Whisper Palmer is ten years old, and she is a fierce fighter.
Her battle is against cancer, which she calls her “dragon.” Fortunately, she is surrounded by the most powerful team of dragon-slayers in Indiana.
They have an arsenal of different swords, all taking aim at the dragon to help Whisper win her fight.
The Sword of Expertise
A few weeks after her diagnosis, Whisper sits in her bed at Riley Hospital for Children at IU Health. “I call my cancer ‘dragon,’ because it makes me feel better and doesn’t make me upset as much,” explains the outgoing girl from Auburn, Ind. “It shows kids that they don’t have to be afraid and they’re going to get better – they’re slaying a dragon.”
Whisper has a type of leukemia known as APML, acute promyelocytic leukemia. Dr. Ashley Meyer is the oncology fellow leading Whisper’s cancer care at Riley. Whisper’s treatment plan calls for daily chemotherapy sessions for five weeks at a time, with two-week breaks in between. They are using arsenic to attack the cancer. “Arsenic has been used for years,” explains Dr. Meyer. “It’s very helpful for her particular kind of cancer. It is targeting and killing the cancer cells that are actively dividing.”
Around 80% of Indiana children who are diagnosed with cancer come to Riley Hospital for their care. Dr. Meyer says there are advantages to being treated in the state’s largest pediatric cancer center. “Riley is different because we do have big numbers. We have a lot of experience and a lot of faculty who’ve been here a long time,” she explains. “Everyone works well together. We have surgeons who can put in ports and central lines at all hours. We can go down and talk to our radiologists about scans even if we’re not next in line to be read.”
The Sword of Compassion
When Whisper and her mother Tammy first arrived at Riley Hospital Pediatric Emergency Medicine and Trauma Center, they came without a suitcase. Riley was ready with a support system ready to embrace them, including Certified Child Life Specialist Nancy McCurdy, who works in the Riley Pediatric Emergency Medicine and Trauma Center. “They came straight from their doctor’s office,” recalls Nancy. “Part of my job became helping this family make the transition so they knew there was a team that was going to help Whisper get through the hardest time in her life.”
Whisper’s first major fear was having an IV needle stick. Nancy used proven comfort techniques, including a fairy book for distraction, and a plastic buzzing bee named “Buzzy” with a cold pack for wings placed above the needle-stick site to deflect the sensations. Later, once Whisper was admitted to the Riley Cancer Center, Child Life Specialists took over her psychosocial care. But Nancy still stops in to check on her. “I just felt that connection. I helped her begin her journey,” she explains. “I wanted her to know that I was still here as a resource, even though there were others who were going to take her on the next leg of the journey.”
The Sword of Innovation
In the Wells Center for Pediatric Research, connected by sky bridge to Riley Hospital, Melissa Fishel, Ph.D., is in a lab sharpening her own “swords.” Dr. Fishel lost her father to cancer at a young age and decided to make a career out of killing cancer cells. She is one of 110 investigators and lab workers in the Wells Center devoted to finding better ways to fight cancer. One of her trials is testing a new combination of drugs that can kill leukemia cells by going after proteins known as APE1 and STAT3. “We can take doses of both inhibitors that don’t kill the cells by themselves and put them together,” explains Dr. Fishel. “Then, the cancer cells are dramatically sensitized to the treatment,” explains Dr. Fishel.
Research is the reason that more than 90 percent of children like Whisper who are diagnosed with APML are now able to beat their cancer, compared with a grim 25-30 percent survival rate just a few decades ago, according to Robert Fallon, M.D., the chief of hematology/oncology at Riley Hospital. Finding better, less-toxic therapies is the goal of many clinical trials being conducted at Riley. Riley Hospital ranks among the top five children’s hospitals in the nation for participation in clinical cancer trials. Riley is also the only Indiana children’s hospital in the Phase I consortium, which gives children access to the newest cancer drugs. “You come to Riley because that is your portal to get innovative cancer treatments that can’t be done in smaller hospitals,” says Dr. Fallon.
With recent advances in genetic research, Riley physicians can gauge the risk-level of a child’s cancer and tailor their treatment plan accordingly. Dr. David Delgado is the Clinical Director of Pediatric Stem Cell Transplant at Riley Hospital—the only program of its kind in the state. He says his team now only recommends high-risk stem cell transplants for patients with the riskiest cancers. “As research has expanded, we’ve found that in some cases patients do just as well but have fewer complications with less aggressive therapy,” explains Delgado.
Riley oncologist Jamie Renbarger, M.D., is also interested in reducing toxic side-effects for children with cancer. She is leading a clinical trial examining how a child’s genetic makeup can predict how quickly they’ll metabolize chemotherapy drugs. “When we think about chemotherapy or radiation that we give to kids, it’s a broad treatment that we’re giving,” says Dr. Delgado. “If we had more targeted therapy for our patients to potentially avoid those complications, that would be great.”
The Sword of Joy
A few months into chemotherapy, Whisper’s long, dark hair has been replaced by a crew-cut, freshly cropped and dyed blue-green for the annual Riley Cancer Center Prom. While an IV drips arsenic into her veins in a chemotherapy infusion room, her mind is back on the dance floor. “They went all out,” Whisper says with wide eyes. “There was candy, a dance floor, and nachos!” She cracks a wide, funny grin for emphasis, then shifts her focus back to her favorite video game. She doesn’t notice her mother’s tears.
Whisper’s battle isn’t easy, and there’s a long road ahead. But at age 10, she seems to understand what a fierce army she has surrounding her. “I like Riley Hospital because if you need anything, they’re always there. They said they can’t find any more dragon in my bone marrow or blood,” says Whisper. “That makes me feel good. I’m going to slay it.”