Childhood Cancer & Chemotherapy
Childhood cancer & chemotherapy: One mother's story about a baby who was born with hepatomblastoma (liver cancer) and went through twelve-weeks of chemotherapy. Discusses treatment processes and effects of treatment.
My daughter is one-in-a-million. I know that all parents think that, but in my daughter's case it is true. One in a million North American children will get liver cancer sometime during their childhood years. In my daughter's case, she was born with it. Hepatoblastoma was the official diagnosis. It is a word I would rather not have learned, but also one which I have learned a lot about. She is in remission now and for that we are thankful. It has, however, been a strange journey.
My daughter was born on the only snowy day in North Texas in the winter of 2000. Immediately her pediatrician noticed a lump in her tummy. She had a sonogram performed when she was just a few hours old; the sonogram revealed a mass the size of half an apple. She was taken to the local children’s hospital where she underwent surgery and the mass was removed. The surgeon told us that the mass he removed did not look malignant. The oncologist told us the same thing. At first, the medical personnel thought that my daughter had an hemangioma – a benign clump of blood vessels. Two weeks later, a pathologist diagnosed her with liver cancer. It sure wasn’t what we’d bargained for when we decided to have a baby. We never even knew that cancer was something to be concerned about in a newborn infant.
After a CT scan that showed that the cancerous cells had been completely removed, we discussed treatment options with the oncologist. Although the cancerous cells were completely removed in surgery, she still had to undergo surgery for both precaution (in case a few cells were remaining) and prevention (because hepatoblastoma is an aggressive cancer which will return). Each type of cancer has a certain set of protocols (or treatment plans) that can be used. Some involve experimental drugs and some involve standards that have been established over time. We allowed our daughter to take one experimental drug along with the standards because this medicine – amifostine – is supposed to reduce some of the ill effects of the chemotherapy.
My daughter’s treatment began when she was just two weeks and five days old. The nurses on the oncology floor of the hospital said she was the youngest chemo patient they had ever had. Her treatment involved four three-week rounds of chemotherapy. Before the treatment began, she had surgery to place a port in her chest which kept her from having to have an IV in her arm (or elsewhere) each time she needed treatment. On Day #1 of each 3-week cycle, my daughter stayed overnight at the hospital and received 20 hours of fluids along with a chemotherapy drug called cisplatin. On Day #3 of the cycle, she would go to the oncology clinic for a dose of vincristine and another of 5-FU. On Day #10 and Day #17 of the cycle, she would have doses of vincristine. Her treatments lasted for 12 weeks, but it sure seemed like a long time. Each drug had its share of side effects so that any time something was wrong, we had no idea if her problems were normal baby problems or chemotherapy problems.
The vincristine, especially, made her sick. The first dosage they gave her was the amount they would have given to a child of any age with cancer – even though my daughter was only 6-pounds. It wasn’t a mistake – they just didn’t know because they did not have a lot of experience in treating very small babies (even in the national protocol) so the oncologists had to experiment to see how much of the chemotherapy drugs to give her. That landed us in the hospital for a week, though. We spent two separate weeks in the hospital while she was recovering from an ileus (shut-down of the gut) one time and a staph infection of her blood another time.
Chemotherapy shuts down the immune system as it suppresses the white blood cells. This meant that we had to stay away from people throughout our daughter’s treatment. Some of the chemotherapy also caused her hemoglobin or red blood cell count to decrease so she had to have three blood transfusions. Fortunately, we had relatives with matching blood types who were willing to donate.
I saw some things that I never knew existed during my daughter’s treatment: a playroom full of kids attached to IV trees – some getting blood, some getting chemotherapy; very small children without hair; hospital rooms which looked like home because the children were there for so long. I also learned that nurses are some of the most caring people in the world. They have a tough job – administering treatments, listening to parents, cleaning up after sick children, following doctors’ orders, monitoring vital signs. I developed a respect for nurses that I had never had at the same time I developed a sense of what cancer treatment entailed.
After my daughter’s twelve weeks of treatment, she had another CT scan. It also showed no signs of cancerous cells. She is considered in remission for five years and if her periodic (every three months at first and then every six months) scans also show no cancer, she will be declared cured. She has a 90% survival rate – survival meaning that the cancer will never recur. That is the hope behind childhood cancer – MOST of the time it is curable.