"Growing pains" was the initial diagnosis Breanna Atwell's pediatrician gave for the 11-year-old's throbbing joints and bones, which often hurt so badly she wouldn't go to school. "Her primary doctor said Breanna needed to tough it out," says her mother, Melissa Hernandez of Shelton, Wash. She didn't buy it. For months, Hernandez pressed doctors to take her daughter's pain seriously. Suspecting rheumatoid arthritis or lupus, a physician at a children's hospital in Tacoma finally sent Breanna to Children's Hospital and Regional Medical Center in Seattle, which treats 230 new cancer cases a year and provides follow-up care to some 3,000 kids and adolescents. She was diagnosed with acute lymphocytic leukemia, a blood cancer. Malignant cells had spilled from Breanna's bone marrow into her bloodstream.
Within hours, she was on chemotherapy. For eight months, she had chemo several times a week: pills, an IV drip, and injections into muscle tissue and spinal fluid. Along with her mother and infant sister—born four months after Breanna's diagnosis—she stayed at the nearby Ronald McDonald House at no cost, avoiding a two-hour commute from home.
Luckily, Breanna was a "rapid responder." Just two weeks into her chemotherapy, the leukemia cells had plummeted from 70 percent of her bone marrow cells to 3 percent, and by the fourth week, no cancerous cells could be found.
But the war wasn't over. Breanna had to return regularly for more than two years of chemotherapy that dulled her memory and weakened her body. She had six transfusions because her platelet and red blood cell counts took a dive. She had blood clots and bloodstream infections. The steroids in her chemotherapy regimen ate away at the cartilage in her joints.
Kindnesses. Yet Hernandez trusted her daughter's caregivers and was grateful for their humanity. "Children's has been wonderful," she says, beginning with oncologist Elisabeth Villavicencio's careful explanation of Breanna's diagnosis to Hernandez, Breanna's grandmother, and her stepfather. Nurses played with Breanna's two younger sisters so Hernandez could stay to hold her hand during chemo sessions. And when Hernandez was pressed, financially and emotionally, at Christmastime, staff arranged gifts for the family through a volunteer group.
Two years and three months of treatment finally came to a close last month with one last intravenous chemo, removal of the central line from Breanna's chest, and a ceremonious disposal of her leftover chemo pills. She will get hometown care from now on—delivered by a pediatrician who sees former Seattle cancer patients and has a solid relationship with Karyn Brundige, Breanna's nurse practitioner at Children's. He also cared for Hernandez when she was a child.
But Breanna will need to return to Children's periodically for at least 10 years, says Villavicencio: "From her growth and development to how she's doing in school and getting along with her family—we're interested in absolutely everything."