When 18-month-old Arden developed a lump in her belly and struggled to sleep over several nights, her mom, Tray, decided it was time for a doctor’s visit.

“You think of all the baby things that it can be,” Tray recalled, listing constipation and ear infections as issues she’d potentially expected.

The lump in Arden’s abdomen though seemed to grab – and keep – the doctor’s attention, calmly but firmly directing Tray to go straight to the local hospital, no other stops.

In a daze, Tray, Arden and the rest of the family gathered at the hospital for what would be the first step on a years-long cancer treatment journey alongside Children’s Hospital of Philadelphia (CHOP), Naomi J. Balamuth, MD and Thomas F. Kolon, MD.

From Delaware to CHOP

Nearly 10 days of diagnostics later, Arden was diagnosed with cancer of the kidneys, a condition called Wilms tumor, with two tumors on one side and one on the other.

“At that point, you'd go anywhere,” said Tray. “I would have been in China if that's where the best treatment was.”

Through a recommendation from a friend and some research on her own, Delaware-based Tray found Dr. Balamuth and the Cancer Center at CHOP.

“I immediately felt connected to Dr. Balamuth,” Tray recalled. “She was so warm, just understanding that I'm a mom and I don't need to know all the technical stuff right now. I just need to get [Arden] there and get her help.

“She was our lifeline for the first couple of months.”

On reaching Philadelphia, the family received a binder containing all the information they might need regarding Arden’s diagnosis and prognosis.

“It was so overwhelming at first,” Tray said. “So, it was just taking it one step at a time.”

Chemotherapy in the Cancer Center

Chemotherapy began the night the family arrived at CHOP.

Reeling, Tray’s mind flooded with questions.

What is Arden going to feel like after chemo? What is that going to mean for life at home? For Arden’s older brother?

How much access can Arden have to friends or family? Can she go to school?

Should she go to school?

Tray eventually came to understand that it was almost always a matter of wait and see.

“Some rounds were fine; some rounds were not fine,” Tray said. “So, it was led by Arden.”

After more than 10 rounds of chemotherapy at CHOP, Tray was thankful not just for her daughter’s treatment but for the mental and emotional support the family received.

“They always had people from Child Life Services coming in with activities and coloring and just things to try to keep Arden occupied.”

That meant plenty of movies and books and lots and lots – and lots – of toys as well.

The family was even encouraged to wander around the hospital, Arden hooked safely up to her “little chemo tree” all the while.

Kidney removal surgery by Dr. Kolon

Following chemotherapy to shrink Arden’s tumors, pediatric urologist Dr. Thomas F. Kolon performed surgery to address the remaining mass. 

And while the procedure went as planned and she had complete response on the right side, Dr. Kolon was unable to save the primarily affected left kidney.

To Tray, it felt like little more than a “blur” as mid-surgery, Dr. Kolon called Tray and her husband back to inform them that he would have to remove Arden’s entire left kidney due to tumor involvement of critical blood supply.

“It was hard to hear,” Tray said. “But her survival and being cancer free was our main goal.”

Tray and the family had learned from Dr. Kolon prior to surgery that many people actually live full, healthy lives with only a single functioning kidney.

Sure, it would maybe be more important for Arden to eat healthy and maintain consistent exercise, but that’s not all that different from a person with two functioning kidneys.

There were only a few more rounds of chemo then before Arden was officially cancer-free and, according to Tray, back to “playing and fighting with her brother” before she even turned 2.

Cancer regrowth, 3D modeling tumor removal

“We always had these little parties every time she would be cancer free,” Tray said. “We just got so used to one year cancer free, a year and a half cancer free, 2 years cancer free.”

At 5, the family came home from Arden’s appointment to signs saying “I'm 3 1/2 years cancer free” – only this time, she wasn’t.

“And it was such a different kid,” added Tray, regarding Arden’s age and awareness.

The family once again went “full force,” starting chemotherapy the very same day for the new tumor in the right kidney.

But again, after more than 10 rounds of chemo, after losing her hair, getting sick, all the IVs and bloodwork and discomfort, surgery was required to complete Arden’s treatment. It would be complex as well, again due to the position of the tumor near critical blood vessels.

Prior to the procedure, Tray had to stop herself from researching “dialysis” and “kidney transplants,” issues Arden might face if she lost her second kidney.

Thankfully, the Children’s Hospital Additive Manufacturing for Pediatrics (CHAMP) Lab in the Department of Radiology collaborated with Dr. Kolon to develop groundbreaking 3D models of Arden’s kidney, helping to plan and successfully complete her surgery – and save her remaining kidney.

And though recovery this time around was far more difficult, Arden managed to pull through.

“You could just see her gaining strength and gaining weight and just looking healthier,” as Arden worked with physical therapists, both in the hospital and at home.