On her list of best birthdays, Jennifer Bernier's ninth birthday isn't high on the list. That was the day almost 10 years ago that she found out she had Ewing's sarcoma, a type of bone tumor.

Jenny, who was then in third grade, had been feeling pain in her back for a while. It bothered her in school, but she didn't want to tell her teacher because she didn't want the other kids to know that something was wrong. But at home, she would wake up during the night crying and screaming.

Jenny had several x-rays and MRIs, but no one could pinpoint what was causing her pain. Then Denis Clohisy, M.D., at the University of Minnesota saw the tumor on an MRI and told Jenny's mom to pack an overnight bag.

On the next day—Jenny's golden birthday—a biopsy revealed that she had cancer. "I was just thinking, 'Why did God do this to me? I'm only 9. I haven't done anything yet,'" says Jenny, who is now 18 years old and a graduate of Ellsworth High School. "But I guess it has made me a stronger person in the end."

A targeted therapy

Jenny had chemotherapy at the University, but she also needed very targeted radiation—something that would kill the tumor on her lower vertebrae but wouldn't damage the organs near it.

Doctors didn't want to do surgery because the tumor was in Jenny's spine. But little Jenny wondered, couldn't they just put a Tupperware container around it and catch it? Unfortunately, her mom explained, that wouldn't work, either.

"It's just another one of those things I have to deal with. But I feel fortunate."

So for three months, Jenny and her mom stayed in California while Jenny got the radiation she needed at the Loma Linda University Children's Hospital. They got to know many other patients and families on the pediatric oncology floor, including a couple who had a baby boy with cancer.

"I felt so bad because he was so little," Jenny says. "No one wishes that on a child. Or on anyone, for that matter."

A new problem, another treatment

After treatment, Jenny went into remission. Although the tumor is still there and always will be, she says, it's inactive. Now the only remaining part of her treatment will be annual visits to the Long-Term Follow-Up Clinic.

At a clinic visit four years ago, doctors found that Jenny's heart wasn't pumping normally, likely as a result of the chemotherapy she received.

Heart conditions are some of the most common late effects of childhood cancer treatment. But with early detection, physicians have found that these complications often can be managed with medication.

Jenny's family did things right by bringing her in to get screened before symptoms appeared, says Jenny's doctor, Daniel Mulrooney, M.D., M.S., director of the Long-Term Follow-Up Clinic.

"Long-term follow-up care provides important information regarding prior treatment and what effect that may have on an individual's future health," he says. "Cancer survivors require specialized monitoring so potential late effects may be identified and treated at an early stage."

Managing her life

Jenny has been on medication for her heart condition for the last few years, but she says she's not limited in what she can do because of it. She played volleyball and softball and joined the danceline in high school and still lifts weights frequently.

She says it's weird to have a heart condition at such an early age, but she's learned to live with it. "It's just another one of those things I have to deal with," Jenny says. "But I feel fortunate."

After spending the summer working at a nursing home, Jenny is starting her first year of college at Minnesota State University Mankato. She's taking generals this year but hopes to get into the school's nursing program next year.

"I want to be a nurse and specialize in pediatric oncology," she says. "Having been through it, you can relate to the children a lot more."

And now as her 19th birthday—and the 10th anniversary of her diagnosis—approaches, Jenny is hoping for better birthdays from here on out.

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The Growing Up After Cancer section of the Masonic Cancer Center Web site was produced by University of Minnesota School of Journalism and Mass Communication graduate student Nicole Endres. The section's medical content was written under the advisement of Masonic Cancer Center member Joseph Neglia, M.D., M.P.H.