By Greg Raver-Lampman
By the time Kim Lambert of Chesapeake reached Children’s Hospital of The King’s Daughters, she knew something was wrong with her 9-month-old daughter, Sydney.
What she didn’t expect was the diagnosis she received after CHKD surgeons removed a softball-sized tumor from Sydney’s abdomen. Kim and Casey Lambert’s baby girl had ovarian cancer.
“You can find a lot of research on ovarian cancer, but not on a 9-month-old,” Kim discovered when she went in search of information.
Dr. Eric Werner, one of Sydney’s treating oncologists at CHKD, agrees that the case was exceedingly rare. Called a juvenile granulosa cell tumor, the growth is formed from ovarian cells that almost never become malignant. “Such tumors are rare at any age,” Dr. Werner said. “When they become malignant, as in Sydney’s case, they can be aggressive.”
Up until the day she was admitted to CHKD’s cancer unit, Sydney had struck everybody as a joyful child.
“She was just a happy baby,” Kim said. “She played, laughed and smiled all the time.”
On the morning of March 16, 2004, Sydney ate breakfast with her mom and her brother Tyler, who’s a year older than Sydney, then they all headed to a mommy-and-me playgroup.
“Sydney was getting really fussy at the playgroup,” Kim recalled. “I thought maybe she needed a diaper change.” When Kim took Sydney aside, she noticed that her abdomen had become distended.
“She looked pregnant,” Kim said. “You could see the veins in her stomach. They were all stretched out.”
Kim rushed Sydney to a nearby hospital where a physician found a large growth in her abdomen and sent her to the pediatric specialists at CHKD.
“I wasn’t scared at that point,” Kim said, “just stressed because nobody could tell me what was going on.”
Kim rode with her daughter in an ambulance to CHKD where a team of ER doctors, a radiologist and an oncologist examined Sydney. A CT scan confirmed the presence of a tumor the size of a softball.
The words stunned Kim. She remembers being unable to ask even basic questions.
“I could hear everything they were saying, but I was just in complete shock,” she said. Doctors told Kim her daughter would be admitted to the hospital for urgent surgery. She recalls thinking, “Look at her. There’s nothing wrong with her. She was just playing this morning.”
CHKD surgeons were able to remove the tumor, which had burst, spilling malignant cells into the peritoneal fluid of her tummy. Pathology confirmed that the tumor consisted of malignant ovarian cells.
Because the tumor had ruptured, Sydney had to undergo chemotherapy to kill all malignant cells that remained in her abdominal cavity. “First we had to find out if there was an established treatment protocol for such a rare tumor in a child,” Dr. Werner said.
CHKD’s oncologists are part of the Children’s Oncology Group, an international consortium of 250 leading children’s cancer centers that share information on the most effective treatment protocols for children. Information about Sydney was compared to other children with similar diagnoses across the country, and a protocol was selected. Her treatment would entail frequent hospitalizations to administer specific drugs shown to be effective.
Sydney’s mom remembers hearing about the chemotherapy treatment, a process that would mean periodic eight-day hospital stays over six months.
When Sydney arrived at CHKD for the first session, the reality hit Kim and Casey Lambert hard.
“Until she started to get that first chemo treatment, I was rock solid,” Kim said. “But then I broke down. I would cry for hours.”
Treating babies with cancer requires an extensive team of professionals who focus on the needs of children, something that’s usually found only at children’s hospitals. “You need a pharmacist who can determine the correct doses for a growing child,” Dr. Werner explains. “You need nutritionists because children sometimes stop eating. You need nurses and clinicians experienced at inserting intravenous lines into tiny veins. And you need a support staff to help with the emotional needs of the parents and the child.”
Kim especially appreciated child life specialists who did play therapy with Sydney and social workers who seemed to understand what she was going through and who befriended her daughter. And Sydney loved the therapy dogs of the Buddy Brigade who visited in her room.
When Kim stepped out of her daughter’s hospital room one day, she returned a few minutes later to find Dr. Werner sitting on the floor playing with Sydney. “I came to learn that it wasn’t an unusual sight,” she said.
During the six months in and out of CHKD, Sydney stayed on track with all the typical developmental milestones. “She learned how to walk when she was in the hospital. I’d walk behind her, pushing her IV pole,” Kim said.
“I’ll never forget how she would sit by the window and be excited to see the boats going by on the Elizabeth River.”
Between hospitalizations when she was home, her brother Tyler, who was just 2 years old, was fiercely protective, telling others they couldn’t touch Sydney because she had an “owie.”
Sydney came through the six-month regimen with flying colors, without developing many of the side effects her mother feared. Although she lost her hair, Sydney never lost her appetite and was generally healthy enough to be home between chemotherapy sessions.
When the chemo was over and all signs of cancer gone, Kim remembers how she felt with the apparent end of treatment. “You’re so excited and so happy it’s over, but it’s bittersweet because you’re leaving behind all these great people who’ve taken care of your child – and you,” Kim said. “When Sydney got sick, I felt so blessed to have these incredible people and CHKD right here, so we didn’t have to travel during the months Sydney was being treated.”
Now 5 years old, Sydney has thrived without further treatment. She loves gymnastics and cheerleading and, according to her mother, “never shuts up.” She attends kindergarten at Grassfield Elementary School in Chesapeake.
She now participates in the Late Effects Cancer Program at CHKD, returning to the
Cancer and Blood Disorders Center for periodic checkups and follow-up study. The Lamberts still participate in CHKD family support events like the annual Halloween party, where they get to see the nurses, doctors and support staff who helped Sydney fight cancer.
“You don’t know how to thank them enough other than to show them what a great kid she’s become,” Kim said. “You just want those wonderful people to know, ‘Hey look, all your work paid off. Look at her now.’”
Dr. Werner, hematologist/oncologist,
practices with Children’s Specialty Group PLLC at CHKD.
This story was featured in the second quarter 2009 issue of KidStuff, a publication of Children's Hospital of The King's Daughters.
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