At 9 years old, Victoria Coats has more experience with cancer than many people who are 10 times her age. Her grandmother and guardian, Karen Coats, battled cancer in 2014. The day before Thanksgiving in 2019, Karen learned her cancer had returned. By the time the holidays rolled around, both Karen and Victoria knew all about cancer treatment protocols.
Then, shortly after ringing in 2020, the usually spunky Victoria became tired and listless.
"One day, she passed out at the mall," Karen says. "We called the paramedics, they said she was coming down with the flu."
Karen was trying to stay away from hospitals because her immune system was compromised by chemotherapy, so she cared for Victoria at home, treating the flu-like symptoms with rest, fluids and tender loving care.
But on the day Victoria was supposed to return to school after the holiday break, her lips turned white. Karen rushed her to the pediatrician's office instead.
"As soon as Victoria stepped through the door, her doctor said she needs to be hospitalized immediately," Karen says. "That's how we ended up in Cedars-Sinai's pediatric intensive care unit."
"We know based on decades of treating children with leukemia that we can't stop treatment just because we don't see any leukemia cells. It's important to ensure these kids have a durable remission, that the cancer doesn't come back."
Road to recovery
Victoria’s journey has come full circle since that scary episode.
She was the first Cedars-Sinai patient to receive a "My Chemo Fairy" through a gifting program brought to life through Cedars-Sinai’s partnership with the Los Angeles Rams. The team’s mascot, Rampage, personally delivered the gift box—complete with the supportive doll and book, which she quickly read with a member of her care team—to Victoria during a recent hospital visit in October.
On Oct. 16, Victoria was also a Coin Toss Captain for the Rams’ “Crucial Catch” game that supports early cancer detection. All of it was a much different experience than the first time she came to Cedars-Sinai.
A model patient
In January 2020, Dr. Nicole Baca, pediatric hematologist/oncologist at Cedars-Sinai, was on call at the hospital when Karen and Victoria arrived. With Victoria's low platelet count, blisters in her mouth and episode of passing out, Dr. Baca suspected leukemia. She ordered blood tests and performed a spinal tap to confirm the diagnosis and determine Victoria's genetic risk.
"I signed the papers for the bone marrow test and the results came back positive," Karen says.
Victoria had acute lymphocytic leukemia. As Karen tried to wrap her head around the diagnosis drawing on her own cancer experience, Victoria was already planning for remission.
"The doctors were amazed with how much she already knew about cancer," Karen says. "She told them, 'I know it goes to sleep and it can wake back up.' Even though she was only 6 years old at the time, Victoria already knew how to advocate for herself."
She knew about chemotherapy and port access, and she asked questions about why she needed different treatments and which side effects she could expect. She also asked the most important question of all: "When will this be over?"
Victoria went into remission within the first month of treatment, but she still had a long journey ahead.
"We know based on decades of treating children with leukemia that we can't stop treatment just because we don't see any leukemia cells," Dr. Baca says. "It's important to ensure these kids have a durable remission, that the cancer doesn't come back."
Taking cancer in stride
Victoria with her grandmother and guardian Karen Coats in 2020.
Victoria's treatment extended over a three-month cycle. The first day of the cycle, she received a spinal tap followed by five days of steroids. Then, she took an oral chemotherapy drug at home at different intervals throughout the cycle.
"During treatment, I just imagined the cancer going away," Victoria says.
The most difficult part: Getting access to her port for the drug inductions.
"It took three or four of us to hold her down to get the port in, but Joanne Ordono from Child Life Services was amazing," Karen says. In fact, for doctors and staff, Victoria is a model patient.
"She's an inspiration because she's so positive, she's almost always laughing and in a good mood," Dr. Baca says. "She's just a really easy child to take care of."
Victoria's arduous cancer journey concluded this past spring. Although her cancer is still in remission, she goes to Cedars-Sinai once a month for treatments.
"Soon we’ll begin seeing her every quarter, then every six months and eventually once a year," Dr. Baca says.
A healthy and happy future
Since wrapping up treatment, Victoria has returned to school and enjoys spending time with her siblings and participating in the same activities as her 9-year-old peers. A favorite pastime: basketball.
"She just started fourth grade and she joined the basketball team," Karen says. "She's doing great."
When Karen reflects on Victoria's journey so far, she thinks God made her a vessel for Victoria.
"Having cancer myself made it easier for me to help her," Karen says. "I was able to talk to her about how she might feel."
The pair got chemotherapy side by side. They talked about treatments, protocols and side effects.
Cancer became a sort of bonding experience for both of them. But through it all, the goal remained the same: to ensure that Victoria's cancer stays "asleep."
"You just watch," Karen says. "She will be victorious."