Bloomsburg girl overcomes life-threatening cancer
“We are going to the school football game tonight, where we will be singing the National Anthem and the alma mater,” she said recently, barely able to contain the excitement in her voice.
What makes her different from her fellow chorus members and middle school classmates is, at 13 years old, she is a cancer survivor.
Looking for answers
At age 11, Sophia complained about occasional stomach and side pain. When the pain became more persistent and wrapped around her back, her mother decided to seek medical attention.“At the emergency room, the doctors felt something in her stomach, and they sent us to the pediatric emergency room at Danville,” Kelsey Erlston said. “They brought a bedside ultrasound into the room and found a large tumor. They immediately admitted her to the pediatric intensive care unit.”
There they met Jagadeesh Ramdas, M.D., director of pediatric hematology/oncology at Geisinger Janet Weis Children’s Hospital. Dr. Ramdas told the Erlstons that they were going to run some tests to further diagnose the tumor.
“The initial scans were very disturbing, because the tumor was so large,” Dr. Ramdas said. “It had encompassed her whole right kidney and was wrapped around several organs and blood vessels.”
Dr. Ramdas ordered a biopsy of the tumor to pinpoint what type of mass it was and plan treatment. The findings were unusual. Sophia had a Stage 4 Wilms tumor, or nephroblastoma, a rare type of kidney cancer that primarily affects children under the age of 5. The tumor had ruptured, which caused more concerns for the spread of the cancer.
“It was the last thing I ever expected to be told,” said Kelsey. “I broke down. I was terrified of losing her.”
“I was confused and filled with sadness and anger,” said Sophia about her feelings at that moment she was told of her cancer. “I was worried about what was going to happen to me.”
Dr. Ramdas was most concerned about the sheer size of the tumor and the fact that it had wrapped around a blood vessel and extended into a vein running to Sophia’s heart, putting her life at considerable risk. That the tumor was affecting a main blood vessel made treatment very challenging. The condition, called tumor thrombosis, is when a tumor extends into and blocks a blood vessel, forming a clot.
Building a plan
Dr. Ramdas mapped out an intense treatment plan for Sophia, beginning with 10 weeks of chemotherapy in an effort to shrink the tumor. Knowing the complexity and risk of the surgery, Dr. Ramdas contacted colleagues at Children’s Hospital of Philadelphia (CHOP) to make plans for her surgery following the initial 10-week treatment.“During that surgery, there’s always concern that the thrombus can break off and get into the patient’s circulation, risking the chance of a stroke or cardiovascular collapse,” Dr. Ramdas said. This is why he relied on Geisinger’s close collaboration with CHOP to make sure Sophia was receiving the best care under expert supervision.
Plans were made for the surgery to take place the day before Thanksgiving 2023. Because there was a chance that the tumor had gone to the heart, the physicians at CHOP had a pediatric cardiologist and cardiothoracic surgeon on standby in the operating room with the oncology surgeon in case they would need to act quickly.
“It was an all-day surgery. I was a mess. My stepdad was there with me,” Kelsey Erlston said. “It was a real rough time for me. I was pregnant and both of my parents had also been diagnosed with cancer.”
Luckily, the tumor did not reach Sophia’s heart. The surgeon told her mom that he had removed as much of the tumor as he could. It had spread over many organs, meaning he needed to remove her right kidney, half of her liver and three inches of her diaphragm.
The road to recovery
Following the surgery, Sophia still had a long fight ahead of her. She spent 6 weeks at CHOP. During that time Sophia started to see the side effects of chemotherapy and was losing clumps of hair.
“I had to shave my head,” she said.
“I shaved mine first,” Kelsey said of her effort to take the trauma away from her daughter.
Before leaving CHOP, doctors scheduled radiation therapy for Sophia, which she received the day before Christmas.
“Since her tumor had ruptured, she needed radiation therapy to her whole abdomen to prevent the risk of a recurrence of her cancer,” Dr. Ramdas said. “The family and our team decided to arrange for photon beam radiation treatment, which is available at CHOP.”
After returning home, Sophia continued her battle for 14 months with weekly chemotherapy treatments at Geisinger’s Foss pediatric outpatient clinic.
“She had good weeks and bad,” Kelsey said. “She had a few times when her blood counts got too low and she needed a few blood transfusions. She also had to have a portion of her right lung taken because of damage. It was a rough time for her; she practically missed a whole year of school.”
In February of this year, Sophia got to ring the bell to acknowledge her last chemotherapy treatment. Her most recent CT scans show no recurrence of cancer and she is feeling great. Now in 7th grade, she is doing very well in school and being a great big sister to her little brother Dante, 6 and little sister, Emma, 1.
“To look at her now and see how well she is doing, it almost all feels like a bad dream,” Kelsey said. “If you look at our life from then to now, it is almost like it never happened. She is doing so well.”
