On a fall day in 2021, AJ Moreno’s mom noticed her youngest son’s belly was bloated.

“It looked like he had eaten a big meal,” Christina Moreno said. “His tummy just looked so full.”

Christina told her husband, Armando. The couple didn’t think much more about it initially. But the next day, AJ’s gut still looked swollen.

“When I touched his stomach, his left side was really firm and his right side was squishy,” Christina said. “We decided to set up a doctor’s appointment for the next week.”

An active and determined kid, 5-year-old AJ was always trying to keep up with his three older brothers. Gifted at sports, he was full of energy and wasn’t the type to complain. But just a few days later, after a color run at school and a much-needed bath, AJ’s mom discovered that his left testicle was also enlarged.

“We decided it was time for an Emergency Department visit,” Christina said.

After scans at the local hospital near their home in Lodi, AJ’s parents heard the dreaded words: We think your son has cancer. That night, he was transferred to UC Davis Children’s Hospital by ambulance.

Moment by moment

AJ was admitted to the UC Davis Pediatric Emergency Department for more scans. Results came back the next day. He was diagnosed with Wilms tumor.

It was very quick. Our world turned upside down in an instant. One afternoon you’re thinking everything is great and then that night you hear your child has cancer. —Christina Moreno, AJ's mom

Wilms tumor, or nephroblastoma, is the most common pediatric kidney cancer and the fourth most common pediatric cancer overall. Symptoms of Wilms tumor vary but can include swelling in the stomach area and a mass that can be felt. AJ had experienced both.

Wilms tumor is typically found in children younger than 5 years old. AJ had just turned 5.

“It was very quick. Our world turned upside down in an instant,” Christina said. “One afternoon you’re thinking everything is great and then that night you hear your child has cancer.”

It was Stage 4, the most serious. AJ had a mass on his left kidney the size of a softball. It had metastasized to his lungs.

“When I think back to that moment, I felt like a wall was immediately put up in front of us,” Christina said. “I couldn’t see the future. I couldn’t see the next day let alone what the next few years looked like. We had to take it moment by moment.”

Watching the clock

The team at UC Davis Children’s Hospital informed the Morenos that AJ would need surgery. He was scheduled for the following Monday morning at UC Davis Children’s Surgery Center. There was no time to waste.

The initial hope was to surgically remove the tumor, but it was large and had adhered to other organs, making it unsafe to proceed. Instead, the team took biopsies and met with the family to outline a treatment plan. AJ’s parents were desperately trying to keep up.

“We quickly realized this was completely out of our control,” Armando said. “We knew we had to trust the experts.”

The care team shared how they would address AJ’s condition. He would undergo chemotherapy and then they’d schedule another surgery. The Morenos held their breath.

“We didn’t know what AJ’s future was going to look like because the stark reality is that this disease has a mind of its own,” Armando said. “But it was very helpful to know we had UC Davis in our corner and that AJ was the type of kid who would fight this.”

We quickly realized this was completely out of our control. We knew we had to trust the experts.—Armando Moreno, AJ's dad

Playing the long game

The Moreno family soon began their weekly trek to UC Davis Comprehensive Cancer Center for AJ’s chemotherapy treatments. Tuesdays were the most dreaded days of the week … except for Dr. M.

Marcio Malogolowkin, known as Dr. M to his patients, is the chief of the division of pediatric hematology-oncology.

“We love Dr. M. He was so good with AJ. We absolutely adored the man,” Christina said. “I remember my husband and I and were sitting in our clinic appointments waiting for Dr. M. to come in. We talked about how amazing it was that we ended up here. We felt like we were in the right place.”

Malogolowkin explained to the Morenos that the intent of chemotherapy was to shrink the tumor on AJ’s kidney so the team could go back in and remove it. The hope was that chemotherapy would also decrease the size of the lesions in AJ’s lungs. It was six long weeks of treatment, but it worked.

“I was very happy with the tumor response to chemotherapy,” Malogolowkin said. “It allowed us to move forward with the surgical procedure.”

AJ had surgery at UC Davis Children’s Surgery Center on December 29, 2021. The team, led by pediatric surgeon Erin Brown, successfully removed the tumor as well as his left kidney. Soon after he awoke, AJ made it clear he was ready to go home.

“He was like, ‘I want to get home and see my brothers. Let me know what I need to do to get out of here,’” Christina remembered, chuckling. “It was important for him to do the things he had to do before we could leave. Standing up, walking, getting all the tubes out. And he did it. We were home four days later.”

Treatment is a team sport

Chemotherapy continued and AJ began radiation. He had seven rounds of radiation on his abdomen. His parents said he was as ornery and determined as could be throughout the treatment, despite losing his hair and feeling awful.

“Here’s a kid who has this confidence about him,” Armando said. “It’s a beautiful thing. He’s built different.”

Christina also marvels at her son’s tenacity.

“We believe that this strong mindset carried him through,” Christina said. “He just wanted to get it done. None of this fluffy stuff.”

But some “fluffy stuff,” namely Huggie the facility dog, did help make cancer treatments a little more tolerable. Care team members like nurse Cheyanne Van Dyke also supported AJ and his family.

“Cheyanne has been instrumental in our journey,” Armando said. “She went out of her way to share in our tears and laughter.”

The Lodi community also took inspiration from AJ’s story. Multiple fundraisers were held in his name, including the annual Tin Cup Cares golf tournament that raises funds for families with children facing cancer.

“There has been an amazing response to what we’ve gone through. We are so blessed,” Armando said.

AJ all the way

Chemotherapy treatment ended May 17, 2022, marking another milestone in AJ’s treatment. Now 8 years old, AJ continues to push forward. A talented athlete who excels at soccer, basketball and baseball, you will rarely catch him without a ball.

“He has this drive in him to always be the best. I don’t know if we’d be sitting here having this conversation if he didn’t adopt that attitude,” Armando said. “He’s a special kid and he reminds us daily to be joyful.”

The Morenos often reflect on their son’s cancer battle and about what the future holds. Though there is still some uncertainty, there are some things they know for sure.

“Landing on the doorstep of UC Davis was probably one of the biggest blessings throughout all of this,” Christina said. “And not only do we have support, love and good care from UC Davis, our community continues to rally around us.”

“It’s great to continue to share all the goodness that came from this,” Armando said. “It really keeps us focused and sharp and hopefully, helps others as well.”