Coco
7 years old

Diagnosis:

In spring 2009, Coco was found to have medulloblastoma, a brain tumor.

Coco's Story:

Coco was enjoying a beautiful spring day in the park with her three siblings and her mom, Robbi. Suddenly, she fell from the monkey bars and screamed out in pain. Coco told her mother her neck and back hurt, and then, with growing fear, Robbi saw Coco's eyes roll back in her head.

She dialed 911 and an ambulance rushed Coco to the nearest children's hospital, where doctors performed a CT scan of Coco's head. She was free from injury from the fall, but the scan revealed something the family never would have expected. There was a cancerous tumor growing in the little girl's brain. Coco had emergency surgery to remove the tumor, and then was referred to St. Jude Children’s Research Hospital for treatment.

At St. Jude:

At St. Jude, doctors diagnosed Coco with medulloblastoma, a rare and aggressive brain tumor. She began a protocol of radiation, followed by chemotherapy. Robbi has found encouragement from the family-centered care offered at St. Jude. "The doctors and nurses are very supportive here," she said. "No matter what's bothering you, someone is there to help you and explain things."

Coco's family is grateful for the donors who help support St. Jude. "St. Jude told me, 'let that be your last worry. The only thing you need to be worried about is getting Coco better,'" Robbi said. "It lifted a burden from me."

Today, Coco is doing well. She returns to St. Jude every few months for checkups. She likes playing board games and watching movies.

August 2010

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August 2010

Rock climbing taught Ciera Blackburn to keep her eyes on the summit. Thanks to St. Jude, Ciera’s aspirations have never been higher.

As a competitive rock climber—and one of her state’s top women boulderers—Ciera Blackburn performed a high-altitude dance of strength, courage and sure-footed concentration. With her goal squarely in sight, Ciera moved inexorably skyward.

“When I’m climbing, I’m just thinking about getting to the top,” she says. “I’m constantly planning my next move and making sure I stay on my route.”

In the summer of 2009, the 17-year-old embarked on the most demanding ascent of her life. Standing in the shadow of the mountain known as cancer, Ciera looked upward, focused on the summit and began to climb.

A different kind of problem

As a high school junior, Ciera had already proven her mettle in an array of sports ranging from soccer and volleyball to softball. After one visit to her high school’s climbing gym, she was hooked.

“I immediately fell in love with it,” she says. “I went out and bought my shoes and harness that weekend.”

As she honed her skills, Ciera amassed impressive upper-body strength as well as impeccable balance. Soon, she could execute two-finger pull-ups as easily as a football player might do chin-ups. Upon completing an exhilarating “problem,” or route, Ciera would pause at the apex, reveling in her accomplishment.

“I like the height, honestly. While I’m climbing, I have this adrenaline rush because I know it’s dangerous but at the same time I know I can’t get hurt doing it because of the safety equipment,”
she says.

Soon Ciera embraced a sport called bouldering, which is climbing in its purest form. Boulderers execute shorter but more technical climbs without the encumbrance of ropes and harnesses.

“In our gym, we practice bouldering on a wall that has a 45 degree incline,” Ciera explains. “One of the reasons I like it is because a lot of girls can’t do it. You have to be able to lift your whole body weight off the ground with your arms.”

In June of 2008, a painful, pea-sized knot arose on Ciera’s shin. Although an X-ray identified the culprit as shin splints, the pain persisted. Ciera underwent MRI scans every few months until a specialist ordered a biopsy.

“I’m 99.9 percent sure it will be benign,” the physician predicted. But after the procedure, he looked solemn. “First of all, I need to tell you that I am shocked,” he said, explaining that Ciera had cancer.

For the next six weeks, pathologists unsuccessfully attempted to determine the type of cancer, finally performing a second biopsy. “We’re almost positive that it’s localized,” the physician said.

Frustrated by their daughter’s 14-month ordeal, Sherri and Mike Blackburn turned to friends for advice. Several people suggested that the family obtain a referral to St. Jude Children’s Research Hospital.

Preparing for the climb

When Ciera arrived in Memphis a week later, she finally obtained a diagnosis: B cell lymphoblastic lymphoma. Clinicians discovered that the cancer had spread to her kidneys, breasts, pancreas, adrenal glands and spinal fluid. Nevertheless, her parents felt reassured and hopeful.

“I was definitely scared at first, but once we were shown around, I loved every single person on Ciera’s team,” Sherri says. “You can tell that they’re here for the children and their families. My insecurities and fear were gone; suddenly we were in a comfort zone. St. Jude even took away the financial stresses, since the costs were covered. That’s a blessing in and of itself.”

Because of the cancer’s advanced stage, Ciera faced an intense treatment regimen. But she faced the challenge with pragmatism.

“I cried when I first found out I had cancer,” Ciera says, “but I told myself from the beginning that I wasn’t going to sit around and be depressed because that wouldn’t make the cancer go away.”

Instead of lamenting the size of the mountain before her, Ciera surveyed her options and plotted a path that would benefit others. Realizing that high-dose chemotherapy would decimate her lush, waist-length mane, Ciera opted to donate her hair to an organization that makes wigs for patients. The day before her first chemotherapy treatment, Ciera and her mom rode the downtown trolley to a Memphis salon. As Ciera’s glorious tresses fell to the floor, Sherri and other patrons shed tears.

“That was probably the hardest day of my life,” Sherri recalls.

St. Jude oncologist John Sandlund, MD, says that event provided him with insight into Ciera’s personality.

“The fact that she would do that is reflective of who she is and where her priorities are,” Sandlund says. “Even at the beginning of therapy, Ciera was thinking about how she could use her experience to help another person. At a time when most people would be thinking, ‘Oh, no, I’m going to lose my hair,’ her first reaction was, ‘How can I turn this into something positive for somebody else?’ That’s very telling about her.”

A rock and a hard place

The first 11 months of treatment have been arduous. St. Jude school-teacher Dennis Medford helped Ciera complete her academic requirements so that she could graduate with her senior class. But French, English, economics and American government were a breeze when compared to the side effects of therapy.

Ciera has endured weakness, nausea, weight gain, mouth sores and avascular necrosis (AVN), a disease that occurs when loss of blood supply causes the bone and surrounding tissues to deteriorate. Because AVN is a side effect of the steroids integral to Ciera’s treatment, Sandlund ordered a baseline MRI soon after therapy began. Surprisingly, the scan indicated the presence of AVN in her hips, knees and shoulders.

“She’s one of the earliest AVN patients of this severity that I’ve seen,” Sandlund observes.

As a result, Ciera underwent an operation in April to address the problem in her hip. Orthopedists will continue to monitor her bone issues.

In the past, Ciera and five other members of her family have suffered from a condition called supraventricular tachycardia (SVT). Since beginning cancer therapy, Ciera experienced several episodes of the frightening condition, which caused her heart rate to accelerate to 230 beats per minute. When an episode would occur, clinicians would quickly administer a medication that would break the high rhythm and lower her heartbeat to a normal rate. Tests indicated that a blood clot had formed in Ciera’s heart. In July she underwent open heart surgery to correct the problem.

Throughout treatment, Ciera has retained her bubbly personality and has delighted her medical team with her inquisitive nature and keen intelligence. She constantly researches medical topics and quizzes her physician to obtain additional information.

“She always has a lot of good questions,” Sandlund says, with a smile. “People who are extremely bright, like Ciera and her parents, inevitably want to be engaged in the medical process. They’re constantly looking beyond the next step. They’re evaluating the implications, side effects, prognosis, short-term issues and long-term issues. Because of that, Ciera is very much a part of the decision-making process.”

View from the summit

Ciera has approached her medical treatment as a learning experience as well as an opportunity for spiritual growth. As a result, she plans to pursue a career that allows her to help other teens and children with cancer.

“Dr. Sandlund is my biggest inspiration,” she says. “I definitely want to go into pediatric oncology, and I only hope to be as amazing as Dr. Sandlund is. I believe that everything happens for a reason. And I personally believe that my reason for being diagnosed with cancer is to meet Dr. Sandlund and realize that this is what I need to do with my life.”

Sandlund says Ciera has the acumen, focus and empathy to excel in her chosen field.

“Pediatric oncology is not merely a career that intrigues her; I think she views it more like a calling,” he observes. “To me, her career choice is a continuum of her very first day, when she cut her hair and gave it away to help someone else. The foundational thing is that Ciera wants her life to count. She wants to use her gifts and abilities to do something that she feels is a ministry to others. It’s not really for herself; it’s for other people.”

Ciera constantly adds items to the list of activities she has planned for the future. Those aspirations include hiking, kayaking, camping, touring Paris and attending medical school. For now, though, she concentrates on completing her treatment, which will continue through March of 2012. Ciera knows she still has a steep climb ahead, but the view from the top will be worth the journey.

Reprinted from Promise Summer 2010

St. Jude Children's Research Hospital has been named the nation's top children’s cancer hospital in the 2010-11 Best Children's Hospital rankings published in U.S. News & World Report. St. Jude received the best overall score summarizing quality of care. St. Jude is the first and only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children and serves as an international resource to physicians and researchers.

"This recognition is an outstanding external acknowledgment for our institution, but more importantly for the dedicated St. Jude faculty and staff who devote their time, talent and lives to the young patients we see every day," said Dr. William E. Evans, St. Jude director and CEO.

This year's rankings were based on how well a hospital did in three areas: reputation; medical outcomes such as cancer survival; and care-related indicators of quality such as the number of patients, nursing staff and other factors.

The 2010-11 Best Children’s Hospitals rankings are posted at www.usnews.com/childrenshospitals. They will also be published in the August print issue of U.S. News & World Report.

St. Jude Children's Research Hospital
St. Jude Children's Research Hospital is internationally recognized for its pioneering research and treatment of children with cancer and other catastrophic diseases. Ranked the No. 1 pediatric cancer hospital by Parents magazine and the No. 1 children’s cancer hospital by U.S. News & World Report, St. Jude is the first and only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. St. Jude has treated children from all 50 states and from around the world, serving as a trusted resource for physicians and researchers. St. Jude has developed research protocols that helped push overall survival rates for childhood cancer from less than 20 percent when the hospital opened to almost 80 percent today. St. Jude is the national coordinating center for the Pediatric Brain Tumor Consortium and the Childhood Cancer Survivor Study. In addition to pediatric cancer research, St. Jude is also a leader in sickle cell disease research and is a globally prominent research center for influenza.

Founded in 1962 by the late entertainer Danny Thomas, St. Jude freely shares its discoveries with scientific and medical communities around the world, publishing more research articles than any other pediatric cancer research center in the United States. St. Jude treats more than 5,700 patients each year and is the only pediatric cancer research center where families never pay for treatment not covered by insurance. St. Jude is financially supported by thousands of individual donors, organizations and corporations without which the hospital’s work would not be possible. In 2010, St. Jude was ranked the most trusted charity in the nation in a public survey conducted by Harris Interactive, a highly respected international polling and research firm.