June 4, 2021
About a month after Alex Hammer turned 4, he started having constant fevers and ear infections. When he started to look like he had marbles in his mouth when he spoke and had trouble breathing, his mother, Krista, took him to an ENT doctor.
Alex, who lives in Washington Township, New Jersey, was diagnosed with mononucleosis (mono) and was put on steroids. He improved immediately, but about a week after stopping the steroid treatment, all of his symptoms returned.
The ENT doctor suggested that Krista see Alex’s pediatrician. It was the day before Thanksgiving in 2016 when they went to the pediatrician. After a checkup and consultation with another doctor in the office, Alex’s pediatrician told them to go home, saying he was going to do some checks and would call later.
When he called 30 minutes later, after seeing a specialist, he told Krista to quickly get Alex to the emergency room at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center. A medical team was waiting for them there because the pediatrician suspected Alex of having cancer.
Holidays like no other
Over the course of the six hours, Alex underwent a number of tests, including x-rays and blood tests. When a 10-person medical team entered Alex’s room, Krista knew the news couldn’t be good. Alex had lymphoblastic lymphoma (LBL), a type of pediatric non-Hodgkin cancer, of the neck and chest. Each year, approximately 800 new cases of non-Hodgkin lymphoma are diagnosed in children under the age of 19. Eighty percent of patients remain disease-free at the end of treatment. It is a highly curable type of pediatric cancer, according to hematologist / oncologist Stacey Rifkin-Zenenberg, DO
Since this type of cancer involves rapidly dividing cells, immediate treatment is recommended. Alex’s medical team wanted to start treatment that evening, but his family asked to wait until after Thanksgiving. “It was hard to believe this was all happening,” Krista says. “My husband said, ‘Let’s go home. Let’s see our family. Let’s wrap our brains around this.
The day after the vacation, Alex was in surgery to insert his port (a small device shaped like a metal donut) into a vein to facilitate blood tests and chemotherapy treatment. His parents were also asked if they would allow him to participate in a clinical trial to test whether a targeted drug given in addition to standard chemotherapy drugs would improve treatment effectiveness.
Whether Alex would get the drug tested was decided at random, tossing a (computerized) coin, but his parents agreed to let him participate in the trial. It is still too early to know the results of this trial, says Burton Appel, MD, Alex’s principal oncologist and associate director of the Children’s Cancer Institute at the children’s hospital. However, we do know that many of the successes in pediatric cancer treatment over the past 50 years have been determined by randomized trials like Alex’s.
The winding road to recovery
Alex’s treatment lasted more than two years, and during that time he experienced the complications typical of chemotherapy, says Dr. Appel, such as fever, pneumonia and a low blood count. Some of these complications took him to the hospital.
Alex was not thrilled to have to go through this, his mother said, and it was a challenge to get him to do things that needed to be done in the hospital. “He’s very stubborn. He knows what he wants and won’t do anything he doesn’t want, ”she said.
The medical team understood. “You could tell he just wanted to feel better so he could get active again,” says Dr. Appel. “I think the hardest thing for him was the time he had to be in the hospital. He just wanted to be home, which of course is very normal for a child.
The good news is that her cancer has responded well to her treatment. He finished his chemotherapy in March 2019. “Most relapses would occur within one to two years of completing chemotherapy,” says Dr. Appel. “So the fact that he’s passed the two-year mark is very encouraging. “
When Alex finished his treatment, the surgeon who put in his port, Keith Kuenzler, MD, removed it in a second procedure, cleaned it up and gave it to Alex’s mother. “Patients and parents are always proud to bring him home on the day of his removal,” he says. “Especially compared to the day I have to put on the port, it’s such a wonderful time. I do not get enough. “
Krista Hammer didn’t know what to do with the piece of metal at first, but brought it home anyway. “I took it home and remember looking at it. I held it in the palm of my hand. It was literally the size of a dime. I was like, ‘This is what kept him alive,’ ”she said.
Then the inspiration struck. Throughout Alex’s treatment, his family called him “Iron Man,” after the superhero Alex admired. In the center of Iron Man’s chest is a circular device that keeps him alive and gives him superpowers, much like wearing Alex.
A family friend put Krista in touch with an artist who modified an Iron Man figure by inserting Alex’s port into her chest. “He’s in Alex’s room, and that’s just the coolest thing,” Krista says.
Now that Alex is over two years after treatment, he will be referred to Hackensack Meridian Children’s Health’s Cure and Beyond program, Dr Appel said. Cure and Beyond is a lifelong support program for childhood cancer survivors that provides medical and psychosocial support services to identify and manage the long-term effects of childhood cancer.
But right now, his mother says, Alex is focused on finally becoming the active, healthy kid he always wanted to be.
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