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Surgery, chemo battle preschooler’s kidney tumor



Three-year-old Ariana LaVaute attended the Skaneateles Labor Day parade on Sept. 1, 2014, and then helped her father trim shrubs in their yard. A few days later, her activity level and appetite diminished. Seemingly overnight, her belly became enlarged.

Ariana‘s pediatrician immediately sent her to the Upstate Golisano Children‘s Hospital. It was the day before she was scheduled to meet her preschool teacher.

Rapidly growing in Ariana‘s abdomen was a Wilms‘ tumor, a cancer that began in one of her kidneys and grew to the size of a melon, invading her pelvis and growing into her heart. “Once they start growing, they tend to present as fairly large masses,” said Gloria Kennedy, MD, Ariana‘s oncologist.

Wilms‘ tumors can start dividing in utero, often becoming quite large before they are noticed. Kennedy explained that a child with Wilms‘ tumor is considered cured after he or she is free of malignancy for as many years as their age at diagnosis, plus 9 months to account for gestation.

Gloria Kennedy, MD

G;oria Kennedy, MD

An initial surgery was done on Sept. 5, in an attempt to remove the mass. Doctors installed a port so that Ariana‘s chemotherapy could begin the next day, with hopes of shrinking the tumor. In the months that followed, medication reduced the tumor size but not its extent, making a surgery that is challenging that much more complex. The final surgery was Jan. 21.

Pediatric surgeon Tamer Ahmed, MD, said the tumor had grown into the vena cava, the vein that carries blood to the heart. To remove the tumor, not only would he have to remove her kidney, “we had the added complexity of having to open up that vein.”

Tamer Ahmed, MD

Tamer Ahmed, MD

It was a big operation, lasting five or six hours and making use of the heart-lung machine so that Ariana‘s heart would lie still while Ahmed and pediatric cardiac surgeon George Alfieris, MD, operated together.

“It was a delicate operation,” Ahmed recalled, “but I think she did very well.”

She has undergone eight months of chemotherapy and radiation treatments, which continued after the surgery. She has been hospitalized for nearly 30 days in total. Through it all, Ariana‘s father,

George Alfieris, MD

George Alfieris, MD

Jeff LaVaute, said she stayed strong. “Her bravery was, has been and continues to be positively inspirational,” he said.

It was April 27 when he received a phone call about Ariana‘s post-treatment scans. They showed she was cancer free and finally on the road to recovery.

cancercarefall15Since then, Ariana completed the last few weeks of preschool, which included her fourth birthday celebration on the Judge Ben Wiles boat. She and her family enjoyed a seven-day Make-a-Wish trip to Disney World. And this fall, a year after her diagnosis, Ariana started Bumblebee Soccer.

This article appears in the fall 2015 issue of Cancer Care magazine.