BREANNA’S CANCER JOURNEY

• In May 2020, Breanna had severe body and abdominal pains for which her father, Mr. Solomon Addai, sought treatment at the Sakumono Community Hospital in Tema. On 3rd July 2020 she experienced body and abdominal pains again but this time with rashes on her body. She was sent back to the same hospital where she stayed for a few days before being sent home.
  
• On 19th July 2020, there was a recurrence of the body, bone and abdominal pains, intermittent fever, and rashes on her body, which led to her readmission to the same hospital where the initial clinical examination was done and subsequently referred to the Korle-Bu Teaching Hospital as an emergency for further investigation.
  
• She was taken to the Paediatric Oncology Unit, Korle-Bu Teaching Hospital on 23rd July 2020 because she showed signs and symptoms related to leukemia (cancer of the blood). They did Computed Tomography (CT) scan of her abdomen and pelvis on 26th July 2020, which showed enlarged kidneys (nephromegaly) with multiple well-defined, rounded, hypoenhancing masses, enlarged liver and spleen (hepatosplenomegaly) and abdominal and pelvic lymphadenopathy. The findings were reported as being suggestive of lymphoma.
  
• Bone marrow aspirate (BMA) for morphology was performed on 28th July 2020 and the conclusion was Acute Lymphoblastic Leukaemia (FAB L1), which is a form of childhood blood cancer.
  
• Chemotherapy commenced on 1st August 2020, using the UKALL1997 protocol (Regimen B).
  
• During Interim Maintenance II (a phase of her chemotherapy treatment), on April 30th, 2021, Breanna was admitted and managed for febrile neutropenia and suspected fungal pneumonia. She also later developed septic shock, which responded to multiple fluid boluses without the need for inotropic support and was admitted to the Pediatric Intensive Care Unit (PICU) for five (5) days during her admission to Pediatric Oncology Unit.
  

On the evening of 9th June 2021, at around 7 o'clock, she began to have seizures. Her father hurriedly took her to Sakumono Community Hospital and she was eventually transferred to the PICU at Korle-Bu Teaching Hospital. MRI/MRA of the brain was done on 10th June 2021 and the report showed that she had developed clots in several of the blood vessels in her brain. It was a terrible blow to Breanna, her father, and the entire family. Her Protein S Activity (a protein that prevents excessive blood clots in the body) was extremely low, and additional lab tests revealed that there was pressure in her left eye.

On 26th July 2021, Breanna was sent to Korle-Bu Teaching Hospital with persistent headaches and intermittent vomiting. She noted anosmia (inability to smell) during the examination, but other cranial nerves were normal. MRI/MRV was repeated on 26th July 2021 and it showed resolution of previously seen CSVT with evolving bilateral frontal lobe hemorrhagic infarcts. Also noted were mild diffuse brain atrophy and mild mucosal thickening of all the paranasal sinuses.

Breanna was doing well and responding to treatment until Maintenance Cycle 4 (a phase of her chemotherapy treatment) when she had complaints of persistent neck pain and left eye deviation and was rushed to the Oncology Unit at Korle-Bu Teaching Hospital on 22nd April 2022. It was noted during the medical examination that she had left-sided facial nerve palsy and a left convergent squint, however, no lateral rectus palsy was noted. She had normal power in all limbs and a normal gait. An MRI of the brain and neck was ordered which showed leptomeningeal enhancement, suggestive of leukemic spread to her brain, as well as mild diffuse brain atrophy with a differential diagnosis of developing mild hydrocephalus. CSF cytology was consistent with ALL with CNS (brain) involvement.

BMA was done on 28th April 2022 and the sample was sent to the USA for flow cytometry. This showed no definite flow cytometric evidence for an abnormal or neoplastic leukocyte population in the analyzed sample.

Breanna was therefore managed for early ALL CNS relapse and she received re-induction, which was started on 28th April 2022 using a modified UK R3 protocol.

Breanna remained stable on the new protocol and completed intensification.

On 26th July 2022, she had some bleeding after injecting her subcutaneous Clexane® (50mg) and complained about her eyes when she was in school for summer classes. She was admitted again to the Oncology Unit, received treatment and FBC was ordered. In the evening her temperature went high to 39.1°C and some black spots showed on her tongue and mouth. She also began vomiting and was feeling weak and drowsy.

Breanna was rushed back to the Oncology Unit on 27th July 2022 where she was admitted. Her condition however later became serious and she was transferred to PICU, where she died on 3rd August 2022 around 12:18 noon.

BREANNA’S ACHIEVEMENT

While she was alive, the late Breanna called for a lot of interventions to be carried out for children with cancer in the country. Some of her calls resulted in the incorporation of childhood cancers into the National Health Insurance Scheme (NHIS) benefit packages to relieve the burden of parents as a result of the treatment of childhood cancer.

The late Breanna appealed to the First Lady, Mrs. Rebecca Akufo-Addo, during the inauguration of the ultra-modern 54-bed hostel built by the Rebecca Foundation for Children with Cancer at Korle-Bu Teaching Hospital, Accra. Her advocacy yielded fruit when the First Lady announced the inclusion of childhood cancers into the NHIS benefit packages during the launch of the second NHIS week celebration in Accra on 15th November 2021.

The package included Burkitt Lymphoma (bone marrow cancer often found in the jaw), Wilms Tumour (cancer of the kidney), Retinoblastoma (cancer of the back of the eye), and Acute Lymphoblastic Leukemia (cancer of the blood).

Little Breanna called for a ceasefire between Russia and Ukraine to help save the lives of children with cancer in Ukraine. Her call influenced world leaders to evacuate children with cancer in Ukraine to get high quality health care in the United Kingdom.

The late Breanna lived a short life but fought a good fight to bring childhood cancers to the attention of authorities and earned the role of Ghana’s Childhood Cancer ambassador.

BREANNA’S SPECIAL ENCOUNTER WITH FAMILY AND FRIENDS BEFORE HER DEMISE

Breanna was a nine-year old girl and the second born of her parents, Mr. Solomon Addai and Mrs. Augustina Addai. She attended Dison International School in Burma Hills Accra, and was in stage 4.

On her first day of joining the Year 4 Sapphire class, Breanna told her dad that she would learn hard to excel and sweep all the class awards. True to her words, she was on course.

She was an exciting, friendly, and mature learner in class. Her contributions during lessons were thoughtful and on point. She would usually share vital personal life experiences during Religious Education lessons.

One afternoon, when Breanna and her older sister Lordina were home spending some time together, Breanna started encouraging her sister to be strong in everything and not to despair no matter what, even if she dies, but rather be happy.

On countless occasions Breanna asked her Dad to start going to work because it seems she was the one keeping him out of work. She was planning to get a job herself online to help her Dad pay her medical bills and the debt that he owes.

On 1st August 2022, at around 2 pm, her Dad went to visit her, and just after spotting her, she smiled at him and said, "I am happy just looking at you and Mummy talking”. Her Dad asked how she saw them talking and she replied, “ I heard your voices.” Later in the evening, around 10 pm, before leaving the hospital, her Dad and Mum held her hands and prayed together.

On 3rd August 2022, the day of her demise, during the usual routine check-up by the doctors, Breanna requested to talk to her sister Lordina but the doctors asked if she would like to talk to her Dad instead since he was around, but she said no and insisted that she wanted to speak with her sister. The doctors informed her Dad about the request made by Breanna, unfortunately upon reaching her bedside to give her the phone to talk to her sister, Breanna had to be attended to by another team of doctors, and this prevented her from getting the chance to speak to her sister. Breanna died exactly 12:18 pm in the presence of her Dad after taking her first drug given by one of the nurses.

Breanna was a very special child who was loved not only by her family members but by almost all that she came into contact with, and her beautiful smile will always be missed.

Breana was more than a child to her father; she was a rock to the father, reminding him whenever he forgot the time for Bible studies due to his workload.

Breanna was a deep student of God’s word who loved to contribute to discussions during Christian meetings. She was confident in the Bible’s promise of a future resurrection to paradise earth (Acts 24:15; Luke 23:43; Rev. 21:3, 4).

She shared a bible quotation with her Mum, Mrs. Augustina Addai – Romans 15: 13 – and it reads: May the God who gives hope fill you with all joy and peace by your trusting in him so that you may abound in hope with power of the holy spirit.