No one is made for cancer, but Perry Oviedo certainly has the spunk it takes to beat it. At just 3 years old, she’s already spent nearly two years fighting a type of blood cancer called acute lymphoblastic leukemia (ALL), and she’s done it with a heaping dose of grit and grace.

“As soon as she started showing glimpses of a personality as a baby, we thought, ‘Oh, God, we need to buckle up because something is different about this kid,’” said Ashley Oviedo, Perry’s mother. “She’s always had a very large personality. We jokingly call her our feral child because she’s just wild, silly and sassy.”

Acute lymphoblastic leukemia is an aggressive cancer in which the bone marrow makes abnormal white blood cells that crowd out healthy blood cells. Red blood cells carry oxygen throughout the body. Having too few of them results in anemia, which means the body’s tissues and organs do not get the oxygen they need to thrive. Perry’s diagnosis came after about six weeks of symptoms that doctors originally thought were due to a viral infection. Some ALL symptoms, such as fever, fatigue and loss of appetite, overlap with common viral symptoms.

Slowly, Perry’s once vibrant personality faded into fatigue, Ashley says. Her cheeks turned pale, and her big brown eyes were overshadowed with dark circles underneath. Once a good sleeper, Perry began waking multiple times at night.

“At her second birthday party, we noticed that she just wanted to be held,” Ashley said. “You would think, even if she wasn't feeling great, she would still somewhat enjoy her birthday party with all of the fun and cupcakes and friends. I thought something might be wrong because she wasn’t really acting like herself.”

In the weeks that followed, Perry’s tired demeanor gave way to a persistent runny nose and stomachache. Maybe she was cutting her molars, had an ear infection, or was fighting a virus or two that came and went, thought doctors and the Oviedos. But Perry never seemed to fully recover, and Ashley kept pushing for answers. 

One finally came on a Wednesday morning in January 2024, and it changed their lives forever.

Clues Emerge

On the eve of that fateful day, Perry spent the morning with her grandmother, who noticed that Perry didn’t look or act as if she felt well—a concern she expressed to Ashley during a phone call discussing pick-up plans. Her mother’s worry confirmed what Ashley and her husband, Joseph, had witnessed for weeks. Something was wrong with their baby, and it was more than just a virus. 

“It was super validating to hear from someone else who knows her so well that they also thought something was wrong,” Ashley said. “I needed to hear that because I didn't want to be the crazy mom making another appointment and insisting that something is seriously up with her.”

Ashley made a beeline to her mother’s house to pick up Perry. 

“When I got there, my mom opened the door and Perry was standing next to her, and I'm not kidding when I say Perry was unrecognizable to me,” Ashley said. “She looked almost jaundice-like and had little bruises on her face.”

Ashley made an appointment with Perry’s pediatrician for the following morning. It was the first time since the onset of Perry’s symptoms that her long-time pediatrician examined her, having been out of the office when Ashley initially took Perry to get checked out weeks before. The doctor immediately noticed the difference between the spirited Perry she was accustomed to seeing and the Perry in her office that day.

By that afternoon, results from bloodwork performed at the pediatrician’s office were in, and revealed troubling abnormalities. Too soon to suggest a diagnosis, the pediatrician’s office called and instructed the Oviedos to take Perry to the Emergency Department at Cook Children’s Medical Center for further testing.

Taken By Surprise

Ashley and Joseph were more relieved at having a potential clue to Perry’s health issues than they were alarmed, never imagining the diagnosis that was to come. At this point, no one had mentioned cancer, or anything close to it.

“I was so naive to the fact that cancer was even a possibility,” Ashley said. “I will never forget, when we were pulling up to Cook Children's to park that day, there was a dad pushing a little boy who obviously had cancer in an umbrella stroller right through the courtyard in front of Peaks the Dragon. And I thought to myself, ‘Oh my God, can you imagine?’”

But in the ER, there seemed to be an elephant in the room. No one wanted to deliver the bad news.  

After several questions from the Oviedos, the ER doctor reluctantly shared a likely diagnosis, beginning with the best-case scenario.

“The cure rates for ALL are very high,” the doctor said.

“What is ALL?” Ashley asked.

“Leukemia,” he replied.

“Before I start overreacting, are you telling me we are here because you think my baby has cancer?” Ashley pressed. 

With a sympathetic nod of his head, the doctor confirmed the diagnosis. The news knocked the breath from Ashley’s lungs.

“In that moment, our world just completely stopped,” Ashley said. “The nurse and the doctor were standing there clearly devastated and heartbroken to be delivering the news to us, but I forced it out of them. In hindsight, they weren't planning to be the ones to tell us.”

Rapid Response

Behind the scenes, Perry’s blood was being carefully studied under a microscope, and a care team was already forming a treatment plan. Two of those team members, Holly Pacenta, M.D., Cook Children’s hematologist/oncologist, and Alan Ready, CPNP-AC, a hematology/oncology nurse practitioner, met the Oviedos in the ER to explain the diagnosis and outline the steps ahead, which included two and a half years of chemotherapy. By that evening, Perry was settling into what would become her home away from home during much of her treatment—Cook Children’s Hematology and Oncology Unit. Within 24 hours, she began her first round of chemotherapy.

“The first 48 hours were a whirlwind,” Ashley said. “I was so grateful that they were able to intervene so quickly at the time. It was unbearable to sit there and hear that your child has cancer, but the rate at which we were diagnosed and started treatment, the efficiency and urgency, it's just unmatched care. We're just so fortunate to be where we are and have the team that we do.”

Perry’s Personality Returns

The 30 days of steroids that Perry received during her initial phase of treatment proved the hardest part for the toddler. Swelling made her uncomfortable and unable to walk, and she wanted to eat constantly—both common side effects of steroids. When Perry requested mac and cheese at 3 a.m., the Oviedos obliged, knowing the small act brought a little comfort and relief to their baby.

As treatment progressed, the Oviedos began to see glimpses of their daughter’s spunky personality return. Her care team noticed, too.

“She is such a sweet little girl with a lot of spunk,” said Dr. Pacenta, Perry’s hematologist/oncologist. “Whenever she comes to clinic, she usually ends up in the workroom where the doctors and nurses sit, entertaining us or showing off her outfit. She is always happy to see us and full of joy, even when she knows she’s coming to her doctor visit to get chemo. It reminds me that she’s still just a little toddler who just wants to play and laugh.”

Now in the final stage of treatment, known as maintenance, Perry takes oral chemotherapy at home.

“She has taken ownership of her own treatment,” Ashley said. “I fill the syringes and she does her meds herself and rinses them out. I can’t believe how big of a girl she has become through all of this. It's just wild to see how she’s adapted to it all.”

In April, following her final dose of chemotherapy, Perry will do what all cancer patients and their families dream of doing. She’ll ring the bell on the Hematology/Oncology Unit to signal and celebrate her completion of cancer treatment.

“We were really fortunate that Perry responded really quickly to treatment and that she checked all the boxes to be considered the most favorable category for the lowest risk of relapse for her type of cancer, which is a miracle,” Ashley said.

Play is Medicine

Medical interventions like chemotherapy may heal the body, but the interruption of childhood can wreck the mind and spirit. Cancer treatment is traumatic, especially for very young children like Perry. They often lack the emotional skills to process and articulate their feelings. Kids battling cancer may also miss out on important developmental and social milestones like play dates with friends or attending pre-school.

That’s why healing supports like play therapy are as important as chemotherapy. Play is a language all kids understand, whether they’re speaking full sentences or have yet to form their first words. It helps them feel like a kid again while walking through a deeply serious and complicated circumstance, and provides an outlet for expressing their feelings and practicing social skills.

“Whether you’re a toddler, or an 83-year-old with profound life experience, play is universal,” said Leah Webb, LPC, Cook Children’s Hematology/Oncology clinical therapist. “Play therapy creates a sacred space for children to be empowered in a world that can feel scary and complex, especially if they are navigating medical treatments that accompany diagnoses such as ALL. During a play therapy session, the clinician has the honor of walking alongside a child as they express their deepest thoughts and emotions via tools such as toys, art or a sand tray. Through play therapy, you get a glimpse of a child’s inner world, and the healing that takes place in this process is truly a beautiful thing to watch unfold.”

Play therapy isn’t just healing Perry’s mind and spirit during treatment, it’s also preparing her for the life that comes after.

“She's just been subjected to so much at such a young age, and she doesn’t know how to articulate that,” Ashley said. “I’m so thankful Dr. Pacenta referred her to play therapy. They're really caring for her as a whole person and supporting all of her needs because they want her to ring her bell and finish treatment and be a normal, healthy, happy and thriving kid in kindergarten. It's just meant a lot to me as a mom that they care about her.”

Even with Perry’s favorable response to treatment, her journey hasn’t been without its complications and setbacks, Ashley says. What they once called spunk and sass, they now recognize as the spirit of the warrior Perry has proven herself to be. Their eyes remain firmly fixed on the prize ahead—that ever symbolic and special bell-ringing day.

“It still feels surreal sometimes, but at the same time, we've been at this for so long now that I literally forget what life was like before we were the cancer family and Perry was the cancer kid,” Ashley said. “It's a rollercoaster of emotions of grief and joy that we've been able to experience even on the hardest days. And to see Perry's resilience, it's just totally changed our family. Turns out, she’s a real warrior.”

Dr. Greer, who leads the Neuroblastoma Program at the Cook Children’s Hematology and Oncology Center, knows from personal experience what it’s like to receive treatment for cancer at Cook Children’s. She knows how it feels to undergo a biopsy, receive a cancer diagnosis, and experience the toll that chemotherapy takes on the body.

Getting treated for cancer in adolescence even shaped a life goal: She made up her mind that one day she’d work as an oncologist at Cook Children’s Medical Center – Fort Worth, the same place she came for those chemo infusions as a preteen patient.

“My journey's pretty unique,” said Dr. Greer, who joined Cook Children’s in 2023. “I know a lot of people attain their goals, but not too many people say when they're 12 that they're going to come back and be the doctor who was taking care of them. I get to do that, so I feel very grateful.”

At the Neuroblastoma Program, Dr. Greer works to help children and teens the way her doctors helped her. She coordinates a team approach. Treatment options for neuroblastoma include chemotherapy, immunotherapy, transplant, radiation and surgery.

“Many children with neuroblastoma present with advanced stage disease, and it is a very complicated, intensive, long treatment journey,” said Kenneth Heym, M.D., Medical Director, Cook Children’s Oncology. “It takes someone with expertise in that specific area who’s really going to dedicate themselves to this disease and this group of patients.”

Dr. Greer understands that cancer feels overwhelming. But she assures her patients that she and the Cook Children’s oncology team are by their side. They’ll make a plan and take it one day at a time.

Memories of having cancer translate into the empathy in Dr. Greer’s approach. She never assumes she knows exactly what her patients and their families are experiencing. That’s because everyone’s circumstances are unique to them. But her empathy stems in part from what she went through:

• Initial uncertainty about what was causing her symptoms
• Long drives from West Texas for five rounds of chemo
• Lodging at Ronald McDonald House and extended-stay hotels
• Several hospitalizations from complications

Dr. Heym points to Dr. Greer as an inspiration for the accomplishments that pay off through diligence and determination. Dr. Heym uses the word “amazing” to describe the colleague he met long before she earned her medical degree.

“She comes off as somebody who has been doing this a lot longer, both in her knowledge base, which is incredibly extensive and shows her dedication to study, and in her clinical skill and the way she carries herself and leads her team,” he said. “It’s clearly beyond what you’d expect from someone at that stage in their career.”

Dr. Greer took a fast track through high school and college before graduating in 2016 from the Texas College of Osteopathic Medicine (TCOM). She went on to do a pediatric residency and research into the long-term risks of cancer medicines for certain patients.

Dr. Greer also sees patients with other types of cancer in the medical center or the outpatient clinic. She derives her passion as a physician from the relationships that develop in an environment of stress and vulnerability.

“That's really why I do what I do,” she said. “Because we care so much, we're going to take great care of the child. The bonds form really strong, really fast, and that is important to help them through everything.”

September is National Childhood Cancer Awareness Month, which gives us the chance to spotlight Dr. Greer's unique expertise. She sees the patient perspective through a lens of awareness and extra sensitivity. Because she’s been there.

Hodgkin’s Lymphoma

Chelsee Greer was an athletic and studious seventh-grader who played soccer, ran cross country, and did homework late into the night. She kept such a busy schedule that her parents weren’t initially worried when she became extremely tired in March 2002. But then came a low fever, night sweats, swollen glands in her neck, and unexplained weight loss. Her first doctor suspected a case of the flu or mononucleosis.

Her fatigue got worse. At school she was so exhausted she would nap in the locker room during lunch. After the school year ended, she slept through much of a family trip to the beach.

“My mom was like, ‘Something’s really wrong,’” Dr. Greer remembers. Another doctor in Odessa ordered a CT scan, and when the results came back, he summoned the family to an evening meeting in his office. The CT scan pointed to lymphoma, the doctor said. They’d need a biopsy to be sure.

Those words didn’t make sense to Dr. Greer at the time. But she figured it wasn’t good news. Her parents were crying. They had to leave for Cook Children’s right away.

So the next morning the Greers drove four and a half hours to Fort Worth. A lymph node biopsy confirmed she did indeed have cancer. Dr. Greer was one of about 8,600 people in the United States diagnosed each year with Hodgkin’s lymphoma, a type of cancer involving the immune system.   

Lymphoma had spread throughout her abdomen and pelvis. The fatigue, fever and other symptoms were her body’s inflammatory response. Doctors at Cook Children’s planned to treat the cancer with five rounds of chemotherapy followed by radiation.

W. Paul Bowman, M.D., became Dr. Greer’s primary oncologist. He remembers her as a 12-year-old with a knack for listening and asking questions.

“She was smart, inquisitive and engaged,” Dr. Bowman said. “She had a sense of commitment and was goal-oriented to put this disease behind her. She was an advocate for herself.”

Dr. Greer saw firsthand how childhood cancer turns life upside down for the whole family. Her mom took a leave from work so that they could make chemotherapy appointments in Fort Worth for a week at a time. Friends, relatives and neighbors pitched in to help her dad take care of her younger sister back in Odessa.  

In addition to the treatments in Fort Worth, she occasionally came for checkups closer to home at Cook Children’s Pediatric Specialties Midland.

“She didn’t feel sorry for herself,” said Julie Jolly, RN, at the Midland clinic. “She just knew this was a hurdle she was going to get over, and her life goals were going to be met.”

There were hard days when Dr. Greer dealt with vomiting from nausea, painful mouth sores and other reactions to the chemo. Her hair fell out. Complications put her in the hospital a few times. She couldn’t attend school in person, so she received homebound instruction for part of eighth grade. But there were bright spots too, including her appreciation for the infusion center nurses.  

“My parents were super amazing. My support system -- my grandparents, my aunts and uncles, my best friend -- definitely made it a lot easier. And I think during treatment it was just kind of like, ‘All right, this is what we're doing.’”

Chemo treatments started in June 2002, and after the fifth round in November, her cancer was gone. She didn’t need radiation after all.

Moving Forward

Dr. Greer graduated from high school in three years. Then, during her summer breaks in college, she volunteered at the clinic in Midland. Jolly taught her how to check vital signs and perform other procedures. She shadowed Dr. Bowman when he saw oncology patients in Midland.  

Dr. Greer went to medical school at TCOM, where Dr. Bowman was a teacher and mentor to his former patient. One of her rotations was at Cook Children’s oncology.

“Maybe she’s matured more quickly because of what she went through, but Chelsee has always seemed kind of grown up. I just have such tremendous respect for her,” he said.  

Dr. Greer did a pediatric residency at Dell Children’s Medical Center in Austin and a hematology and oncology fellowship at UT Southwestern Medical Center in Dallas. Then she joined the oncology staff at Cook Children’s. As Dr. Bowman puts it … she came back to her roots.

Unique Perspective

Surviving childhood cancer became a driving force in Dr. Greer’s life and medical practice. She sets high standards for herself. She advocates for broader access to health care in underserved communities. Because she remembers the anxiety of waiting after a scan or biopsy, she goes out of her way to communicate those results promptly any time of the day or night.

“I think I have an empathy that's built in that you can't be taught,” she said. “I really know what it's like to be waiting for those test results.”

She tells her patients that cancer is a big speed bump in life. And she wants them to know she’ll do everything possible to help get them on the other side of the speed bump. Don’t give up on your goals, she advises.

Dr. Greer stands out for her work ethic, attention to detail, and focus on every patient, Dr. Heym said. She’s already done incredible things in pediatric oncology. And Dr. Heym predicts much more to come.

Grit and aspiration propelled her from her first visit to Cook Children’s -- as a 12-year-old facing cancer – to the same health care system, now as a physician and leader in the fight against the disease.

Dr. Heym describes Dr. Greer this way: “Everything you do, do it right, do it to the fullest, make it worthwhile. And then being able to turn that into a life of helping others.  You can’t think of a more heartwarming story.”

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Boosting Research Toward a Cure for Childhood Cancer

Marlee Munguia has a rare cancer that wasn’t responding to standard chemotherapy when she was first diagnosed at age 3.

But her doctors at Cook Children’s had other strategies to try, including immunotherapy and two stem cell transplants. Thanks to those treatments – along with radiation, surgeries and scans over the past three years – Marlee has a healthier and happier outlook. 

Now age 6, she still needs treatment for neuroblastoma, a type of cancer involving nerve cells.  Cancer, however, doesn’t define her. Marlee rests up after each medical procedure or inpatient stay at the medical center in Fort Worth. Then she resumes her full schedule of play, horseback riding and representing Cook Children’s as a patient ambassador. 

Marlee shines in her role as ambassador, which suits her outgoing personality and chatty friendliness. She attends charity events, poses for publicity photos and even spoke on the radio to share her love for Cook Children’s. As her mom puts it … Marlee is social as a butterfly and fierce as a lion.  

Those ambassador duties put Marlee and her family in the spotlight to help promote The Blast fundraiser. The Blast is a 5-kilometer walk on April 6 benefitting the Cook Children’s Hematology and Oncology Center.

And it’s a cause close to the hearts of Marlee’s parents, Lani and Mason Munguia. That’s because every dollar donated at The Blast brings more research, clinical trials and treatments closer to home for cancer patients in North Texas and beyond.

“Without these newer drugs that require research and research money, Marlee wouldn’t be here today,” Lani said. “We need new drugs and less harsh drugs that don’t cause so many side effects. We can’t do that without research.”

Cancer therapies work by destroying the cancer cells, but they often cause brutal side effects to the rest of the body. Marlee lost much of her hair, eyebrows and eyelashes. At times she couldn’t eat because of vomiting and the sores in her mouth. One of her transplants led to septic shock and a rare liver complication, putting her into the pediatric intensive care unit (PICU).

Cook Children’s oncologist Chelsee Greer, D.O. points out that just 4% of the annual federal budget for cancer research goes toward pediatrics. Financial donations help close the gap and can lead to development of new therapies that take less of a toll on children, she said. 

“Patients and families deserve more options, and that’s why it is so important to continue ongoing research and clinical trials,” Dr. Greer said. “It’s also important that the community help support organizations close to home, like Cook Children’s. Donations to our hospital help families here in DFW and across the state of Texas.”

About 15,000 children and adolescents are diagnosed with cancer each year in the United States, according to the Centers for Disease Control and Prevention. As therapies improved, cancer death rates among those 14 and younger have dropped nearly 70% over the past 40 years.

The Blast aims to raise awareness and salute everyone touched by childhood cancer. What inspires the mission? “Together, we’ll walk in celebration of the children who have fought and won, in remembrance of those who have passed and in hope for a world in which pediatric cancer does not exist.”

Team Marlee Strong will be out in force for The Blast. Her supporters include Munguia family members, friends and baseball players from Fort Worth’s Chisolm Trail High School, where Mason coaches. Here’s more of Marlee’s story, and information about ways you can join The Blast to help #blastawaycancer.

Resilience and Hope

Marlee began getting sick frequently when she was 3. In January 2021, severe pain sent her to a hospital in Odessa, her hometown, where doctors found a mass growing in her chest and abdomen. The main tumor was behind her heart, wrapped around the aorta and blood vessels that supplied the spinal cord.

It was too stormy to fly, so an ambulance took her right away to Cook Children’s Medical Center – Fort Worth. Chemotherapy started a few days later. Marlee needed a round every 21 days, staying in the hospital for at least a week afterward to be monitored.

Mason and Lani wanted to remain close by because of how frequently Marlee would be admitted. So Mason’s student athletes and their friends in Odessa boxed up their belongings; the Munguias found local housing and now live near Saginaw.

“We never got to really say goodbye to our home. It was sold by a friend of ours who was a real estate agent,” Lani said. “We never went back for like a year.”

Marlee’s course of treatment since the beginning has included several surgeries, 12 chemo rounds and 18 days of radiation. During one point in 2021, she was hospitalized for an 80-day stretch that spanned Thanksgiving and Christmas.

For much of 2023, her scans looked good. She had the energy to swim, play tennis and start kindergarten. Treatments ended and her ports were taken out. But last September, cancer was found in her femur bone.

It was a crushing setback. But Marlee resumed her immunotherapy and radiation sessions with a spirit of resilience and upbeat positivity.

Lani says her daughter shows up for appointments with a smile on her face and a wave for everyone in the medical center’s hallways. Headed to a checkup one day, for instance, Marlee chose to wear a yellow dress and hairbow. A photo captures her sunny radiance. 

She’s very much at home at Cook Children’s. Visits with the staff – including the drama therapist, Child Life specialists and Sit … Stay … PLAY therapy dogs – make Marlee’s experience as good as it can possibly be, even during a painful procedure or on the days where she ran fever and had no appetite.   

The older she gets, the more she understands that the pokes and side effects of cancer treatment aren’t easy. But she considers Cook Children’s a place where she’s safe and loved. The Glitter Girls paint her fingernails, the nurses play Roblox with her, and Marlee sings for the staff.

The grateful Munguia family leans on prayer and their support system. And they return the love by doing what they can to help other families at Cook Children’s. One year they put together 10 holiday baskets with snacks, gift cards and toys for children spending Christmas in the Bone Marrow Unit. 

Marlee’s oncologist describes her as spunky and sensitive to the needs of other people.

“Even at such a young age she understands the importance of helping others,” Dr. Greer said. “During the difficult times she has the ability to spread joy. She and her family are always looking for ways to help.”

As an ambassador for Cook Children’s, Marlee raised pledges on the Radiothon. She decorated gingerbread as part of the Cookies & Castles fundraiser for the oncology department. Her picture made the Spring 2024 cover of the Cook Children’s Health Foundation’s Promise magazine.

 Marlee likes to share her pride in Cook Children’s, Lani said. These days she takes homebound lessons for school, enjoys horse camp and is asking for drum lessons. Marlee plans to join her team at The Blast as long as she’s feeling well enough.

Lani said making a donation for research means everything for children with cancer.

“And it gives them hope. If we don’t have hope, then we really struggle every day to get through this battle,” she said. “I think that’s why The Blast has been so important to me, because it gives parents and children hope when standard treatment isn’t working.”

More about The Blast

The 17^th annual The Blast will take place April 6, 2024, at Panther Island Pavilion in Fort Worth. Families and friends of kids like Marlee walk every year to find a cure for childhood cancer.

When a child is battling cancer, their family suffers as well. Parents often must spend days and weeks away from work and their other children as they support their child through inpatient admission. Siblings struggle with feelings of loss and loneliness.

You don’t have to know someone who has been affected by childhood cancer to get involved. The Blast is a way to stand with these families in their hope for a brighter future. Show your support by signing up to walk, making a donation and spreading the word.

Visit blastwalk.org to sign up for The Blast 2024 today.

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• The Blast Builds on a Promise, Fighting for a Cure 
• Twelve-Year-Old Defies all Odds, Achieving Remission from Back-to-Back Cancer Diagnoses