BLOOMINGTON — Alexa Cunningham is an engaging, 2½-year-old girl who showed visitors her toy dogs, Minnie Mouse Playhouse and collection of princess books.
Then Sara, her mother, raised the back of Alexa's shirt to reveal back scars where a tumor was biopsied twice. Later, Alexa lifted the front of her shirt to show off her new "buddies" — ports placed into her body Dec. 30 and through which medical professionals may draw blood, provide chemotherapy or a blood transfusion.
She played with her "Bravery Beads." Every time the child undergoes treatment at Children's Hospital of Illinois in Peoria she gets another bead.
She has a lot of beads. She also has a warm smile.
"She is very sweet," her mother said. "She's also got a feisty side and bounces back quickly."
The latter two attributes have benefited Alexa — and parents Jeremy and Sara — for the past year and a half. That's when she was diagnosed with neuroblastoma, a rare type of cancerous tumor that generally affects children. It is Stage 4, meaning that the cancer had spread to her bones and bone marrow.
Since then, she has undergone biopsies, had eight rounds of chemotherapy at Children's Hospital and taken medication to prevent the neuroblastoma cells from spreading.
A few weeks ago, her parents found out that the tumor was growing again. The survival rate for a child with a relapse of neuroblastoma is 20 percent.
But the Cunninghams decided to delay her next treatments until after Christmas. That resulted in a Christmas season that Sara — fully aware of the irony — called Alexa's "best Christmas ever."
It included family time, a visit from princesses, a limo ride and gifts and care packages and cards from people who Alexa has never met.
"Having our community surround us has helped us in a big way," Sara said in the Cunningham's modest home near Bloomington on Dec. 31. "It's a good feeling to know that we don't have to fight this battle alone."
The Cunninghams have lived in the Bloomington area for five years. Alexa was born on April 14, 2012.
At 7 to 8 months of age, she had a high fever for several days. But her pediatrician could find nothing wrong, figured the fever may have been related to Alexa's teething and the fever subsided.
A couple months later, Alexa stopped crawling and was in pain. She was diagnosed with a bladder infection.
At 13 months old, the Cunninghams found a lump in the middle of Alexa's back. An MRI (magnetic resonance imaging) revealed an egg-sized tumor. Doctors at Children's Hospital found that the mass had wrapped around Alexa's spinal cord.
"It was millimeters away from paralyzing her. That's why she wasn't walking yet and why she couldn't stand by herself," Sara said.
A biopsy confirmed a diagnosis of neuroblastoma in late July 2013. Because the tumor affected the spinal cords, chemotherapy would be used right away rather than surgery, which could cause paralysis. And the Cunninghams were told the cancer was Stage 4.
"I was just numb," Sara recalled. "Jeremy's reaction was, 'We'll do whatever we need to do to make this better.'"
Five days of chemotherapy began immediately. Alexa remained at Children's Hospital for 12 days. When she was discharged, she was prescribed an antibiotic, an anti-nausea medicine and morphine for pain relief.
She returned to Children's Hospital several times to check her blood cell counts and for medicine to boost her white blood cells. She had seven more rounds of chemo at Children's Hospital, each lasting several days.
"She tolerated her chemo well but she did lose her hair and, when her counts were low, she'd get tired and achy," Sara said.
Along the way, Alexa was fitted with ankle braces, underwent physical therapy and learned to walk.
"It was exhausting," Sara said of the Cunninghams' life from July to December 2013. "Alexa got used to all the doctors and nurses. It became our new normal."
Alexa was prescribed medicine to reduce the risk of the neuroblastoma cells from spreading.
But a scan in October 2014 revealed growth of the tumor in her back. A biopsy of the tumor and of bone marrow confirmed on Nov. 12 that Alexa had a relapse and that the disease was in the tumor and bone marrow.
"That was extremely difficult," Sara said. "For me, it was like a grieving process."
Scans were redone during Thanksgiving week and, in early December, the Cunninghams took Alexa to a neuroblastoma expert in Chicago. That oncologist confirmed the diagnosis and agreed with the treatment plan of the Peoria oncologist.
"But we wanted to wait on that aggressive treatment until after the holidays," Sara said. "We wanted Alexa to have a normal Christmas and be a normal kid before all the craziness started again.
"So we did fun things. We went swimming. We took her to the aquarium in Chicago."
Alexis Anderson and Dede Verplaetse, volunteers with the American Cancer Society Relay For Life of McLean County, found out about Alexa's relapse, that the family was delaying the next round of treatments until after Christmas and that Alexa liked princesses.
Knowing that the Bloomington High School drama department has a princess program, they contacted drama teacher Susan Cortesi. She arranged for Snow White (as portrayed by senior Liz Gerwick), Cinderella (senior Ellen Golowski), Ariel (senior Kiera Martin) and Tiana (junior Mattie Helm) to come to the Cunningham home on Dec. 20, present Alexa with a tiara and blanket, have a tea party that included a story and songs, and then go on a brief limo ride to a McDonald's for french fries and ice cream.
Alexa smiled as her mother described that day.
"They (the princesses) were loving and sweet and kind to her," Sara recalled. "It really touched me."
Verplaetse said, "The situation is sad but that day was magical. It warmed all our hearts.
"Cancer is horrible," Verplaetse continued. "It's uglier when it affects a child. But when we can bring a smile — that's all we're after."
Alexa returned to Children's Hospital this week to begin high-dose chemotherapy. The plan is for five rounds of chemo over several months, followed by a stem cell transplant at St. Jude in Memphis, Tenn., radiation and other medication. Treatments may wrap up in early 2016.
"She still has a chance," Sara said. "There are success stories out there. That's what we focus on."
The princesses may visit Alexa again at Children's Hospital.
"No kid should have to go through what she's going through," Sara said. "But it's good to know that we don't have to fight this alone."