The milestone of reaching high school graduation carries a deeper meaning for a Texas teen who walked the stage after facing four separate cancer diagnoses.

Makayla Nelson’s first cancer diagnosis was at age 11. Stomach pain led Nelson, who was a sixth grader at the time, to the hospital, where she learned she had kidney cancer and needed to have a kidney removed.

“I’ve had cancer, but cancer is not me,” Nelson told Tyler news station KTRK, who first reported the story. “God has me here for a reason.”

Since then, she has dealt with recurrences in her lungs and brain, and has had to undergo surgery, radiation, chemotherapy and stem cell transplants.

Her mother, Sherree Nelson, said her daughter hoped that she would make it to middle school graduation. Now, she’s a Tyler High School graduate.

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“You want your children to achieve all their dreams and goals,” Sherree Nelson said. “But when this constant reminder keeps getting thrown in, it’s hard.”

Makayla is currently in treatment after being diagnosed with a brain tumor last month. She is waiting to decide the next steps, but said that faith, family and purpose is what inspires her to carry on.

While Makayla said it is sometimes hard to remain optimistic, she’s doing what she can to stay positive. Whatever her doctors say is best, she said, she will do.

Despite the ongoing struggle, Makayla said she felt “in awe” that she made it to her high school graduation. Now, she’s preparing to attend University of Texas at Tyler, where shes plans to study pediatric oncology nursing. It’s an educational path driven by her own experiences.

“I knew that there was something bigger ahead of me,” Nelson said. “It’s just something in me that drives determination to be something bigger – because I’m here for a reason.”

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This article originally published at Texas teen faces cancer four separate times, celebrates high school graduation.