By Dr. Rishi Chavan, pediatric stem cell transplanter and oncologist at CHOC
Not too long ago we had a patient; a child who underwent stem cell transplant for relapsed acute myeloid leukemia. Their donor was a sibling who lived in Mexico, and we had them travel here to have their bone marrow harvested prior to their transplant. The transplant was challenging as the patient had developed an infection in their lungs prior to transplant. We had to treat the infection first while doing bridging chemotherapy to ensure sustained remission because the transplant would temporarily wipe out their immune system. Now, they are more than a year post transplant and happily back with family in Mexico. They still visit us to ensure sustained remission and long-term follow up.
This patient was one of our sweetest. Not only were they extremely polite, but despite their pain while undergoing chemotherapy, they were always very grateful.
We often ask patients, “How are you doing today?”
This patient always responded, “Bien, gracias a Dios” or “Good, thank God.”
September is Childhood Cancer Awareness Month. As the motto goes: “No one fights cancer alone.” At Hyundai Cancer Institute at CHOC, we truly live this motto everyday as it takes a village. We have an amazing army of nurses, child life specialists, pharmacists, experienced advanced practitioners, occupational and physical therapists, nutritionists, music therapists, social services experts, chaplain, care coordinators, medical interpreters, research coordinators, quality mangers, laboratory and blood bank staff, radiology technicians, schedulers, front desk staff, environmental support staff, volunteers and many who are tirelessly working behind the scenes closely with multiple subspecialties of physicians to help families care for their loved ones. Their only hope is to ensure that the child receives the best possible treatments as guided by the amalgamation of recent research advances and years of evidence based clinical experience.
Cancer often starts with a few cells in the body choosing to misbehave while its misery extends well beyond the patient to their extended family. What inspires us to do what we do is our patients and their families. We can never really have a bad day as there are always families whom we know very intimately going through difficult times. We can also never even have a bad hair day – most of our patients lose their hair while getting chemotherapy and radiation.
Amongst these untiring days are also teary-eyed moments of joy when we watch our patients ring the bell to complete their last chemotherapy, transition to a long-term survival clinic, get married or graduate college. Apart from these sparks, what propels cancer care is the ongoing research — which is one of the most collaborative effort in almost all of science. Childhood cancer researchers are a very close-knit community where most physicians are eager to collaborate and work together to help advance overall survival while safeguarding quality of life and minimizing long term side-effects of treatments. At the Cancer Institute, we are a part of major clinical research consortia with access to multiple national and international phase 1 and 2 clinical trials with most physicians leading their own investigator-initiated trials to help advance various aspects of childhood cancer care.
As our patients and families continue to push through their multiple hardships and smile beyond the pain, we all are greatly enthused and feel sincerely grateful to be a part of their stories. Lastly, in case you were wondering how we all were doing amidst the crazy COVID-19 pandemic:
Bien, gracias a Dios!
CHOC Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2023-24 Best Children’s Hospitals rankings and ranked in the cancer specialty.