Better chances for childhood cancer in Brazil

The first sign that something was wrong with Guilherme was that his legs were painful. It got to the stage that he could no longer bear to touch the floor with his feet. After some tests the little boy, who was only two, was sent to the GRAACC hospital where the diagnosis was confirmed: a brain tumor.

Treatment involved a year of chemo sessions, surgery and an autologous bone marrow transplant (BMT). “Although around 70% of cases of cancer in young children can be successfully treated with chemotherapy, radiotherapy and surgery, there are a certain number of cases that do not respond well to the initial treatment and which, because of their aggressive nature, require this procedure.

An autologous transplant may also be indicated for solid tumors that are more resistant to chemotherapy, such as head cancer and stomach cancer”, says Dr. Zecchin, the doctor in charge of the BMT center at the GRAACC Hospital.

Two other types of bone marrow transplant carried out at the GRAACC Hospital are allogeneic transplants from a donor who may or may not be a relative, which is for patients with leukemia; and haploidentical transplants, from a first degree relative with 50% compatibility, as an alternative when a 100% compatible donor cannot be found.

In Guilherme’s case, we removed his own healthy bone marrow and froze it, gave him high doses of chemotherapy to clean out the sick cells in his body, and then replaced the bone marrow. The process is similar to a blood transfusion. The stem cells are inserted into the bloodstream through a catheter and make their way to the bone marrow, where they are stored.

In the 20 years since GRAACC opened its Bone Marrow Transplant Center, 691 patients have been treated and 736 procedures carried out. This is often the only way to achieve a cure. “One of the key success factors in a transplant is its timing – the further the disease has progressed, the lower the chances of a cure. Being in a specialist center gives us the autonomy to act quickly”, says Dr. Zecchin.

After the procedure, the patient is kept in a special area of the hospital, where there is protection against infection. During this period the patient is without immunity and so very vulnerable. After a few weeks the medulla starts working and producing healthy cells again.

“When we got the news that the medulla had grafted it was a huge relief. Guilherme got better very quickly and soon he was playing games and running around the hospital again”, his mother, Gislene, recalls. Now he is free from the tumor and goes to GRAACC for checkups.

Being a specialist center gives GRAACC autonomy to provide quicker, easier access to treatment. The area, which is a reference in Brazil, is equipped for the most complex types of transplant, with a cryopreservation laboratory and top quality apparatus, run by a group of specialists in handling cells. The multidisciplinary team and the personalized nature of the treatment are fundamental for the success of these highly complex procedures, giving patients every chance of leading normal lives in the future.

Luna is 9 and her rhythmic gymnastics movements are so graceful and beautiful that her mother is overcome with joy when she watches her daughter perform. “She always wanted to be a great gymnast and we have given her every support to help make her dream come true”, says her mother.

 But the little girl’s life was not always so easy. When she was just two years old she began to feel severe pains in her stomach, and her parents were terrified.

 An ultrasound scan detected a large lump in one of her kidneys, which was diagnosed as a tumor already at an advanced stage. She was immediately taken to the GRAACC Hospital where she started chemotherapy and was then operated on to remove her left kidney.

 “I had no idea what sort of disease this was. We were fortunate enough to go to this marvelous GRAACC hospital which provided all the facilities our daughter needed for a cure”, her mother recalls.

 The procedure was a success, and for eight months Luna appeared to be in good health, until they found that the tumor had returned and, this time, was very close to the vena cava. Radiotherapy was prescribed to treat the tumor without risking damage to the heart. Luna underwent 24 months of treatment in all, until the hospital told them she could be discharged.

 “I learned a lot about resilience from Luna. Even when she was little she was strong and faced difficult times with a smile. As a way of commemorating this victory, we all took part in the GRAACC Run and Walk which takes place every year, and we have kept the medal so that we never forget that the battle was long but the result made up for it”, says Luna’s father.

 Luna’s treatment stopped five years ago. She goes to school, loves dancing and going to the pool, enjoys spending time with the family, especially her younger brothers and sisters, and is determined to learn the finer movements of rhythmic gymnastics. Now she has all her life ahead of her.