Oklahoma Teen Finds Hope for Aggressive Cancer at Oklahoma Children’s Hospital OU Health – Jimmy Everest Center

Annabelle Byers, a member of the Choctaw Nation, was feeling unwell and had a persistent cough. The 16-year-old student with autism had just finished her freshman year and was looking forward to summer break, but lingering respiratory symptoms had her feeling miserable. Annabelle’s mother, Stephanie, took her to the pediatrician and she tested positive for Influenza A. With directions to rest and drink lots of fluids, Annabelle went home.

A week later Annabelle was feeling worse — the cough was no better and she had a sore neck. Stephanie phoned the pediatrician and was assured that recovery from the flu could take a couple of weeks and to continue with rest and hydration. However, when Annabelle noticed a lump on her chest, her mother wasted no time getting her to the emergency room. She thought that with the ongoing cough and symptoms Annabelle was experiencing, she may have pneumonia.

Emergency care physicians took X-rays of Annabelle’s chest and noted a large cloudy area, which was thought to potentially be a collapsed lung. At 3 a.m., Annabelle was transferred by ambulance to Oklahoma Children’s Hospital OU Health.

Over the next couple of days, Annabelle underwent a series of tests. Imaging revealed a mass almost the size of a loaf of bread in her chest. The mass was pushing her heart to the left and had grown out through her rib cage. Additionally, the tumor was suppressing her superior vena cava — a blood vessel that returns blood from your upper body to your heart. Annabelle had so much fluid in her chest that her lung was collapsing.

A Devastating Diagnosis

Annabelle and her family received devastating news — she had Diffuse Large B-Cell non-Hodgkin lymphoma Stage IV, that had spread to her kidney.

Non-Hodgkin lymphoma is a fast-growing cancer that starts in part of the immune system called the lymphatic system. The lymphatic system helps fight infections and diseases. Sometimes the cells mutate and grow out of control and spread to other organs and tissues in the body — this is called metastasis. Non-Hodgkin lymphoma can happen at any age, but it is rare in children, and affects boys more than girls.

Annabelle has a family history of cancer. Her father is in remission from Hodgkin lymphoma and her grandmother had endometrial cancer and peritoneal carcinomatosis. A great aunt also had Hodgkin lymphoma and squamous cell carcinoma, and a great uncle had prostate cancer. But even a family history of cancer does not automatically mean that a person will get it. Cancer cannot be passed down from parents to children, and genetic changes in tumors cannot be passed down either. However, a genetic change can increase the risk of cancer if it’s present in a parent’s sperm cells or egg.

Because of where the tumor was, and the size of it, surgery was not an option. Annabelle was fitted with a chest tube to drain the fluid in her chest, allowing her lung to re-expand, and started immediate cancer treatment at the Oklahoma Children’s Hospital – Jimmy Everest Center. Her mother, Stephanie, stayed with her in the hospital while her stepfather stayed home with Annabelle’s three younger siblings.

Cancer in Children

Approximately 1 in 285 children in the U.S. will be diagnosed with cancer before their 20th birthday. The American Cancer Society reports that after accidents, cancer is the second leading cause of death in children ages 1 to 14. However, because of major advances in treatment in the last few decades, 85% of children with cancer now survive more than five years.

Approximately 800 children and teenagers are diagnosed with non-Hodgkin lymphoma every year in the U.S. It accounts for 5% of childhood cancers and is more common among white children. The 5-year relative survival rate for children up to the age of 14 with non-Hodgkin lymphoma is 91%.

James "Jimmy" Christopher Everest died from bone cancer in 1992 at the age of 17. To honor his life, family and friends made memorial donations leading to the creation of the Oklahoma Children’s Hospital – Jimmy Everest Center for Cancer and Blood Disorders in Children. Annabelle’s treatment at the Jimmy Everest Center ensured that she would receive world-class cancer care, close to home.

Annabelle’s Resilience

As Annabelle’s diagnosis of non-Hodgkin lymphoma was Stage IV, she required an aggressive schedule of chemotherapy. The tumor was so large that the PICC line (peripherally inserted central catheter), which would normally be placed in a vein in the upper arm and guided into a large vein in the chest, had to be placed in Annabelle’s leg instead. The PICC line helped deliver the chemotherapy medications she needed.

Annabelle changed her schooling to virtual learning so she could continue from her hospital room, and Stephanie, a remote IT worker, also worked from Annabelle’s room.

Annabelle struggled with the side effects of chemotherapy and was given calorie boosters as she lost so much weight from the nausea and vomiting. Throughout all this, Annabelle managed a full school course load and was rewarded with straight As. Despite how sick she was, Annabelle maintained a positive outlook.

“She is amazing,” said Stephanie. “Annabelle was so sick, and yet she managed to give compliments to her nurses and mostly maintained an upbeat attitude.”

Chemotherapy was administered for one week, followed by a two-week break. About a week after each chemotherapy treatment Annabelle would be neutropenic. Neutrophils are a type of white blood cell that along with other white blood cells, help the body fight infection. They are made in the bone marrow. Cancer cells form new cells more quickly than normal cells, and it’s these cells that are targeted by chemotherapy drugs. However, normal cells are also damaged along with the cancer cells, as chemotherapy drugs can’t tell the difference. The good news is that normal cells recover from the effects of chemotherapy, whereas cancer cells typically do not.

With many of Annabelle’s white blood cells being killed in the process of destroying the cancer cells, she became severely neutropenic. This meant that for a while after chemotherapy treatments, her body was unable to fight any infection or illness — even simple ones. During this time Annabelle and Stephanie had to stay isolated from others, including family members who may have unknowingly picked up a virus, until her white blood cell count improved. Over time, Annabelle’s white blood cells would increase, providing her with some protection against illness.

Ringing the Bell

Annabelle was first diagnosed with non-Hodgkin lymphoma in June 2023. By December 2023, at age 17, Annabelle was finally cleared of active cancer and was able to ring the bell to mark the end of cancer treatment.

While part of the tumor remains, the cancer cells are no longer alive, and the tumor continues to shrink. Annabelle’s doctors monitor her closely with ultrasounds and X-rays. Annabelle is back at school and thriving and was just inducted as a sophomore into the National Honors Society. She wants to go to college and hopes to become a chemist in the future.

“I tease Annabelle and tell her that maybe she can develop chemotherapy drugs without the severe side-effects,” said Stephanie. “She is such a great kid and despite how unfair it has been that she, or any kid would have to go through this, she has been a trooper and managed it all so well. We are so grateful to everyone at Oklahoma Children’s Hospital – Jimmy Everest Center. Every person we came in contact with was so kind and helpful, and the Child Life Specialists were wonderful with Annabelle.”

“We provide compassionate, multidisciplinary cancer care to children with all types of cancer,” said pediatric hematologist-oncologist Dr. Rachel Gallant, M.D., assistant professor in the Department of Pediatrics at the University of Oklahoma College of Medicine. “Our multidisciplinary approach allows us to tailor care to meet the unique needs of each patient and their family. Coupled with the advances we make as an academic health system, this allows us to provide the most up-to-date, patient-focused care here in Oklahoma.”

Learn more about the comprehensive, compassionate, family-friendly treatment at Oklahoma Children’s Hospital – Jimmy Everest Center. Request an appointment or get a second opinion or find out more about the available services by calling (405) 271-4412.