Little Dorothy Ann Mishalanie slid down the big slide, delighted over a pair of crinkly leaves she found in the grass and twirled in her tie-dye dress before racing over to her mother to snack on some big juicy strawberries.
“Straw-bewees!” she said with glee, her little hands quickly grasping the sliced fruit as she, very politely, first offered her mother a piece before eating her own. Aside from her long locks that have fallen out due to the tell-tale signs of chemotherapy, one would never know that the cheerful little girl playing at a San Luis Obispo park on a recent afternoon has cancer.
“She’s just this happy, outgoing, really special 2-year-old girl,” said her mom, 25-year-old Shannon McDonald. “Everyone who meets her always says what a special girl she is.”
Until last month, the youngster hardly even had a cold, McDonald said.
But on July 13, everything changed for the San Luis Obispo family.
A friend was watching Dorothy that Sunday while McDonald was working as a caregiver at a local assisted living facility.
“She texted me and said, ‘I’m looking at her potty and it looks weird. Like there’s juice in it.’”
McDonald called the on-call pediatrician, who urged her to take her daughter to a hospital emergency room. The red tint in her urine turned out to be blood.
What started out as a routine test for a urinary tract infection turned into an ultrasound that found a 9-centimeter mass in Dorothy’s left kidney and then spiraled into an emergency ambulance ride from Sierra Vista Regional Medical Center in San Luis Obispo to Cottage Hospital in Santa Barbara.
Dorothy’s father, McDonald’s fiancé Mark Mishalanie Jr. closed his business, Black Stallion Restaurant in Paso Robles, early and followed behind in his car.
Five days later, after various scans and a biopsy surgery, Dorothy was diagnosed with Stage 3 Wilm’s tumor, a rare kidney cancer found in children.
“It was the most shocking news of my entire life,” McDonald said. Even more alarming were scans that showed the tumor extending out of the little girl’s left kidney, up through the vena cava, a major vein, and into two-thirds of the right atrium in her heart.
“I went from complete shock and crying for days to moving toward a place of acceptance,” McDonald said of her daughter’s diagnosis. “I just realized I had to be her rock. And I don’t want her to feel worry — I can feel that for her.”
Her daughter’s diagnosis came as McDonald was still recovering from her father’s death in early February. He was diagnosed with Stage 4 gastric cancer in his lungs, heart and bones at the age of 60 and died seven months later, she said.
“I mean, first my dad and now my daughter,” McDonald said through tears. “Why does it have to be her? Why can’t it be me?”
But McDonald said there’s hope. Even through the tumor had grown from Dorothy’s kidney, doctors told her it technically hadn’t metastasized, which would have made the cancer a more serious Stage 4 diagnosis.
“The doctor said the tumor was probably only with her a couple of months. The symptoms are pain, fever and pee in the blood. So thank God we saw it in her pee. We caught it early,” said McDonald, who has taken a leave from her job to care for Dorothy.
Wilms' tumor is a rare kidney cancer — also known as nephroblastoma — that most commonly affects children ages 3 to 4 and becomes less of a risk after a child turns 5 years old, according to the Mayo Clinic. The outlook for most children with Wilms' tumor is “very good,” the medical nonprofit organization’s website says.
McDonald said her doctors say Dorothy has an 85 percent chance that she will be cancer-free after her treatments and that it won’t return.
After she arrived at Cottage Hospital, Dorothy underwent a whirlwind of tests and a biopsy surgery.
After initial struggles with a blood infection and clotting in her bladder, she was discharged after a two-week hospital stay. She returns every Thursday for chemo treatments, which she receives through a central catheter line inserted into her arm. The chemo has been tough.
“She’s never ever been a cranky, fit-throwing 2-year-old,” McDonald said. “And since all this has happened, she’s just not feeling good and you can tell. She was independent and last night before going to bed she was holding me so tight.”
Doctors plan to remove Dorothy’s left kidney, and hope that the chemo destroys the tumor in her heart and vena cava, so they can avoid open-heart surgery on the toddler.
Such an outcome is looking likely. On Aug. 7 a test showed that the chemo had already begun to shrink the tumor in her heart and a further scan this week will determine by just how much. That means she may be able to get the surgery sooner to remove her kidney and start her recovery treatment — several days of radiation and a few more months of chemo.
“The fact that her body is responding so quickly to the chemo makes me know we’re doing the right thing and I just know she’s going to be OK,” McDonald said. “She’s a strong little girl. I feel like there are angels watching over her — my dad, maybe.”
HOW YOU CAN HELP
Dorothy’s family has set up a GoFundMe campaign online to help pay for her medical expenses, which are not fully covered by her Medi-Cal benefits. You can also read her Facebook page, Dorothy Ann Mishalanie's Fight