Shannon McDonald first faced the thought of losing her daughter when she sat in the confines of a waiting room 200 miles from home, desperately wanting news of how her 2-year-old’s surgery was going.
Then, the surgeon walked through the door.
“I was so nervous, just waiting to look at his face,” the San Luis Obispo resident recently recalled about that pivotal day in her toddler’s journey with cancer. “And he just looked exhausted — like he was coming from a war.”
But, the news was good. Dorothy Ann Mishalanie survived her surgery and celebrated her third birthday on Nov. 4.
When The Tribune last spoke with Dorothy’s family in August, they had just learned four weeks earlier that their baby was diagnosed with a rare kidney cancer called a Stage 3 Wilms’ tumor, which they discovered when they found blood in her urine.
The mass had grown from the toddler’s left kidney, into the inferior vena cava (a major vein) and had taken up two-thirds of the right atrium in her heart. She was undergoing chemotherapy in hopes to shrink the tumor out of the heart and avoid heart surgery. But, even though initial scans showed it was out of the heart, the mass remained in the vena cava and kidney.
On Oct. 15, doctors at Children’s Hospital Los Angeles removed all of the mass, her left kidney, 20 lymph nodes and a suspicious-looking piece of tissue in her abdomen that ended up not being cancerous.
Now, the family, including Dorothy's father, McDonald’s fiancé Mark Mishalanie Jr., says they’re in awe of Dorothy’s strength.
“I knew she was an amazing, special little girl. But she really just blows my mind every day,” her mother said. “Through all of this, her personality has stayed. So not only is she going through all this horrible stuff with radiation and chemo and surgery, but she still is constantly making me laugh and constantly impressing the nurses with how she is.”
Dorothy is always playing, laughing and making friends, her mother said. She thanks her mother during treatments and has developed a coping mechanism where she smiles even if she’s crying.
“I hate that she has to be so brave,” McDonald said. “But the way she’s handled it all, I feel like it’s stronger than most adults could handle it — probably stronger than I could handle it.”
That strength was important, according to her mom, because Dorothy’s post-surgery recovery was difficult.
For five days, the toddler was under sedation, on several medications and hooked up to a breathing machine.
“We were completely warned of what she would look like,” McDonald said of the first time she saw Dorothy after the surgery. “But when I walked into that room, and I saw her, I just lost it.”
The toddler’s blood pressure dropped dangerously low on several occasions, and it was a fight to keep her body functioning.
“Somehow we made it through the night,” she said.
On the fifth day, Dorothy opened her eyes and, a little while later, smiled and asked to watch a movie.
Soon, “she went from not even wanting to stand to taking steps,” McDonald recalled.
Now at home, the family has to battle another complication. To remove all of her tumor, the surgeons had to scrape out the vena cava’s smooth lining, causing a clot to form through the entire length of the vein. That clot is still there, as is the daily threat that it could travel to her lungs or brain. To help stabilize the clot, her mother gives her daily injections of a blood-thinning drug at home — with the hope that it goes away on its own.
Until then, the family is going forward with a treatment plan that involved seven days of radiation, completed Nov. 6, and chemotherapy until February. After that, they hope scans will show she is cancer-free. If that happens, Dorothy must get regular scans for at least five years.
There’s a chance Wilms’ tumor will come back in the other kidney and an additional possibility that another cancer could form — such as breast cancer — since she had radiation therapy. While McDonald said doctors didn’t give her specific numbers, they said the chances of Dorothy’s survival are good.
“I’m basically just forever changed by this experience. Not so much the worry, but she’s taught me so much of what it means to be brave,” McDonald said. “We were close before, of course, but our bond will for sure be unbreakable after this.”