Cancer Fight Can't Curb Nine-Year-Old Girl's Creative Spirit

Spend some time chatting with young Cassandra “Cassie” Lazo and you’ll quickly discover that this nine-year-old is not one to let adversity keep her down.

In 2015, when she was just eight months old, Cassie was being treated for a urinary tract infection (UTI) when the doctor noticed she had hemihyperplasia, a rare disorder in which one side of the body grows more than the other due to an excess production of cells, causing asymmetry.

The doctor ordered some scans which showed Cassie also had a lesion on her right kidney that he thought may be a precursor to a Wilms tumor, or nephroblastoma, the most common type of kidney cancer in children.

Cassie was otherwise healthy and over the next few years she was followed by her doctor and closely monitored by her mother, Francis Lazo of Homestead. Mrs. Lazo, a single mother of three girls, watched her like a hawk for any signs or symptoms that she was developing a Wills tumor.

Doured Daghistani, M.D., medical director of pediatric oncology and hematology at Baptist Health Miami Cancer Institute

Her worst fears came true in 2021 when Mrs. Lazo noticed her daughter’s urine was red. Alarmed, she took Cassie to the emergency department at Nicklaus Children’s Hospital, where scans and ultrasounds revealed that Cassie did indeed have a Wilms tumor on her right kidney.

Cassie ended up seeing Doured Daghistani, M.D. – known affectionately as “Dr. D.” by his patients and colleagues. Dr. Daghistani is a longtime pediatric oncologist with Baptist Health and medical director of pediatric oncology and hematology at Baptist Health Miami Cancer Institute.

Understanding Wilms Tumors

Dr. Daghistani says that pediatric cancers represent less than one percent of all human cancers and Wilms tumors are uniquely pediatric cancers. “These tumors, which start in the kidneys, become less common as children grow older and are very rare in adults,” he says. “I’ve been treating pediatric cancers for 30 years and I’ve only seen two young adults with Wilms tumors.”

According to the American Cancer Society (ACS), Wilms tumors are the most common type of kidney cancer in children. Around five percent of all cancers in children – and about nine of 10 pediatric kidney cancers – are Wilms tumors.

Each year, the ACS says, 500 to 600 new cases of Wilms tumor are diagnosed in the U.S., with the average age of children at diagnosis roughly 3 to 4 years. Wilms tumors are slightly more common in girls than in boys, the ACS adds, and risk is slightly higher in Black children than in White children and is lowest among Asian American children.

A very ‘very’ kind of girl

Cassie, who loves being on camera, was visibly thrilled to be interviewed for a story about her cancer journey – dancing, mugging for the camera and playing with her mother’s hair the entire time. She has many interests, from “acting, dancing, painting and coloring” to “riding bikes, roller skating and playing musical instruments.”

Mrs. Lazo frequently relies on the word “very” when describing her daughter, and it’s clear she’s not overstating things. “Cassie is very bubbly, very outgoing, very active and very fun to be around,” she says. “She’s just one of those kids who’s very ‘out there’ – she’s not at all shy. She is very creative and very into the arts, too, and she’s also a very giving person.”

Another quality of Cassie’s that came through during her treatment is that she is a very secure and unselfconscious person. According to her mother, she was unconcerned about losing her hair during chemotherapy. “During her whole treatment, I’d say, ‘Cassie, let’s get a wig,’ and she would say ‘No, why would I want to get a wig? People see my bald head – that’s me,’” Mrs. Lazo recalls.

An unpleasant surprise

Dr. Daghistani says that following surgery to remove her diseased kidney, Cassie underwent several months of chemotherapy that ended in September 2021. “We kept a close eye on her, and everything was good,” he says.

But then in March 2022, a follow up CT scan showed her cancer had returned, this time in her lung. “I never thought she was going to relapse – it was an unpleasant surprise,” Dr. Daghistani admits.

The tumor was surgically removed and Cassie underwent two weeks of radiation therapy and still more chemotherapy, which she completed in February of this year. This time, it appears to have worked. “Cassie is cancer-free as of today – she has a very good prognosis,” Dr. Daghistani says. Mrs. Lazo adds, “She’s doing great – healthy, feeling fine and following up with ‘Dr. D’ every 3 months.”

Easing her anxiety at a difficult time

During her treatment, the outgoing young patient endeared herself to Dr. Daghistani, who describes Cassie as a “very sweet little girl” and someone who likes to show people how thankful she is.

“All kids are sweet but she’s unique in her sweetness,” says Dr. Daghistani, noting that her treatment didn’t change her personality a bit. “She is always smiling and giving everybody hugs when she comes in for follow-ups.”

Cassie and her mother both love “Dr. D.” and Mrs. Lazo says he and the entire staff at Miami Cancer Institute are “such nurturing and compassionate people” who helped ease her anxiety at an extremely difficult time. Cassie thinks “Dr. D” is very kind and very nice, and also fun “because he’s funny and he makes me laugh.”

Mrs. Lazo says “Dr. D” is professional and experienced and has great communication with his patients. “He answers all your questions and he’s available any time – even in the middle of night,” she says. Sometimes I’d see something on Cassie and call him in the middle of the night and he would always take my calls. He does that with all his patients.”

Soothing her journey with art and music

Cassie and her mother also expressed appreciation for the artists and musicians who are at Miami Cancer Institute every day as part of the Institute’s innovative Arts in Medicine program, funded entirely through philanthropic gifts to the Baptist Health Foundation. “I liked the music people,” Cassie says. “One of them (Robin) taught me how to play the violin.”

“They’re very understanding with kids and great at what they do,” Mrs. Lazo says of the artists in residence at the Institute. “Music and arts therapy is very important and makes a real difference, especially for young children. Every day when she was here, Cassie would have arts and crafts and music and she just loved that. It’s very therapeutic and it helps take their minds off of their treatment and distract them from their pain.”

As a single mom who was dealing with her little girl’s cancer diagnosis, Mrs. Lazo says she never felt alone at Miami Cancer Institute. “I was going through hell, but it was a great experience. ‘Dr. D.’, the nurses, the social workers and the childcare specialist who walked me through the whole process – they were beyond great and they really helped put my mind at ease. I was putting my daughter in their hands and I knew everything was going to be fine.”