Quick cancer A scrappy but scared little boy has been fighting for his life in with medical problems his parents say were undiagnosed or misdiagnosed for 1-1/2 months in Guam.
diagnosis gives
6-year-old hope
Leukemia had sped through
Christopher Viloria's body
in just weeksDoctor says specific
child cancer curableBy Helen Altonn
Star-BulletinSix-year-old Christopher Viloria underwent a battery of tests at Kapiolani Medical Center for Women and Children after flying to Hawaii on Easter Sunday with his parents, Glenda and Ronald, and a doctor.
"Within three hours of arrival, they already knew what he had, compared to more than a month of going to doctors (in Guam), doing all these tests for nothing," said Ronald Viloria.
On their first visit to a doctor in Guam, they were told their son could have leukemia or cancer, said Glenda Viloria. "The whole night I cried and cried.... Later on, they changed their minds."
The doctors there "ruled out all the bad guys" like leukemia and pancreatitis, Viloria said. "But what they said he didn't have, he has."
Dr. Darryl Glaser, Kapiolani attending physician in pediatric hematology and oncology, said Christopher has a rare type of cancer that grows and spreads quickly: B cell leukemia, or Burkitt's lymphoma.
"Burkitt's is so sudden and so fast, it's critical to treat it right at the start," Glaser said.
Children die if it isn't diagnosed early, but it responds quickly to chemotherapy, he said. "This particular tumor is quite curable."
The little tyke with the big smile in his kindergarten class picture isn't smiling much now. He curls up in his hospital bed with two big fluffy toy dogs, Scooby-Doo and Scrappy-Doo, comforted by his parents at his side.
"If you'd known him before -- he was the happiest and most loving child," his father said.
Though Christopher looks very sick, he's "actually doing real well now," Glaser said. "When he came in, he was quite ill. He had leukemia all over his body."
His kidneys had shut down and the cancer had spread through his bone marrow, kidneys, liver, pancreas and spinal fluid. He is still quite sick but most of his cancer is gone, Glaser said.
Although Christopher's illness wasn't diagnosed in Guam, he was given medicine for other reasons that slowed his cancer's growth, Glaser said.
The Vilorias, both 31, described an agonizing experience in Guam trying to find out what was wrong with Christopher after he began having pain in his jaw and swelling of his saliva gland. Thinking it was a dental problem, they took him to two dentists and a dental surgeon for different opinions, Ronald Viloria said. "They said the saliva gland was infected but it was working."
They then took the sick child to a doctor who said he just had a virus and it would pass. The second week, the doctor found his blood count was low and gave him some iron pills, Viloria said.
"After that, his blood count dropped again. He was always tired ... so finally, we went to another doctor who suggested we go to the hospital because he had low blood count and some kind of infection."
Despite many tests, the doctors still couldn't explain exactly what was wrong with Christopher, his father said. However, because of high secretion in his pancreas and saliva gland, they gave the child steroids, he said.
"He was in the hospital about three days.... They sent us home with no diagnosis, no what's going on, no prescription, no medication."Guam Memorial Hospital has a pediatric floor but no pediatric doctor, Viloria said.
He said Christopher began getting bloated the third week, so they took him back to the doctor, then to the hospital, where he was given a blood transfusion and more steroids.
The couple thought their son was getting better because he had a good appetite. They didn't know it was caused by the steroids. He spent another three days in the hospital and "his stomach was getting big -- like a pregnant lady," his father said.
When Christopher's blood count improved, the hospital released him despite the swelling in his stomach, Viloria said. "The next day, his swelling moved down to his groin area, and it looked bad. It was just a lot of pain for him. So we brought him in again to the emergency room.
"Finally, they told us his kidneys had shut down. After that, they finally said 'we're going to Hawaii,'" Viloria said.
The distraught parents had already asked twice for a referral to Hawaii, in the second week of their son's illness and again when he had a blood transfusion. The referral is necessary for insurance coverage, they said. Both times, they were denied.
Christopher was on dialysis for a week after arriving at Kapiolani, Viloria said.
He said he's tried to talk to the child about what's happening, but it's hard for Christopher to understand "and he's really scared."
Glenda's sister, Grace Delin, lives in Honolulu, and Ronald has aunts here. But the couple has been living in Christopher's hospital room. "He looks for us," his mother said.
"Even in ICU, we would sleep on the floor," Ronald said. "We don't want to leave him alone in a strange environment."
Glaser said Christopher must have chemotherapy for about six months.
With most of Christopher's cancer gone, Glaser said, "We're worried now about changes in the family's lifestyle.... A big part of what we do is treat the family as well as the patient."
"It's like our whole lives have just flipped upside down," said Ronald Viloria, a pastry chef in a hotel. Glenda is a bookkeeper for a wholesale company.
Both said their employers have been very understanding and they're lucky because they have family here.
But Glenda's sister had to go to Guam because their father is ill. And the couple faces hundreds of thousands of dollars in medical bills. Viloria said his insurance covers 80 percent of costs, but not dialysis or blood products.
Transportation also is costly, Glenda said, noting they had to pay $1,218 for a doctor to fly here with them from Guam.
Ronald said a social worker at the hospital is helping them apply for aid, and once Christopher is out of the hospital, he must return to his job to earn income and keep his medical insurance. Glenda will remain here while Christopher continues chemotherapy.
But the father frets about leaving their frightened son.
"He thought Hawaii was the hospital," Viloria said. "He said, 'I want to go back to Guam. I don't like Hawaii.'" He said he tried to get Christopher to look out the window of his hospital room, telling him Hawaii was out there.
"Most of his hair is gone. He keeps touching his hair and gives me a worried look, 'Daddy, I'm scared.'"
About 25 kids at Christopher's school and the school's pastor-president shaved their heads so Christopher won't feel alone, Viloria said. He said he plans to do the same.
The medical community "has made incredible strides" in treating and curing pediatric cancer in 20 years, says Dr. Darryl Glaser, pediatric oncologist. Doctor says specific
child cancer curableTreatment shared between nations
has boosted survival ratesBy Helen Altonn
Star-BulletinCutting-edge technology and the newest therapies are available because of a Children's Oncology Group across the United States and Canada, he said.
"Pediatric cancer is so rare, we need a lot of patients to learn and share data."
Burkitt's lymphoma had an 80 percent mortality rate 30 years ago, said Glaser, attending physician in pediatric hematology and oncology at Kapiolani Medical Center for Women and Children and an assistant professor in the University of Hawaii medical school.
Burkitt's is a rare cancer that occurs most often in young people and causes a rapidly growing tumor in the abdomen.
Because of clinical trials, Glaser said, the mortality rate has been reversed, with 80 percent of patients surviving after chemotherapy.
He said a cure is possible for eight or more children out of 10 at the stage of Burkitt's that Christopher Viloria is in now. The cancer responds so quickly to chemotherapy that it can be dangerous, because poisons are released as cancer cells die and spill into the body, he said.
However, he said medical teams have learned so much, and there is so much support in the Intensive Care Unit, "we can get kids through it."
Glaser said Kapiolani gets a number of young patients from Guam and Saipan and often gets calls from doctors on Guam if they suspect a patient has cancer.
"Pediatric cancers are rare. Certainly, it is not the first thing they think of when a child has complaints like Christopher."
Christopher's symptoms (a swollen jaw and inflamed pancreas) were unusual for Burkitt's lymphoma, and the hospital in Guam has no board-certified pediatric oncologist, Glaser said.
"No one thought it was cancer. No one called us."
Doctors can't give false hopes, Glaser added. "Some cancers aren't curable. But this is very curable."