Indiana toddler visiting Jacksonville grandmother for the summer ends up with life-threatening condition
Routine visit to the Wolfson Children’s ER leads to Divine’s diagnosis of rare kidney cancer by Wolfson Children’s and Nemours Children’s Health providers
Jacksonville, FL -
It was summer break for Arabia Brumfield’s children and the South Bend, Indiana, mom wanted her three girls, Nariah, Aria and Divine, to spend time with their paternal grandmother in Jacksonville. Arabia was in school studying to become a massage therapist and cosmetologist and was starting a new job, wanting to give it her all to help support her daughters.
Divine and her closest sister Nariah had gotten into a sisterly “scuffle” on Halloween night in 2022, Divine dressed as a scarecrow and Nariah dressed as Snow White. Divine fell off the bed. Their grandmother found that Divine had a “knot” on her stomach and grew concerned so she took her to urgent care and then to the Wolfson Children’s ER.
Divine’s Wolfson Children’s emergency medicine physician ordered a bloodwork panel and an imaging scan. The shocking results showed that Divine had multiple tumors on her left and right kidneys, resulting in a diagnosis of a rare but aggressive condition called bilateral Wilms tumor. “Her left kidney was engulfed with tumors,” said Ms. Brumfield. “And there were two tumors on her right kidney as well.”
Scott Bradfield, MD, a pediatric hematologist/oncologist with Nemours Children’s Health and Wolfson Children’s chief of hematology/oncology, said while a Wilms tumor is rare and often one-sided, the condition can present in early diagnosis as bilateral, which means it impacts both kidneys.
“In the case of bilateral Wilms tumors, we try to take out parts of both kidneys to save as much of the child’s kidneys as possible to postpone or avoid dialysis,” said Dr. Bradfield. “The protocol upon imaging confirmation is to start chemotherapy immediately to try to shrink the tumors and plan for surgical removal of the kidney or kidneys as needed.”
A family’s two-year journey begins
Divine started an aggressive chemotherapy treatment regimen on Nov. 2, 2022, spending weeks at Wolfson Children’s Hospital and then its new Eckstein Family Infusion Therapy Suite at Nemours Children’s Health, Jacksonville.
The surgical procedure to remove 1-1/2 of her kidneys was complex and well-planned as the hope was that Divine wouldn’t need dialysis in addition to her chemotherapy treatment. Nemours pediatric urologist Andrew Stec, MD, and pediatric general surgeon collaborated to perform the procedure.
Arabia remembered, “The surgery took place on Valentine’s Day of 2023. I was so scared. But her Wolfson Children’s OR nurse Cheryl Gaball was assigned to me so she could update me at every stage. Her updates let me know Divine was alive, when the big part of her surgery was done, and that she was doing well.”
Finally, after the surgical treatment and chemotherapy regimen, Divine completed her treatment. She rang the bell, a tradition that signifies the “end of treatment” although not being “cancer-free.”
Sadly, only days later, her imaging scans showed that Divine’s cancer had spread to her lungs.
“Divine had to start a new chemotherapy regimen at that point,” said Arabia.
“Her current course based on her scans is a chemotherapy regimen that aims to spare her remaining kidney function,” said Dr. Bradfield.
“Diva D” inspires her medical team
Somehow, through all of this treatment, Divine (nickname: “Diva D” for her charm and sassy personality), now 4, has a near-constant smile, with adorable dimples that the entire treatment team at Nemours and Wolfson Children’s recognizes when she’s at the clinic or hospital.
“Divine is so personable and interactive with our teams since early in her treatment,” said Dr. Bradfield. “She is a happy, optimistic little girl who absorbs all the love her mother, family members and our team bestow upon her, giving hugs to everyone! She gives a boost to our team, including me. Every day we get to see her, it reminds us of why we work so hard to treat kids like Divine.”
“Divine is a celebrity here at Wolfson and Nemours,” said Arabia. “When they see those dimples, they know, ‘That must be Divine.’ She is a sweet, loving, sassy girl who is adored by her family, including her sisters, and we are so grateful for the care she has received!”
Arabia said while her survival rate based on the spread of her tumors to her lungs is around 40 percent, she is hopeful. “She has been doing so well throughout her treatment, which has been tough, and she is always sweet, sassy and full of energy. She is such a joy in our lives.”