Since the day Derek Noriega was born, he had always been a healthy and physically active child. He rarely ate out and preferred healthy, home-cooked meals by his mom Yaris. But in late February 2021, when Derek was 7 years old, he began developing unusual symptoms that concerned his mother.
”Derek had random bruises all over his legs,” said Yaris. “They were huge and looked very painful. When I asked him how he got his bruises, he didn’t know. He told me he didn’t bump his leg on anything. When I asked Derek if the bruises hurt when he touched it, he said, “No mom. They don’t hurt.”
Then, a few days later, Derek developed a fever and complained of pain in his left leg. Yaris knew something was wrong with Derek because he continued to say the bruises did not hurt but the pain in his leg was new. She took her son to their family physician and then scheduled an appointment to see a pediatrician. Before Yaris could take Derek to the pediatrician, he had a nosebleed at school. He was bleeding out of both nostrils. When he got home from school Derek felt stomach pain that would not go away. Deeply concerned about her son, Yaris rushed him to the nearest emergency center.
Since Derek couldn’t bear the pain, Yaris took him to an ER close to home. Derek had X-rays, blood tests and an ultrasound to examine the area where the pain was coming from. Derek was prescribed steroid medication to address his symptoms.
The next day, Derek had another episode of nosebleeds at school. Later that night, when traces of blood were present in his stool, Yaris contacted her son’s doctor, Children’s Memorial Hermann-affiliated pediatrician, Dr. Michelle Suhendra, who advised them to go directly to Children’s Memorial Hermann Hospital Emergency Center in the Texas Medical Center.
While at the Emergency Center, Derek underwent more diagnostic tests. Shortly thereafter, his doctors determined it was best for Derek to be admitted.
“Despite his unusual symptoms, Derek was still the same active child he was before the bruises and nose bleeds, but I was deeply concerned about him,” said Yaris. “While at the hospital, Derek underwent more tests to see if his symptoms were caused by a virus. He also had a bone marrow biopsy to rule out other potential possibilities. I prayed many times for Derek. That’s all I could do.”
On March 1, 2021, after waiting patiently at her son’s bedside for the lab results, Yaris received the news that no parent is prepared to hear: “Your child has cancer.”
“I was in a state of shock when I found out Derek had leukemia,” said Yaris. “It was hard for me to accept and process. I relied on my faith and prayed a lot. I had to be strong for my children and my husband, who was a ship captain and was gone for several months out of the year. I knew God was with us and Derek would be okay. But still, I kept asking myself how this could happen?”
Derek had B-Cell Acute Lymphoblastic Leukemia (ALL), the most common type of bone marrow cancer in children. ALL causes bone marrow (spongy tissue in bones) to make too many immature white blood cells (lymphoblasts). These abnormal cells crowd out healthy red and white blood cells and platelets in the blood and bone marrow, making it difficult for the body to fight infection and diseases. If left untreated, ALL can spread quickly to lymph nodes and other parts of the body.
Derek participated in the Pediatric Cancer Program at Children’s Memorial Hermann Hospital. Led by affiliated cancer specialists on the faculty of McGovern Medical School at UTHealth Houston, the team works closely with all pediatric subspecialties at Children’s Memorial Hermann Hospital to combine the latest advances in research, procedures and technology to diagnose and treat a full range of pediatric cancers with the ultimate goal of delivering the best possible patient outcomes.
“Cancer treatments are not one size fits all,” said Ann Marshburn, MD, an associate professor of pediatric hospital medicine at UTHealth Houston and pediatric hospitalist who leads the Pediatric Cancer Program at Children’s Memorial Hermann Hospital. “When a patient is diagnosed with cancer, our providers work with each patient and family to create an individualized, comprehensive plan of care. The patient’s care team is led by a pediatric oncologist and pediatric hospitalist, and depending on the child’s needs, may also include other members of the care team including pediatric residents, nurse navigators, child life specialists, social workers, and therapists (occupational, physical, speech) to meet the patient’s unique medical and social-emotional needs.”
Following Derek’s ALL diagnosis, Yaris met with Derek’s oncology and hematology care team from the Pediatric Cancer Program. They included McGovern Medical School at UTHealth Houston physicians affiliated with Children’s Memorial Hermann Hospital Douglas Harrison, MD, David McCall, MD, and Branko Cuglievan, MD.
After meeting with Derek’s team, Yaris explained to her son, “We have good cells and bad cells. The cells that need to be good are misbehaving in your body. I told him his treatments will help the cells behave normally again. It would be a very long process, but Derek was ready.”
Derek began chemotherapy on March 12, 2021. During the induction phase, he spent one month in the hospital where his chemo treatments were administered through his port or by spinal tap. He also took steroids in pill form while undergoing chemotherapy.
“He tolerated the treatments well,” said Yaris. “He was very positive and upbeat. When Derek was on chemo, he never lost his energy. He gained a lot of weight due to the steroids because it made him hungry all the time. After completing his first month of chemo at the hospital, he took chemo pills at home and would go to the Children’s Infusion Center at Children’s Memorial Hermann Hospital for weekly chemo treatments. After several months of weekly chemo sessions, we transitioned to treatments every 15 days for chemo, and then once a month.”
Chemotherapy is the primary treatment for patients with ALL. Derek received different combinations of chemo medication throughout his treatment to destroy as many cancer cells as possible to induce remission.
“Chemo medications affect cancer cells at different points in the cell cycle,” said Dr. Cuglievan. “When treating Derek, we used a combination of various types of chemo agents and adjuvant medications, medication administered after initial treatment, to increase the chance that all the cancer cells will be eliminated. Each is strategically timed to be administered in a particular phase of treatment as well as in a particular phase of cell cycle growth. With combination chemotherapy – using more than one medication at a time – this can also help reduce the likelihood the leukemia may become resistant to any one chemo drug.”
Derek’s treatment plan will take a little over two years to complete – but he is more than halfway there. He achieved remission after the first phase of treatment and is now in the maintenance phase of therapy. He takes most of his medications at home. Derek goes to the pediatric oncology and hematology clinic every three months for chemo, and he has monthly assessments and labs.
“When I first met Derek, he was sad about his cancer diagnosis and being in a new place,” said Michelle Oakley, a pediatric oncology nurse at Children’s Memorial Hermann Hospital. “He was fearful. He wanted to know everything that was going on. We had to build up our trust with him over time. It was a great privilege to work with Derek and to help him cope with his diagnosis early on. I have seen him grow up in the last year. He is more patient, calmer and more understanding.”
Derek will finish his last treatment in May 2023, if everything goes as planned. So far, Yaris says her son is doing well and his treatments are working.
“Derek is a strong person,” said Yaris. “However, there were times when I could tell he felt alone even though there were people always around us at home and at the hospital. I did my best to listen to him and ask him questions about his feelings to really get to the bottom of how he was doing. We focused on the little things and talked a lot to each other. Also, I am grateful for all the love and support that everybody has shown Derek. His doctors and nurses have been very kind to him. They have been compassionate and answered all our questions and concerns. I was very well updated on everything. My son loved working with Hailey W. from the Children’s Memorial Hermann Child Life team who he always called “my Hailey.” She explained everything to him, and she had this way of keeping him calm and comfortable before his procedures. They connected well.”
While this journey has been challenging, Yaris says what helped her get through the ups, downs and uncertainties, was her faith in God. She never allowed negative thoughts to cross her mind.
“My advice for other families is to keep their faith, pay attention to your instincts and do what’s best for your child.” said Yaris. “Deep down, I know my son, Derek, will overcome this. I know God brought us here for a reason, so that Derek could receive the care he needed. We are blessed to have a wonderful team who has been there for my son. I can’t wait until the day he finishes his treatment. Until that day comes, I will continue to pray for Derek.”
Learn more about the Pediatric Cancer Program at Children’s Memorial Hermann Hospital »