies. She and her supporters have faced threats of violence, even death.
- "Ashley Kirilow granted bail: John Howard Society steps up after nobody else did". Hamilton Spectator. 2010-08-20. Archived from the original on 2010-10-21. Retrieved 2010-10-20.
She must be supervised by the John Howard Society and live where the organization tells her to. She must also report to the police and the John Howard Society weekly and she is not allowed to use and or possess a computer or cellphone.
- Mary Gazze (2011-08-03). "No jail for woman who faked cancer: Under psychiatric care after pocketing donations". Winnipeg Free Press. Archived from the original on 2011-10-07.
Both the Crown and the defence took more than an hour to argue reasons behind their recommendation for no jail time, citing Kirilow's mental state and her increasing need to seek attention after a troubled upbringing where she was shuffled between the homes of her separated parents and her grandparents for years.
- Rob Lamberti (2011-10-13). "Ashley Kirilow to face shoplifting charges". Toronto Sun. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
Police said the suspect was arrested around 3 p.m. Oct. 7 at a grocery store on Dundurn St. Police said she is charged with theft under $5,000 and possessing stolen property under $5,000.
- "Cancer faker proves to be her own worst enemy: Charged with shoplifting, she's not getting the psychiatric help she needs". Hamilton Spectator. 2011-10-14. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
But Ashley is more psychiatric patient than criminal. And like so many others with mental health issues, she has firmly wedged herself into a system where it is quicker and easier to get inside a jail cell than a psychiatrist’s office.
- Michele Mandel (2011-10-14). "Maybe Kirilow didn't get the help she needs". Toronto Sun. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
And everyone had been so hopeful last spring. Were we misled yet again by this con artist? Or are we looking at a very ill young lady who keeps crying out for help — and isn’t getting the treatment that she needs?
- Ken Peters (2011-10-22). "Fifteen days in jail for minor shoplifting crime". Hamilton Spectator. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
Ashley Kirilow, the 24-year-old Burlington woman who received a 15-month conditional sentence in April for a fraud involving her faking cancer, was sentenced to one day of jail after pleading guilty Friday to theft under $5,000.
- Susan Clairmont (2011-11-10). "Judge firm but gentle with Kirilow: Convicted fraud artist gets 30 more days in jail". Hamilton Spectator. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
Yet, like a stern but kind rebuke from a grandfather, a judge showed more concern and caring for Ashley Kirilow on Thursday than just about anybody has for a very long time.
- "Cancer faker appears in Milton courthouse". Hamilton Spectator. 2012-02-08. Archived from the original on 2012-02-29. Retrieved 2012-02-29.
Cancer faker Ashley Kirilow appeared briefly in a Milton courthouse Monday for allegedly breaching her probation a second time.
- Melissa Ratlis (2012-02-06). "Kirilow appears in court for breach". CHCH TV. Archived from the original on 2012-02-29. Retrieved 2012-02-29.
- "Cancer faker Ashley Kirilow jailed for latest breach". The Hamilton Spectator. 2012-03-01. Archived from the original on 2012-03-25. Retrieved 2012-03-24.
Defence counsel Kirstie Bloomfield, who noted Kirilow breached her house arrest conditions Jan. 30 by visiting her boyfriend, said her client will remain in jail until the end of May.
- "Accused cancer fraudster faces new charge". CTV News. 2010-08-11. Archived from the original on 2012-03-25. Retrieved 2010-08-19.
Care noted that Kirilow had visited small children in hospitals, an act that "upsets me no end."
- Reka Szekely (2010-08-13). "Charities extend their reach online". Durham Region News. Archived from the original on 2010-08-18. Retrieved 2010-08-18.
At worst there's the case of Ashley Kirilow, the Burlington woman accused of faking cancer and bilking thousands of dollars from people eager to support her. Ms. Kirilow is accused of posting pictures of herself bald and with plucked eyebrows and eyelashes on her Facebook group for an alleged bogus charity called "Change" for a cure. Reading about the allegations against Ms. Kirilow is disheartening and inevitably leaves people feeling jaded about charitable organizing via social media.
- Kevin Gallagher (2010-08-20). "Woman charged in cancer fraud out on bail". National Post. Archived from the original on 2010-09-05. Retrieved 2010-09-04.
Bob Muck, the heavily tattooed man who appeared at Kirilow’s bail hearing on Thursday, was not at yesterday’s proceedings and has withdrawn his intent to post her bail.
- Linda Nguyen (2010-10-13). "Family looking for help to raise $300,000 for experimental treatment". Toronto Sun. Retrieved 2010-10-20.
Rick Wronzberg said the family was worried that people wouldn't want to give after the recent high-profile case of a Ashley Kirilow, a 21-year-old Burlington, Ont., woman facing fraud charges for allegedly pretending to have cancer to raise funds. They appear to have been proven wrong. A spokeswoman with the Canadian Cancer Society could not say if donations to cancer charities have lagged in light of the recent fraud case. She urged people who make donations to check a charity's status and to check out where their donations are being sent.
- Brendan Kennedy (2010-08-07). "Kirilow blames cancer charity scam on miserable childhood". Toronto Star. Archived from the original on 2010-08-19. Retrieved 2010-08-19.
The 23-year-old woman who faked having cancer, ran a bogus charity and scammed hundreds of people of at least $13,000, says she did it to get back at her parents for a miserable childhood. 'I took it as an opportunity to make my family feel bad for how I was treated,' she said.
- Brendan Kennedy (2010-08-06). "Woman faked cancer to raise money". Toronto Star. Archived from the original on 2010-08-19. Retrieved 2010-03-16.
Skate4Cancer’s involvement with Ms. Kirilow was based solely on fulfilling what the organization believed to be a legitimate final wish from a terminally ill individual.
- "Ont. woman faked cancer for cash, Disney trip: report". Montreal Gazette. 2010-08-08. Archived from the original on 2010-09-05. Retrieved 2010-09-05.
She befriended different local groups and recruited volunteers to help her organize events and benefit concerts in her own honor, and even convinced a cancer awareness organization — Skate4Cancer — to fly her to Disney World to fulfill what she said was a dying wish. All told, she raised C$20,000 ($19,400), volunteers said.mirror
- Tim Whitnell (2010-10-01). "Kirilow 'cancer' case in court". Inside Halton. Archived from the original on 2010-10-21. Retrieved 2010-10-20.
Ashley Kirilow was not in Milton assignment court on Wednesday morning, but her lawyer, Oakville’s Brendan Neil, represented her in court for the first time since Kirilow’s bail hearing in late August, an event that attracted massive media coverage.
- "Timmins woman accused of faking cancer to get money". Timmins Times. 2010-11-07. Archived from the original on 2010-11-07.
The story is similar to that of Ashley Anne Kirilow, a Southern Ontario woman who earlier this year admitted to police she faked cancer symptoms and collected more than $7,000 from sympathetic friends and supporters. The case shocked and upset many people, especially those with friends and family members truly struggling with cancer.
- "Second woman accused of faking cancer for money". Toronto Sun. 2010-11-07. Archived from the original on 2010-11-07.
In August another Ontario woman was caught scamming hundreds of people out of a total of $7,400 by pretending to have cancer. Twenty-three-year-old Ashley Anne Kirilow from Burlington pled guilty to one count of fraud over $5,000 last week.
- "Second Ontario woman alleged to have faked cancer". CTV News. 2010-11-06. Archived from the original on 2010-11-07.
The arrest comes days after Ashley Kirilow, of Burlington, admitted in court that she faked terminal cancer and kept thousands of dollars from sympathetic donors.
- Tobi Cohen (2010-11-07). "Ontario woman faces charges in cancer fraud". Winnipeg Free Press. p. A16. Archived from the original on 2010-11-07.
Days after a woman admitted in court that she faked cancer to play on the sympathies of those around her and cheat them out of their money, police in Ontario are accusing yet another young woman of the running the same scam.
- Colby Cosh & Aaron Wherry (2011-12-06). "Villains: Meet the shame gang". Maclean's magazine. Archived from the original on 2011-12-28. Retrieved 2011-12-28.
Canada saw a wave of cancer fraudsters this year, including their photogenic queen, Ashley Kirilow of Burlington, Ont., who was convicted of raising $12,000 from unsuspecting marks. Kirilow’s artistry fell far short of Douglas Clark’s, however. The Port Coquitlam, B.C., man reportedly claimed to be an ex-admiral needing cancer treatment in the U.S., and is said to have raised $460,000 from just two friends. Meanwhile, in St. Catharines, Ont., Michelle Clemmer-Meller is accused of using false cancer claims to scam $200,000.
- Katie Schneider (2012-09-15). "Alleged brain cancer fraudster back in Calgary to be charged". Calgary Sun. Retrieved 2015-03-12.
The case has been likened to one in Ontario where Ashley Kirilow received 10 months house arrest and 100 hours community service for shaving her head and lying about having the disease in order to solicit donations and hold fundraising events.
- "Calgary Cancer Faker Kristopher Cook Ordered To Pay Canadian Cancer Society $7,500, Sentenced To Six Months In Jail". Huffington Post. 2013-01-11. Retrieved 2015-03-12.
Last year, Ashley Kirilow of Hamilton, Ont., pleaded guilty to fraud after admitting she raised $12,000 in donations by convincing people that she had cancer. Kirilow was given a 15-month conditional sentence and was ordered to complete 100 hours of community service.
- "Grimsby cancer faker says her motives were not financial". Hamilton Spectator. 2013-04-01. Retrieved February 27, 2016.
Three years ago, 24-year-old Ashley Kirilow, of Burlington, pleaded guilty to two counts of fraud for deliberately scamming people out of thousands of dollars after lying about a terminal cancer diagnosis.