Joy Bell laughed in describing her daughter, Ciera, as "mean and ornery" when asked if she is as normal as other children approaching their second birthday.
Bell and her husband, Lucas, Ciera's father, did not have much to laugh or smile about this past April 10. That's when Dr. Amy Leverant, a Phoenix ophthalmologist, diagnosed Ciera with retinoblastoma in her left eye.
Retinoblastoma is a rare but fast-growing childhood eye cancer, according to the Daisy's Eye Cancer Fund Web site. Early diagnosis and treatment leads to a 95 percent cure rate. Late diagnosis often results in the loss of one or both eyes. And if the cancer spreads past the optic nerve into the brain, death usually results.
A Magnetic Resonance Imaging scan was done two days after Leverant's diagnosis to determine how far the cancer in the left eye had spread and to determine the size of the tumor, Bell said.
Ciera, who turns 2 next month, had her eye surgically removed in a six-hour operation April 24 at Phoenix Children's Hospital. The eyeball was sent to a Los Angeles pathologist to ascertain if the cancer had spread further.
"Ciera began chemotherapy a week later as the tumor went into the second layer of the eye," Bell said. "Doctors told us there was a 70 percent chance that if we didn't have chemo nothing more would grow, but they wanted us to be above 90 percent in case some cancer cells were floating around."
Tim and Pam Steinberger, Joy's parents, were immensely supportive during the difficult time. Her mother traveled with her to Phoenix for all of Ciera's chemotherapy sessions over a five-month period.
Ciera underwent six rounds of chemo every three weeks, two days at a time. Treatment lasted six hours the first day and three hours the second day.
It was in March that Bell first suspected something was amiss with Ciera's eyes.
"The left eye was barely turning outward, but not enough to call it lazy eye," she said. "But in changing her, there were certain angles in which I could not see the black of the pupil. I was looking inside the eye, as the tumor was present and had detached the retina."
Bell began contacting local eye doctors for an emergency appointment, but nothing was available until May, she was told.
She managed to secure an appointment with Dr. Daniel Schickner, who examined Ciera within 24 hours of the call to his office. Schickner referred Bell to Leverant in Phoenix and Ciera was seen there one week later.
Removal of the eye was just the beginning of the ordeal.
A port-a-cath had to be inserted in Ciera to permit chemotherapy. That was removed Oct. 8.
Another MRI was done after completion of chemotherapy. It revealed some swelling around the muscle to the optic nerve and slowed down healing, Bell said.
Ciera is to have another MRI done Nov. 2 on the left eye. She also undergoes exams of the right eye bi-monthly.
Child Rehabilitative Services aided the Bells in getting a "bioeye" implant for Ciera.
"Basically, it's a circle with holes through which the muscle is sewn and tissue grows through it," Bell said. "It works like the eye.
"A plastic conformer keeps the socket open until an ocularist puts in a prosthesis in November."
One of the organizations to which Bell is grateful for assistance is the Kingman Cancer Care Unit.
She had no paperwork when she first contacted the organization, yet treasurer Lila Newton quickly issued a check for $400.
"They provided gas and food help every time I went to one of their meetings, even going past the usual cutoff point for assistance," Bell said.