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

It is a heartbreaking position for any parent to be in — knowing that a potentially life-saving drug treatment may also cost your child the ability to hear. This was the difficult reality for Brant and Ashley James after their son, Pierce, now 3, was diagnosed with a rare cancer. 

In his nearly 4 years of life, Pierce James, who his family calls Fierce Pierce, has faced more challenges than many adults experience in an entire lifetime. He was born at the edge of viability at 25 weeks gestation and spent 83 days in a neonatal intensive care unit. Even so, Pierce thrived as an infant and toddler despite some delays due to his prematurity.

But four days before his 2nd birthday, the James family received devastating news.

Just as Brant and Ashley were on the mend from a bout with COVID, Pierce seemed to be coming down with the virus as well. So Brant took his son to an urgent care close to their home in Rockwall to get checked out. He was soon told it wasn’t COVID. Instead, physicians suspected something much more serious and arranged for Pierce to be transferred to a nearby hospital. 

“About four hours later, I received a phone call from the doctor and my husband, and the words out of the doctor’s mouth was, ‘We have some bad news to tell you,’” Ashley said. “At that moment, they told me that they were pretty confident that Pierce had cancer.”

In fact, Pierce had a rare liver cancer called hepatoblastoma. It was classified as stage 4, metastasized to his lungs and required aggressive chemotherapy to treat. 

Risk and Reward

Throughout the course of his treatment, Pierce experienced several setbacks, some of them life-threatening. But one complication was particularly difficult for Ashley to reconcile. 

Pierce’s chemotherapy protocol included a drug called cisplatin. While it is effective at killing cancer, it is also an ototoxic medication, meaning it can damage the inner ear and cause hearing loss. Thanks to the chemotherapy protocol, Pierce is now cancer-free, but he does have permanent and profound hearing loss. 

“The cancer is gone and we're believing it's never ever coming back,” Ashley said. “But the hearing loss, without a miracle from God, is irreversible. It's not going to change and it’s just very hard. I've come to terms with it, but it's still very hard for me that my baby has lost his hearing because, I'm like, hasn't he suffered enough?”

Once the cancer was under control, Brant and Ashley turned their attention to dealing with Pierce’s hearing loss. As a then 2-year-old, Pierce was at a critical point for speech and language development. His parents wanted to be as persistent with audiology interventions as they were with chemotherapy. The family turned to Cook Children’s Pediatric Audiology services for help.

“There are certain chemotherapies that cause hearing loss in children and adults. So we're very involved with Hematology and Oncology,” said Lisa Vaughan, AuD, manager of Cook Children’s Audiology services. “A lot of times we do testing prior to the kids starting chemo. We get a baseline hearing test for every kid before they start, and then we monitor them throughout all of their treatment.”

Sometimes, if hearing loss is suspected, treatment can be adjusted. Other times, as in Pierce's case, hearing loss is the lesser of two evils. 

“It's really hard because it's just one more thing for these families,” Dr. Vaughan said. “Your child has cancer and we now have to watch their hearing. You're going to go through some really horrible treatments, and then when we're done with this and things are better, we may be saying your child’s hearing is permanently damaged. It’s a hard conversation because these families have been through so much.”

Cook Children’s Audiology services moved quickly to help Pierce. He completed his final round of chemotherapy in September 2022 and, by the end of that month, also had his first set of hearing aides.  

The New Age of Sound Waves

Each year, one to three out of every 1,000 babies are born with hearing loss. Others experience hearing loss from trauma or as a result of medical treatment. 

 Because of developments in audiology technology there is hope for hearing-impaired children.  Dr. Vaughan says with early intervention, children with hearing loss perform as well as their hearing peers academically. 

“We can do the surgical cochlear implant as early as nine months to get a baby hearing great so that they can compete with their hearing peers,” Dr. Vaughan said. “The other big thing on the horizon is unilateral loss and being able to implant a cochlear device in just one ear. In the past we've thought hearing from one ear will suffice. But what we've realized over the last 15 years is that kids with hearing loss in one ear have lots of trouble in the classroom because of background noise and localization. Now we can make both ears equal.”

Hearing aids have come a long way, too. Gone are the days of manually turning the volume or frequencies on hearing aids up and down using a screwdriver. Now, hearing aids are sleeker, come in multiple colors, are equipped with bluetooth technology and are digitally programmed to allow individuals to hear everything from the tiniest frequency to the biggest sound.

Cook Children’s Audiology services offer these interventions, as well as bone conduction implantable hearing devices and a full range of auditory testing. They also provide protective devices such as custom earplugs, like those that help protect the hearing of musicians while also allowing them to hear each musical note. 

“Musician plugs have a filter on the end that allows musicians to hear the sound but at a lower volume. They do not distort or affect the quality of the music,” Dr. Vaughan explained. “We see a lot of performers now with monitors in their ears. Those are also to protect their hearing so they can perform longer. These are great for kids in high school bands or those that like listening to loud music.”

Early Ear Intervention

Protecting your child’s hearing and having your newborn screened for hearing loss are the two most important things parents can do for their child’s audiology health and for their speech and language development. 

Newborn hearing screenings are required at any birthing center with 50 or more births per year. If a baby fails the screening at birth, they can be rescreened at one month. If they fail the second screening, a diagnostic evaluation can confirm hearing loss by three months and intervention can begin by six months, giving a child the best chance at language development on par with their hearing peers. 

“Without that, when we wait until they are two or three and discover their words aren’t sounding great or they aren’t talking at all, then their brains have missed two to three years of learning,” Dr. Vaughan said. “It’s really hard to backtrack to correct. Newborn hearing screening is so very important. If we do the hard work on the front end and get things moving, hearing impaired children perform at equal levels to fully hearing children.”

The James family’s urgency to have Pierce fitted for hearing aids as soon as possible following cancer treatment set their once-hearing child on a course to recover as much speech and language development as possible. Since the completion of cancer treatment one year ago, Pierce has relearned to crawl and walk, and recovered many fine motor skills. He’s beginning to vocalize a number of sounds, too, including the sweetest sound to every mother’s ears — her baby calling for “mama.” 

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If you talk to Caitlin Schwartz for even a few minutes, you will learn she is wise beyond her years. In the last two years of her life, she has endured more than most can even imagine. Still, she wears an infectious smile and shares her story with clarity, humor, and resilience. 

Caitlin’s Diagnosis

In September of 2021, Caitlin woke up to a pain in her right shoulder. She thought she might have slept on it wrong or hurt it in gymnastics, which she practiced once a week. Caitlin and her mom, Jessica Allen, initially didn’t give the pain much thought. But when it grew progressively worse over the next couple of months, they decided to make an appointment with her pediatrician.

Four weeks later, a pediatric orthopedic specialist took X-rays of Caitlin’s shoulder and initially suspected that her shoulder blade was broken. Caitlin got an MRI that same day and received the results a day later.

Jessica, who is a teacher, was in her classroom when she got the life-changing phone call. Caitlin had not broken her shoulder blade — she had cancer. Jessica first took Caitlin to Cook Children’s as soon as possible and was admitted just a couple of days later. 

“They diagnosed me with Ewing Sarcoma in my right shoulder blade,” Caitlin said. Ewing Sarcoma, named after Dr. James Ewing, who first described the tumor in the 1920s, is a rare type of bone cancer that most commonly occurs in children and teens. By the time Caitlin’s tumor was discovered, it was so large that it covered her entire shoulder. Thankfully, her cancer was stage two and was isolated to her shoulder.  

Only the Beginning

For the next six months, Caitlin completed chemotherapy at Cook Children’s. Starting in May of 2022, she underwent a total of 36 sessions of proton radiation on her shoulder at Texas Oncology. Caitlin experienced every side effect in the book from chemotherapy, including hair loss, nausea, and weight loss. She also got radiation burns, for which she had to take special medication.

Miraculously, by the time Caitlin had finished all of her treatment in October of 2022, her scans were clear. She and her family enjoyed a huge celebration for her birthday, the end of chemo, and achieving remission. Little did they know, Caitlin’s battle was far from over. 

Caitlin went back to school for only three days before she started to feel extremely sick. Jessica brought her back to Cook Children’s for emergency lab work. Shortly thereafter, Kenneth Heym, M.D., of Cook Children’s Hematology and Oncology, diagnosed her with Secondary Acute Myeloid Leukemia (AML). 

“She just totally threw everybody for a loop when she came into the hospital and her blood counts were abnormal,” Dr. Heym said.

Caitlin had contracted AML from one of the chemotherapies used to treat her Ewing Sarcoma. “Secondary leukemia can happen after treatment for solid tumors like Caitlin’s, but it’s pretty rare,” he says.

Jessica wasted no time in asking Dr. Heym for a prognosis — and he told her the survival rate for AML was very low.

“He told Caitlin she had a less than 50% chance to beat this,” Jessica said. According to Caitlin, Dr. Heym had “never been so straight up.”

“We know that secondary leukemias that are caused by chemotherapy are very, very difficult to treat,” Dr. Heym said. “And if you want to cure them, your only chance is going to be bone marrow transplants.”

The problem is, bone marrow transplants won’t work unless the patient is in remission — which is very hard to achieve with AML. 

“She was understandably upset because she was looking forward to being done,” Dr. Heym said. “But she still maintained that positivity and that smile and that snarkiness and all of those features that just endear you to her immediately.”

Restarting

To treat Caitlin’s AML, Dr. Heym started her on what he calls “blow you out of the water” chemotherapy. It was extremely harsh on Caitlin’s body and ultimately unsuccessful. Luckily, he found a clinical trial at MD Anderson Cancer Center in Houston for patients Caitlin’s age with her leukemia’s specific type of genetic abnormality. 

Caitlin and her mom headed to MD Anderson. After a few trips back and forth, Caitlin was admitted in January of 2023 to start the clinical trial protocol. Caitlin started on a new form of chemotherapy, which her body responded to much better than the first.

She also began the clinical trial drug itself — a Menin inhibitor, which is in clinical development for the treatment of genetically defined subsets of acute leukemia.

Once again, Caitlin made a remarkable recovery. After completing her clinical trial, her AML was gone.

“They said she was the fastest person to ever achieve remission there,” Jessica said. According to Dr. Heym, Caitlin’s remission is “nothing short of a miracle.”

The next step in Caitlin’s treatment was her bone marrow transplant.

“She's basically restarting her body, but with my good cells and my good blood in hopes to keep her cancer away and prevent relapse,” said Jessica, who was her transplant donor.

Caitlin completed her transplant on May 4 of this year. Her family and doctors refer to that date as her “rebirth day.” The aftermath was extremely tedious on Caitlin’s body, and she was hospitalized for almost seven weeks.

“Nothing Short of a Miracle”

Despite wreaking havoc on Caitlin’s body, her bone marrow transplant was incredibly successful.

Though Caitlin’s labs look great and she’s been doing exceptionally well, she has run into some hiccups with side effects. She developed a hematoma, had some chemoport issues, and developed pericardial effusion, which is a buildup of fluid around the heart. She is still fighting to get her immune system back to normal and even though she is in remission, she is not out of the woods quite yet.

“There is still a good chance that her leukemia is going to come back, and if it does, it's going to be that much harder to treat,” Dr. Heym said. “But she’s beaten the odds so far in terms of where she's gotten and how well she's doing, so if anybody’s going to continue to do that, it's going to be Caitlin.”

Caitlin recently got cleared to start taking her Menin inhibitor again post-transplant. Because transplants wipe out all immunizations, she will stay home from school for another year and start immunizations in the spring. Her original Ewing tumor is still on her shoulder, but it’s much smaller than it was and will eventually turn into scar tissue. Moving forward, Caitlin will continue to have follow-up appointments for her side effects and will be closely monitored to ensure her AML and Ewing Sarcoma stay in remission. 

Finding Joy and Sharing Smiles

Throughout her battle, Caitlin has found joy in the hospital’s fur babies and friends she’s met along the way.

“If a dog wasn't hanging around, she would ask a nurse to go find her one,” Jessica laughs.

Caitlin also made friends with other kids and families wherever she went, whether it was on the HO floor at Cook Children’s, at MD Anderson, or anywhere in between. “We joked that she was the mayor of the floor when she was here because she would just walk around talking to everybody,” Dr. Heym says with a smile.

Caitlin has also selflessly volunteered to participate in Cook Children’s research studies. “She wanted to help other kiddos from the beginning,” Jessica said. “I also told her that other kiddos need to hear her story because she might have a friend who’s diagnosed with something similar one day.”

Right now, Jessica and Caitlin are taking every new day in remission as it comes and leaning on their village of family and friends for support.

“We're working on just being able to be a kid again and do all the stuff we've missed out on the last two years,” Jessica said. “We’re just looking forward to some kind of normalcy after all of this.”

Through it all, Jessica and Caitlin have learned to cherish the time they have together.

“When you have to watch your kiddo fight for her life, it just forces you to move everything else to the back burner,” Jessica said.

She admits that when Caitlin was diagnosed with AML, she didn’t think she would make it to Christmas. Caitlin, with her tenacious spirit, chimes in, “I didn’t think that!” It’s no wonder cancer has been no match for her.

“No child that age should be challenged as much as she has,” Dr. Heym said. “But she continues to show us that she's going to meet every challenge with courage, grace, humor, and attitude. Nothing, whether it's cancer or the treatment, is going to stop Caitlin from being Caitlin. And I feel lucky to have been able to help take care of her.”

To keep up with Caitlin’s journey, follow Jessica on Instagram @thestoryofthree. 

By Charlotte Settle

The unstoppable Rebekah Tate is a proud graduate of Baylor University, a former Algebra 1 and IB Math teacher at Arlington High School and a current professional organizer. She is also a survivor of childhood cancer. On July 28, after 27 years at Cook Children’s, Tate celebrated her very last appointment as a Life After Cancer patient. Though it’s a bittersweet departure, she carries nothing but fond memories with her into her next chapter of survivorship.

When Tate was only three months old, her parents noticed a lump below her right knee. Her grandmother, who was a nurse, suggested they get it checked out sooner rather than later. Tate’s parents lived in Arkansas at the time and took her to Arkansas Children’s Hospital to have the mass examined. After performing a biopsy, the doctors found that it was a cancerous tumor. Tate was diagnosed with Alveolar rhabdomyosarcoma (ARMS) — a cancer of the muscle tissue.

Shortly thereafter, Tate’s family relocated to Arlington and continued her care at Cook Children’s. Her surgeon, Mayme Richie-Gillespie, M.D., first attempted to remove Tate’s tumor via resection. The procedure was ultimately unsuccessful and the next best option for treatment was amputation. Though it was an extremely difficult decision, Tate’s parents chose to move forward with the operation.

At a little over four months old, Tate had her leg amputated from above her knee. Miraculously, the procedure worked and she was completely cancer-free from then on. 

“I was born in November and it happened April 2. That’s what I count as my cancer-free date,” she said.

After her amputation, Tate completed three different types of chemotherapy over the course of nine months to ensure her cancer didn’t spread elsewhere in her body. In her 27 years since then, she hasn’t received any more treatment related to cancer.

“I was lucky because the chemo did its job in the sense that it was there to catch anything that might have spread,” she said.

When Tate went through chemo as a baby, she lost her hair and got sick frequently. Her main side effect since then has been dental issues, which her doctors attribute to her teeth still forming when she underwent treatment.

“I'm missing a lot of adult teeth and I still have baby teeth,” Tate laughs. “My dentist always says they're going to come out soon and I’m like, I don’t need to know that!”

After she completed chemo, Tate had routine check-ups and MRIs on her leg until she was about 5 or 6 years old. From that point on, she transitioned to the Life After Cancer Program (LACP) at Cook Children’s. Most of Tate’s appointments since then have consisted of routine check-ups and blood work — thankfully, she has remained healthy and cancer-free throughout the years. Now that she has graduated from LACP, her general practitioner will take over the care she has received at Cook Children’s.

Though Tate had been preparing for her last appointment at Cook Children’s for years, it was still an emotional event.

“When I walked in, I just assumed they would say they were going to keep me another year,” she said. “It wasn’t a happy or a sad moment. It was just an emotional moment.”

A Special Bond

A couple of months before her last appointment, Tate was notified that her nurse practitioner of 23 years, Lisa Bashore (PNP), would be transitioning to a different area of the hospital. Naturally, Tate was shocked and thrilled when Lisa made a surprise appearance at her last visit.

“She came to see me at my last appointment and I just started crying,” Tate said. “She’s the world’s most incredible nurse. It was such a big moment.”

Bashore took care of Tate since she started working at Cook Children’s in 2000.

“Rebekah always thrived and the sky was the limit. There were no limitations for that young lady,” Bashore said. She especially enjoyed getting to see Tate’s new prosthetic leg every year. “I just couldn't wait to see the new design,” she said. “She loved to show off her leg. I think that shows her resiliency.”

Tate laughs as she recalls Bashore constantly grilling her about wearing sunscreen.

“It doesn't matter what treatment they had, I always encourage survivors to be mindful of those general health practices that will potentially minimize the risk of relapse,” Bashore said.

Tate now wears her sunscreen every day — not just because she knows it’s good for her, but because Bashore cared enough to remind her year after year. 

“Just her yearly piece of my life was a big piece of my life,” Tate said.

Bashore admits that watching Tate transition out of LACP was emotional for her, too. “I've been with her since I’ve been at Cook Children’s,” she says. “It’s been incredible helping her get through this.”

This isn’t the end of their relationship, though. Bashore keeps her door open to all of her former patients, offering them a space to chat and ensuring their needs are met with their new doctors.

“We just want them to know that we are here,” she says.

Prosthesis

Even more than cancer, Tate feels her prosthesis has had the greatest impact on her life.

“It was really the leg that changed me, even though cancer was the cause,” she says.

Tate got her first prosthetic leg at 10 months old and has gone through about 24 total as she has grown over the years. 

“I used to hate when people would come to talk to me about it because it made me different, but now it's something that connects me to other people,” Tate said. 

Tate notes that Cook Children’s and her prosthetics hospital have always been in close contact regarding her care.

“At Cook Children’s, they always asked about my prosthesis,” she said. “Once I had to leave my children's hospital for prosthetics, they asked me if I needed help finding somewhere to go. So they’re very interconnected.”

When Tate was little, she didn’t understand that most kids who have cancer don't have prosthetics.

“When we went to events at Cook Children’s, I always expected to see other kids with prosthetics and I just never did,” she said.

In high school, she had a game-changing experience when she got to go on a trip with other amputees for the first time.

“It was a ski trip and we all skied in different ways — some sitting, some standing, some snowboarding,” she said. “Hanging out with people who had the same experience as me growing up was just powerful.”

Tate feels her prosthesis has allowed her to connect with people in ways she otherwise might not be able to. It has allowed her to form impactful bonds with others like her — including a student she would see in the hallway at Arlington High School who also had a prosthesis.

“I remind myself that I wouldn't have had so many opportunities or met so many people if I didn't have this challenge — or blessing,” she said. “I never want kiddos to have to go through that, but if they do have to, I want to be someone who’s there to check in on how they’re feeling.”

Cook Children’s Community

Throughout the years, Tate and her family found community, comfort, and joy through Cook Children’s events. They often attended “Celebrate Life” — a festival on campus at the hospital for kids who had beaten cancer and their families.

“It was a really cool event because normally when you come to the hospital, it's scary,” Tate said. “This was just all about crafts, food and fun.”

She laughs about the fact that there was a butt sketch artist working at the event one year. The sketch of her family’s butts still hangs in a bathroom at her parents’ house to this day.

For several summers, Tate’s family also attended Camp Sanguinity at Camp John Marc — a program designed specifically for children with cancer and their families.

“It’s built to accommodate kids who are going through any type of treatment,” Tate said. “We kind of built a community we could connect with over our experiences.” The patients’ doctors and nurses tagged along on the trip, too. “It was cool to get to grow with those people,” she says.

To Tate, Cook Children’s will always be the world’s most special place.

“When I go to my regular adult general practitioner, it's gray,” she said. “It’s so different at Cook Children’s, because it's bright and exciting and colorful. It's a somber place because people are struggling and in so much pain, but they work so hard to be there every step of the way.”

Because Cook Children’s has been such a special part of her life, Tate regularly contributes to the organization however she can.

“I watch their wish lists online and I collect a lot of soda tabs for the Ronald McDonald House,” she said. “Because they've done so much for my family and so many families, I’m always sharing on my Instagram story when Cook Children’s is in need of something. The money or the time that you’re giving is going towards incredible things to help kiddos stay alive.”

Though Tate’s cancer happened nearly three decades ago, it’s still a very sensitive topic for her parents.

“It's not fresh, but it was a big deal,” she said. “It’s a big shock, having that happen to your first kiddo. I can’t even imagine the decisions that they had to make regarding their newborn baby.”

Tate’s parents have been her biggest advocates and cheerleaders every step of her journey.

“They raised me in a way where they told me nothing could stop me or hold me back,” she said. “They always asked, how can we do it differently?” 

Though it hasn’t been an easy road, her parents have found solace in connecting with other parents and families at Cook Children’s.

“That was a big thing for them, because there's no way you can handle that either by yourself or even with your spouse,” Tate said. “You have to have community.”

Adolescent and Young Adult Child Life Specialist at Cook Children’s, Lauren Bridge, speaks to the importance of holding space for families of those battling cancer.

“I love incorporating parents and siblings into the conversation,” she said. “Sometimes it’s just talking to a mom about questions a patient’s younger sibling has and meeting that sibling’s needs to maintain some sense of normalcy.”

Bridge works with patients — some teenagers and some closer to Tate’s age — who are still fighting their battles with cancer. She holds space for them to address their emotions, grapple with the concept of mortality and ask questions they might be afraid to ask.

“As they're trying to figure out who they are and develop independence, we're telling them they’re actually going to be stuck in a small room and not really given a lot of choices,” Bridge said. “I love convincing them to leave their rooms and go do something, even if it’s just a game of pool and a little bit of trash talk. I’ve found that during those walks down the hall, they really open up and I see a side of them I haven’t seen before.”

One of Bridge’s favorite things about her job is reconnecting with patients who have achieved remission and are back to living their normal lives — all of whom, like Tate, have gone through the Life After Cancer Program.

“LACP just really helps them go from being in true remission to transferring into the adult world of medicine, or really just out of oncology because they don't need us anymore,” she said. “It's so incredible that we help patients with that transition here at Cook Children’s.”

“As a leukemia survivor and pediatric oncology nurse here at Cook Children’s, this fundraiser is close to my heart, and I feel that I have been given the opportunity of a lifetime to help others,” Harris said.

The Man & Woman of the Year program is a philanthropic competition among a group of motivated and dedicated individuals in communities across the United States driven to support blood cancer research.

To participate, candidates form fundraising teams and compete in honor of two local children who are blood cancer survivors. The man and woman who raise the most funds during the campaign will be awarded the title of Man or Woman of the Year.

Harris is one of 11 nominees from Tarrant County, and her 10-week campaign runs through June 10, 2022. To support Harris and donate to the cause, visit her campaign website.

In August 1993, when she was 4 years old, Harris was diagnosed with Acute Lymphoblastic Leukemia. After three years of intense treatment at Cook Children’s, she returned home cancer-free and ready to pursue a new dream: to become a nurse.

She went on to graduate from Tarleton State University in 2012 with a Bachelor of Science in Nursing and became a registered nurse. She now serves as a nurse manager of the same unit at Cook Children’s that treated her when she was a child.

Harris says she is excited to participate in the fundraising competition because she hopes to benefit families who are going through experiences similar to those her family faced.

“I love the Leukemia & Lymphoma Society’s mission because the organization is not solely dedicated to finding new drugs,” she said. “They support families throughout their journeys in many different ways.”

The funds raised through the Man & Woman of the Year are used for continuing research of lifesaving therapies, educating and supporting patients and families, and driving policies that increase the development of and access to new treatments.

Go here to Harris's campaign website to learn more.

#WeAreCookChildrens

The latest set of eyes to see it? Ellen DeGeneres! The uber-famous comedian and talk show host interviewed the Yielding family about their journey with “keulemia” and surprised them with a special gift during the holiday season.

You can view their interview here.

Here are three articles about the kids who fight cancer and the work Cook Children's does to hopefully someday #erasekidcancer for future generations:

When it comes to battling cancer: she rocks!

Tori Pence has loved music since she was 7 years old when her grandfather gifted her with her first guitar. But it wasn’t until she was admitted to Cook Children’s that her passion for music flourished. Click to read her story.

Luke's story

On Tuesday, Sept. 1, Cook Children's began this year's #erasekidcancer campaign for Children's Awareness Month with a ceremonial 1k walk. Fifth grader Luke Lange, who’s in remission for Hodgkin’s Lymphoma, stepped up to the podium and lowered the microphone to fit his 10-year-old height to share what Cook Children’s means to him. We found it so inspiring, we thought everyone should hear his story.Click to read Luke's words. 

Our efforts to #erasekidcancer

The Cook Children's Hematology and Oncology Center works every day on medical treatments and research to help make the blood disorders and cancers that affect children and teens, disappear. Here are some of our efforts to #erasekidcancer: Click to watch great videos about our MIBG program, Bone Marrow and Stem Cell Transplant Program and Complex Blood Disorders and Diseases program.

More about Hematology and Oncology

As a specialty, hematology and oncology was formed because there are so many instances where blood diseases and cancer cross paths. Just like adults, children get cancer, but the cancers children have are very different in many ways than adult cancers. Because of the unique nature of children with cancer, they must be evaluated and treated by pediatric specialists. Our top priority is providing the best care for your child.