Noah Escobar opens the “Good Dinosaur” lunchbox and removes a tiny orange. The dinosaur-decorated box has been loaded with fruit packed by his parents, Daniel and Alexandria Escobar, for their 2-year-old son’s five-day stay at Valley Children’s Hospital.
He is here for his last round of chemotherapy to treat neuroblastoma, a rare form of cancer most often found in children younger than 5, usually in more boys than girls. Most cases are diagnosed before the age of 6 months.
Valley Children’s Hospital doctors see an average of three or four youngsters each year who have some form of neuroblastoma. Those patients go through a series of treatments that can include extended stays in the hospital.
“We have five bags in the car,” Daniel Escobar says. “It took some time to pack everything he would need – which toys to pack as distractions.”
This last chemotherapy treatment marks the end of a long medical battle that started last June. The Escobars became concerned when the left side of Noah’s face became swollen. Initially, doctors thought the swelling was caused by an infected gland, and antibiotics were administered.
Once scans were done, it was obvious the swelling was in the boy’s jawbone, and he was diagnosed with neuroblastoma.
Look for The Fresno Bee’s special Kids Day section Tuesday, March 8. Volunteers will be on street corners selling the paper for $1 to raise money for Valley Children’s Hospital.
“I brought him into the emergency room by myself,” Alexandria Escobar says. “I was trying not to think it was cancer but nothing more than an infection. My husband and I were very, very shocked. When they told me, it didn’t seem real. It felt more like a scene out of a movie.”
Neuroblastoma is one of three types of adrenal cancer. It’s found in developing nerve cells of the medulla. According to the American Cancer Society, about one in three neuroblastoma cases begin in the adrenal glands, which are on top of each kidney. Noah’s cancer started in his adrenal gland and spread to other parts of his body through his bone marrow.
Valley Children’s Hospital’s Dr. Daniel Ozeran, who is board certified in pediatric hematology/oncology by the American Board of Pediatrics, describes Noah as one of “the most adorable children in the hospital right now.”
Along with having a mass on his adrenal gland and other smaller tumors, Noah had three spots on his skull. Ozeran explains that Noah initially was diagnosed with high-risk neuroblastoma, but after further examination, his cancer designation was reduced to intermediate.
“The spots on his skull are fairly common for children with neuroblastoma,” Ozeran says. “This is typical with neuroblastoma because it actually tends to spread to the bone itself.”
Once the doctors knew what they were fighting, chemotherapy was started to reduce the tumor in Noah’s jaw to the size of a marble. That was followed by surgery to remove masses in his abdomen and on his glands.
Noah’s body didn’t respond to treatment as strongly as Ozeran had hoped, so his status was elevated back to higher risk. Since then, though, Noah has responded enough that he’s now in his final treatments.
The last round of chemotherapy means five more days in the hospital. Alexandria Escobar has spent every night at the hospital, while her husband has split his time between the hospital and at home looking after the couple’s 6-year-old daughter, Azya.
“We will be happy to all be together at home all the time again,” Alexandria Escobar says.
As with so many cases of neuroblastoma, doctors weren’t able to tell the Escobars exactly what caused the cancer. All the couple knew was that their son was sick.
Daniel Escobar has trouble finding the words to describe the emotions he went through after hearing that his son had cancer. He’s better able to talk about how the family dealt with the battle against the cancer.
“We would not have made it without our faith in God,” he says.
There were times when Daniel Escobar questioned why his son got cancer, but never to the point of doubting that everything would turn out for the best.
Back in the small examination room, registered nurse Minal Patel opens a small port that was implanted under the skin on Noah’s chest during his surgery. Noah has gone through the process so many times that he gets upset as soon as his shirt is raised to prepare the port.
Things calm down quickly, much to the credit of Joy Barton, a child life specialist with a massive supply of items that blink, make sound, light up or float through the air to entertain young patients.
The Escobars agree that the hospital staff has been extremely helpful in keeping them informed about what is happening with their son.
“Even when I would ask about little things, they were really good about letting us know what to expect,” Alexandria Escobar says.
Noah’s chemotherapy was divided into two groups. He was given 30 infusions the first round and 60 for the last round. Doctors have told the family that there should be no more chemo sessions.
There’s proof that Noah’s battle has reached an end: All cancer patients are presented with a T-shirt after their last infusion. It reads “No Mo Chemo.” Often the staff sign the shirt for the patient.
Noah’s time at the hospital won’t end here. Doctors will monitor his health and continue to run tests to ensure the neuroblastoma does not return.
The Escobars have a deep faith it won’t.
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