Claire’s story: A 6-year-old San Luis Obispo girl’s triumphant battle with lymphoma

NBC’s “Bay Area Proud” featured Claire’s inspiring story on November 1, 2018: “Days after final chemo treatment, 7-year-old cancer patient asks to return to hospital to cheer up fellow patients.” Watch the segment:

It was February when Lindsey Noland received the call that catapulted her San Luis Obispo family into a world they would never have asked to explore. Claire, their sweet 6-year-old daughter, vibrant and extroverted, faced a reality that no child should ever have to come to terms with. In a candid video journaling a sunny California day, Lindsey Noland shared a raw revelation with the world in a whisper that is barely discernable: “I just got a call. Claire has . . . cancer.” In the video, Claire can be seen climbing an orange tree in the front yard of the family’s home. At the time, she was unaware of her condition.

An unexpected diagnosis

Only months before, the family of five was enjoying the Christmas season. This was when Lindsey first noticed Claire’s symptoms. Claire expressed discomfort when Lindsey lifted her by holding her under the arms. At first, Lindsey attributed the pain to the normal bumps and bruises of childhood. But in the coming weeks, Claire’s underarm lymph nodes swelled painfully to the size of two kiwi fruits. Soon after, when the entire family was shut down with the flu, Lindsey took Claire to see the doctor.

At first, doctors believed Claire was suffering from an infection, and her symptoms did seem to improve once she recovered from the flu. Despite this improvement, Claire had developed a rash on her chest, which Lindsey originally dismissed as eczema. Relieved to see initial improvements, the Nolands felt Claire was on the mend. Doctors urged the family to move forward with a few more tests, just to be sure. It was the results of these tests which ultimately revealed Claire’s unexpected diagnosis: stage 4 anaplastic large T-cell lymphoma (ALCL), a rare type of non-Hodgkin lymphoma. ALCL develops in the body when white blood cells become abnormal and build up in the lymph system.

The Noland Family, Dec. 2017: Claire, Lindsey, Katherine, David, Daniel

Access to expert care

In a whirlwind, Claire was pulled from her kindergarten class without even being given the chance to say goodbye to her elementary school classmates and friends. “One day she was in school, and the next day she wasn’t,” says Lindsey. She was referred to experts in the Bass Center for Childhood Cancer and Blood Diseases at Lucile Packard Children’s Hospital Stanford, which is part of the NCI-designated Stanford Cancer Institute and nationally ranked by U.S. News & World Report.

Liora Schultz, MD, a pediatric hematology-oncology specialist at Packard Children’s, and a member of Claire’s multi-disciplinary cancer care team, oversaw her treatment for ALCL. While ALCL is among the most common of the mature T-cell lymphomas, it is rare, accounting for only one to two new pediatric cases per million children each year.

“For these rare diseases, it’s optimal to have children treated at major academic medical centers, where there is greater volume and cumulative experience navigating patients through similar treatments,” explains Dr. Schultz. “Even throughout Claire’s case, there were multiple diagnostic dilemmas where we relied on pediatric lymphoma expertise here at Stanford, and being part of the academic community ensured that we were making the best decisions for Claire’s individual case.”

Claire’s weapon against cancer

In the coming months, Claire and her mother returned to Packard Children’s several times, making the three-hour drive to Palo Alto from their home in California’s Central Coast region to undergo six rounds of chemotherapy. Lindsey took a leave of absence from an MBA program at California Polytechnic State University in San Luis Obispo to attend to Claire’s needs as a full-time “momcologist.” On the home front, Daniel Noland, husband and father, played a vital role juggling the family’s regular activities. He managed a full time job, their household and the education and extracurricular undertakings of Claire’s siblings, David, age 11, and Katherine, age 9.

“My husband played a vital role to keep the wheels on our metaphorical family bus,” said Lindsey. “He was the rock that held our family together while we endured the hardest challenge in our family’s history.”

Claire’s treatment included an alternating cycle of chemotherapy, a cocktail of drugs that attacked the cancer in her body, leaving her neutropenic, which occurs when the count of white blood cells important to fighting off infections is abnormally low. She received blood transfusions to bolster her immune system as she rode the waves of nausea and vomiting. She developed mouth sores, her eyes were puffy and her cheeks were swollen from steroids. By March, Claire had lost her eyebrows and eyelashes, and the day finally arrived when Lindsey knew it was time to shave Claire’s lingering strands of golden blond hair.

In April, a four-hour PET scan revealed promising results. No metabolic or cancerous activity was found in Claire’s brain or on four spots that previously had active cancerous spots: her underarm lymph node, a shoulder lesion, a hip nodule and her groin lymph node. But Claire still had several rounds of chemotherapy to go. Through it all, Claire and Lindsey remained positive.

“To give Claire and her mother appropriate credit, their primary and most important weapon in navigating cancer was not our chemotherapy, rather their positive attitude,” recalls Dr. Schultz. “They showed up armed with these contagious smiles and effusively positive, radiant energy. Their attitude was powerful and it brought color to our hospital.”

A star is born

To relieve stress and distract herself during her treatment, Claire filmed a series of how-to videos in the Broadcast Studio at Packard Children’s on topics ranging from butterfly crafts and slime-making tutorials, to candid monologues about what it’s like to be a kid with cancer. As part of a special program offered by Packard Children’s Child Life and Creative Arts department, the studio gives children the opportunity to create multimedia content and broadcast it across the hospital’s closed-circuit SmartTV system, called PackardVision.

Cancer free

Claire attended her last session of chemotherapy in July 2018. Her treatment, spanning the course of six months, 154 days and 30 trips to the hospital, had finally come to a close. Claire was cancer free.

On the horizon

Now that Claire’s cancer is in remission, she has rejoined her classmates at Bishop’s Peak Elementary School for first grade. She also began her first primary ballet class, and will be expressing herself through movement this fall.

“I’m a mess over here watching Claire gracefully move on with life after cancer,” said Lindsey in a Facebook post. “I sobbed watching Claire dance and be a little six year old once again.”

On the horizon, Claire dreams of becoming a “port doctor,” a surgeon that places and removes ports in children. Inspired by her experience at Packard Children’s, she is one of a rising generation of Stanford Medicine hopefuls. Her fascination with surgery and biopsies has prompted her to secure letters of recommendation from her cancer care team for her application to attend Stanford in 2030.