Timely, Life-Saving Treatment for a Fast-Growing Blood Cancer: Brandon's Story

Brandon Buchanan seems like a typical 7-year-old. A spirited, outgoing jokester from Charlestown, Massachusetts, he loves dancing, rollerblading, and hockey. You'd never guess he recently went through a terrifying medical ordeal.

"We're at the Bunker Hill pool on a Tuesday," said Brandon's mother, Nicole Bourgeois. "On Wednesday, he starts having a stomachache. On Thursday, we find out he has cancer. That's how quickly it happened."

Fortunately, Brandon was in good hands: the Division of Pediatric Hematology and Oncology at Mass General Brigham for Children.

"As a children's hospital within a hospital, we have specific expertise in pediatric oncology, intensive care, surgery, radiology, interventional radiology, and more," said pediatric oncologist Alison Friedmann, MD. "All of these pediatric specialties work together to provide seamless, state-of-the-art care for critically ill children like Brandon."

Brandon's care team found he had Burkitt-like lymphoma. This extremely rare and aggressive form of blood cancer is more common in children than in adults.

"It literally grew overnight."

That Thursday morning, Nicole took Brandon to urgent care. The clinicians suspected he had a burst appendix. Since this medical issue requires hospital care, she next headed to Massachusetts General Hospital, where Brandon and his twin sister, Addison, have a pediatrician.

As Brandon had blood work and a CT scan done, a large lump suddenly became noticeable in his abdomen. Two doctors told Nicole it was a tumor—probably cancerous. "It literally grew overnight," she said. "I was shocked, to say the least."

At this point, Dr. Friedmann and her colleagues suspected Brandon had Burkitt lymphoma or one of its variants. The tumor's rapid expansion was a telltale sign.

"A lymphoma like this can grow right before your eyes in a matter of days," she said. "We consider it a real medical emergency because people can get very sick from it very fast. That's not the case with most lymphomas."

By the next day, the tumor had tripled in size, preventing Brandon's lungs and diaphragm from expanding. His care team placed him on a ventilator. A subsequent needle biopsy, in which a small sample from the tumor was removed for testing, confirmed it was Burkitt-like lymphoma, a variant of Burkitt lymphoma. Brandon was immediately started on chemotherapy to shrink the tumor and make breathing easier.

Although it was cancer, Dr. Friedmann was hopeful about the young patient's outlook. "These tumors are exquisitely sensitive to chemotherapy," she said. "Once you begin treatment, the cells tend to die very quickly."

Tolerating chemotherapy with minimal side effects

Brandon was on the ventilator and sedated for a week while receiving the first round of chemotherapy. He ended up staying in the hospital for 25 days. Either Nicole or her fiancé, Sprague Buchanan, was by his side the entire time.

Three days after going home, Brandon started first grade with Addison. His teachers and friends, many of whom sent him videos during his hospitalization, welcomed him enthusiastically. "Our friends and family have been so supportive throughout all of this," Nicole said.

Though Brandon had tolerated the chemotherapy well, his hair began falling out. Soon he had his head shaved. Sprague, Nicole's father, and several others did the same out of solidarity.

Brandon spent five days at home before returning to Mass General Brigham for Children for a second round of chemotherapy, which also lasted a week. Two more intensive, week-long rounds would follow, each requiring an inpatient stay.

"It was a lot for him to take, but he didn't get sick," Nicole said. "He'd dance around while getting treatment."

"He didn't slow down and had minimal side effects from treatment," Dr. Friedmann agreed. "He's a sturdy kid who's always focused on play. Just an amazing little fellow."

Support of child life team was instrumental

Nicole praised the skill and compassion of Brandon's oncology team, including Dr. Friedmann; Howard Weinstein, MD, unit chief, pediatric hematology/oncology; nurse practitioner Samantha Vincent, CPNP; and a host of other nurses. She also appreciated the support of child life specialists, who help children and families navigate the mental, emotional, and social effects of illness, medical treatment, and hospitalization.

"The entire child life team was fabulous with Brandon," Nicole said. "He was really close to one specialist in particular, Casey Johnson, who saw him a lot in the hospital. Those two were kindred spirits."