Children & Teens

At age 26, Savannah Kaspar was a typical young adult: working, spending time with family and friends and planning trips. But after a colorectal cancer diagnosis, she faced a lot of unknowns. 

Savannah’s colorectal cancer symptoms

In February 2023, Savannah started having pain in her lower abdomen. She thought it might be due to an ovarian cyst, so she saw her gynecologist. A routine exam showed there wasn’t any cause for concern, so her doctor had her keep a food diary to see if anything she ate made the pain worse. Her diet didn’t seem to be causing the issues and the pain continued, so her doctor scheduled an ultrasound.

A few months later, Savannah developed more symptoms.

“I started having really bloody stools, so I went to the emergency room,” she says. “My CT scan was normal, so they referred me to a gastroenterologist who did bloodwork and a stool sample. My stool sample came back positive, but the doctor thought it was due to hemorrhoids. My bloodwork showed a positive inflammatory bowel disease marker, which can be associated with Crohn’s disease.”

Savannah was younger than the recommended age to get her first colonoscopy, but she had abdominal pain, bad constipation and bloody stools. She knew her symptoms were serious, so she pushed for a colonoscopy.

In August, a colonoscopy revealed a mass in Savannah’s sigmoid colon. Doctors said it was noncancerous but told Savannah she needed surgery to have it removed.

“They said it could develop into cancer later,” says Savannah. “They asked if I wanted to go to MD Anderson since I worked there.”

Savannah works as a program coordinator for Nephrology at MD Anderson, so she felt comfortable coming here for her surgery. She had her first appointment a couple of weeks later.

Savannah’s colorectal cancer diagnosis

At MD Anderson, Savannah had bloodwork and another CT scan. The CT scan showed that her lymph nodes were enlarged.

“They suspected I might have stage III colon cancer,” Savannah says. “And the tumor could possibly be attached to my uterus.”

She had a flexible sigmoidoscopy, which examined the rectum and lower part of the colon. Doctors couldn’t reach her tumor during the procedure, so she had a repeat colonoscopy four days later.

A biopsy confirmed Savannah had colon cancer, but the stage was unknown.

“I was shocked,” she says. “I went from thinking I didn’t have cancer to learning it could be stage III. I didn’t know if it was genetic, if I needed a hysterectomy or if I’d need an ileostomy. There were so many unknowns, and they hit me all at once.”

An MRI showed that the cancer hadn’t spread to Savannah’s uterus, so she could have surgery to remove the tumor. But first, Savannah met with oncofertility specialist Laurie McKenzie, M.D., and decided to freeze her eggs. She knew this was important to do before beginning cancer treatment, so she’d have more options for parenthood in the future.

“I went to New York City to have one last trip before I started my colorectal cancer treatment,” says Savannah. “The trip was planned before my diagnosis. It was an awesome opportunity to clear my head and mentally prepare to begin treatment.”

Savannah’s colorectal cancer treatment

On Oct. 18, 2023, Savannah underwent a partial colectomy at MD Anderson to remove part of her colon, including the tumor and a small amount of tissue surrounding it. She had 30 lymph nodes tested, and they all came back clear. The cancer was declared stage II.

The pathology report revealed that Savannah had lymphovascular invasion and perineural invasion. This put her at a higher risk for recurrence. So, eight weeks after surgery, she completed four rounds of chemotherapy to make sure all the cancer was gone. She received infusions of oxaliplatin and took oral chemotherapy capecitabine under the care of gastrointestinal medical oncologist Ryan Huey, M.D., at MD Anderson West Houston, close to her home. Savannah completed her last chemo treatment on Feb. 1.

MD Anderson helps Savannah manage chemotherapy side effects

Like many cancer patients, Savannah says the first round of chemotherapy was the toughest.

“That first night, my left hand locked up and became stiff, and my vision in one eye went black,” recalls Savannah. “I would blink, and in a few seconds my vision would come back.”

Savannah called MD Anderson’s help line and spoke with the on-call oncologist. Because her symptoms were on one side of her body, they had her come to MD Anderson’s Acute Cancer Care Center to make sure she wasn’t having a stroke. Savannah had a CT scan and MRI of her brain. They both came back clear.

Savannah’s hair thinned slightly during treatment, she had muscle cramps at times and she had bad nausea the first week.

“My care team added in an extra nausea medication for my second round of chemo and prescribed a muscle relaxer for my cramps. That helped a lot,” she says. “Dr. Huey and his team had an answer to everything and were so quick to find a solution for my side effects.”

Finding support from family, friends and coworkers

Savannah says her mom, boyfriend and other family and close friends were her biggest supporters during treatment.

“I called my mom almost every day, even before the diagnosis,” she says. “When I was stressed because I knew something was wrong but didn’t know it was cancer, she was always my first phone call. And my boyfriend is my ray of sunshine and positivity. He’s always able to lift my spirits and make me laugh.”

Savannah also had the support of her colleagues at work.

“I’m thankful to my department managers for allowing me to take time off or work from home when needed,” she says. “I’m grateful for the doctors who helped answer my questions. My team collected donations for me and visited me in the hospital. It’s awesome how supportive they were.”

Embracing a new outlook after colon cancer treatment

Savannah continues to have bloodwork done every three months. She will have a CT scan and a colonoscopy a year out from surgery. The results will determine how often she’ll need follow-up testing.

Because she was diagnosed at such a young age, Savannah had genetic testing to make sure she didn’t have Lynch syndrome. This would put her at a higher risk for other cancers. Her genetic testing came back negative.

“When I first reached out to a former colleague after my diagnosis, she said something that really stuck out to me,” recalls Savannah. “She said, ‘Your life is forever changed. Some days will be hard, but it gets better every day.’”

When starting treatment, Savannah wondered if her life had changed forever.

“Looking back, I know it’s true. I’ll never be the same person, but it’s changed me for the better,” she says. “I’m stronger. I don’t stress about little things anymore. I don’t take my health for granted. It’s made me appreciate the positives in life, and it’s made my faith stronger.”

Savannah and her boyfriend are planning a trip to Europe later this year to celebrate the end of her treatment.

She offers this advice for other young people facing a new cancer diagnosis: “Just be open with your care team. They’re always on your side and willing to help.”

Request an appointment at MD Anderson online or call 1-877-632-6789.

When it comes to MD Anderson’s pediatric cancer patients, Tomika Gamble is the agent of fun.

As program director for pediatric support programs, Gamble handles camps, prom and other special events for some of the hospital’s youngest patients and their families.

“I like to say I’m responsible for putting smiles on the faces of many,” says Gamble.

Part of that is because of the unique aspect of the programming, which serves the entire family. For example, Gamble’s team hosts a three-party prom where patients, their caregivers and siblings can all take part in exciting activities.

“I’ve had dads run up to me after events and say, ‘Y’all are amazing,’” she says. “Sometimes the kids are in tears when they get back into their parents’ cars after camp because they enjoyed themselves so much and don’t want to leave.”

A son's childhood cancer diagnosis

The old adage, ‘If you do what you love, it doesn’t feel like work,’ rings true for Gamble.

“I probably have the most enjoyable job at MD Anderson,” she says. “My goal is to give our pediatric patients a sense of normalcy.”

Gamble knows firsthand how much that’s needed.

When her oldest son, Isaiah, was diagnosed with a rare form of lung cancer at age 3, she was pregnant with her second son.

“It was a very difficult time for our family,” recalls Gamble, who had previously lost her grandmother to salivary gland cancer and her aunt to pancreatic cancer.

At the time, Gamble was doing public relations for a local school district, and her husband was a coach in another local school district.

“We received so much support from our community,” she says. “Our community taught us the importance of giving, so once my son’s treatments were done, it then became: ‘How can we give back?’”

Passion and purpose come together

Gamble started a nonprofit to support children facing life-threatening medical conditions, which gave her the opportunity to work on events with MD Anderson. When she applied for and ultimately accepted a role at MD Anderson managing pediatric support programs in 2018, it was a dream come true.  

“I had wanted to work at MD Anderson for a long time, but I didn’t know where I fit in,” says Gamble. “It was a blessing to watch it come full circle – my son’s cancer diagnosis and my experience in PR and special events helped me take on the responsibilities of my role and really connect with the families we serve.”

Gamble’s family also volunteers with MD Anderson’s programs. Isaiah, now 17, is a summer camp counselor at Camp Star Trails where children ages 6 to 14 can attend. They have the opportunity to begin training to be counselors starting at age 16. Isaiah has also participated in MD Anderson’s Boot Walk to End Cancer®.

“At MD Anderson, I know I’m doing the work that God placed me on this earth to do,” says Gamble. “When you find that passion and that purpose, it’s the most amazing feeling ever.”

Request an appointment at MD Anderson online or call 1-877-632-6789.

Three years ago, at age 17, I was diagnosed with melanoma. As I learned, cancer is tough, especially for teens, who often think they are immune to it.

For teens, a cancer diagnosis isn’t expected at all. Most teens think that they aren’t susceptible to any type of cancer. As parents and adults, the best thing we can do is educate young people about the dangers of cancer, and how every little thing -- sunburns, not using sunscreen, not taking care of yourself -- can affect you, now or later.

When dealing with a teen who has cancer, here are a few things to keep in mind.

Teens are scared

First of all, even though they may not show it, they are scared.

Teens don’t spend their time researching cancer and other diseases, so fear of the unknown is great. A lot of times, teens will try to act like adults and be strong after finding out they have cancer, but the news can often be too much for the teen mind to comprehend.

Let teens come to you at their own pace

Teens also don’t really like asking for help. When I had cancer, I constantly had to ask for help -- help carrying my heavy bags, help cleaning my bandages and help driving to appointments. Teens want to do it all, so having to rely a lot on others during cancer treatment and surgeries is a definite lifestyle change.

It’s important to be supportive and available, but let the teen come to you at his or her own pace.

Respect communication wishes

Often, many teens will not want to talk about their cancer with people they know. Cancer can seem like a “weakness,” and teens want to feel invincible and youthful.

It took me three years before I felt completely comfortable sharing my story with anyone except those who are very close to me. As a parent or guardian, keep this in mind. Your teen may not want everyone in the world knowing that they have cancer, so be respectful of that. Cancer is a hard enough thing to deal with as a young person without the constant questions and comments that others will have.

Support makes a difference

Cancer is scary, especially for people who think they have many years to go before they have to think about it. Make sure you’re available for the teen in your life. She's not a teenager with cancer, she's just a teenager. Cancer doesn’t define anyone, and getting it at a young age should do nothing to deter a person’s feelings about herself or what she can accomplish.

As an adult, encourage the teens around you to go to their dermatologists regularly for skin checks. It might be hard to fit into a teen’s busy schedule, but it is absolutely worth it.

Autistic children with cancer often face unique challenges during treatment. Because autism spectrum disorder affects how a child communicates and interacts, families and doctors need to take extra steps to create a comfortable environment for these patients.

We spoke with Child Life Services Manager Nicole Rosburg and The Faris Foundation Music Therapist Melissa Melo about how parents and caregivers can help autistic and other neurodivergent children during cancer treatment.

Communicate early and often with your child’s care team

When it comes to communicating with your child’s care team, the earlier the better.

“The role of the Child Life team is to reduce anxiety for patients and families in the medical setting, and we work closely with other support programs to do so,” says Rosburg. 

This means there’s a team of people working to make sure your child has the best experience possible.

“For example, if your child gets incredibly anxious when waiting for long periods, we can speak to their radiologist and say, ‘I know you normally ask patients to check in 30 minutes before their appointment, but this child can’t sit in a waiting room for 30 minutes. How can we work with you to change the process so this child can come to the hospital and go straight in for their MRI?’”

Other things parents should communicate to their child’s care team are:

• your child’s triggers
• things you fear that may trigger your child
• behaviors you’ve witnessed from your child in other scenarios
• your child’s previous traumatic health care experiences
• your child’s previous health care experiences that went well and why

Bring comfort items to appointments

Unfamiliar faces, noises and smells in a hospital could be a potential trigger for an autistic child. That’s why Melo suggests parents bring items that are comforting to their child to every appointment.

A “coping bag” could include a tablet, a soft blanket or any other item that can be used to comfort or distract an anxious child.

“These items can help regulate the child in that moment,” says Melo. “For example, a blanket could smell like their bed at home, which brings them back to a comfortable, safe space.”

Melo notes that parents shouldn’t be too hard on themselves if their child is struggling to adjust at first.

“Understand that this is a new experience, and it can be overwhelming,” she says. “You’re not doing anything wrong.”

Discuss the schedule with your child ahead of the appointment

Doctor’s appointments or cancer treatment can be disruptive to a child’s routine. To minimize this disruption, parents can create storyboards at home to use as a visual representation to help the child understand what to expect.

For example, a parent might use an image of a doctor in a lab coat or other images similar to a clinic setting to show the child what they’ll see when they arrive at the hospital.

Timers can also help prepare a child for what’s to come.

“A parent may say, OK, we have 5 minutes until we get poked,” says Melo. “‘Poked’ might mean a needle to draw blood or something else. It helps the patient understand that something is coming.”

On the other hand, if a patient is triggered by knowing something is coming, then a timer wouldn’t be advised.

“Each method depends on the individual patient,” Melo says.

Pay attention to body language

Autistic patients may have trouble expressing feelings, like when they’re in pain.

“I’ve seen doctors use the happy face pain scale, which uses happy faces to represent no pain and a sad or crying face to represent the worst pain possible,” says Melo. “Children can point to those faces or faces in between to communicate the severity of their pain.”

But for younger children, it’s important to pay attention to their body language.

“Are they hitting? Are they pulling your hair? Why are they frowning? Understanding the underlying foundation of why they’re doing what they’re doing guides us,” says Melo.

Parents are integral in this as well. A parent may know the child doesn’t like the color red, so the child becomes agitated when a nurse brings in a red ball to the appointment. In this scenario, the solution is easy: remove the red object from the room.

“With any neurodivergent person, their body language speaks to a lot more than what they can say,” she says. “So, I think the most important thing is to understand their body cues. We’re good at assessing those in the moment.”

Use the gift of music

In her experience working with pediatric patients as a music therapist, Melo notes that many autistic children are innately musical.

“They can connect with music and it comforts them,” she says. “They’re able to communicate through words that they cannot communicate with.”

If parents know of a song or instrument that brings their child comfort or joy, Melo encourages them to bring it to the hospital.

“We don’t care if it’s ‘The Wheels on the Bus,’ and we have to listen to it for 35 minutes,” she says. “If that’s going to help your child feel more comfortable, we’ll do it. I can also perform it live. Music can bring that relaxation from home into the hospital.”

Ask for what your child needs

Rosburg says constant assessment allows the care team to provide patients with the best care possible.

“After each appointment, we debrief to discuss what worked, what didn’t and how we can tweak our approach in the future,” she says.

Whether it’s asking the doctor to crouch down when visiting the patient, so they don’t appear tall and scary or requesting a live rendition of ‘The Wheels on the Bus,’ Rosburg says parents should never be afraid to ask for what their child needs.

“We have a ton of resources,” she says. “All we want is for the child to have a positive experience and the family to feel supported. Just tell us what you need.”

Request an appointment at MD Anderson online or by calling 1-877-632-6789.