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LULA, GA - As the mother of 12-, 6-, and 3-year-old girls, and 18-month-old twin boys, Charles and Edward, there is a good chance you will find Heather Strunk on the floor of their Lula, Georgia, home playing with her children.
The twins were born in November 2022, after an uneventful pregnancy.
"No complications at all for me," Strunk says. "No time in the NICU for them. No preemie time. Nothing wrong with them at all."
When the twins were about 4 months old, Heather and her husband Ross noticed a bump on the side of Charles' head by his ear.
"It was like a pimple, and we were looking at it, and it just, it hurt him to touch it," she says.
Mother investigates mystery bump on baby
When the bump did not go away, Strunk says, she took Charles to a nearby ER, then his pediatrician, then an ear, nose and throat doctor, then to a Children's Healthcare of Atlanta emergency department.
"We saw over 23 different doctors within the course of 3 or 4 months," the 32-year-old says.
The doctors thought Charles might have an ear infection, a swollen lymph node, a clogged duct.
"And this thing on my son's face is getting bigger and bigger and bigger," Strunk says. "And, I mean, it was taking over his eyes, like his eye was swollen shut."
Finally, in April 2023, Charles Strunk underwent a biopsy at Children's Healthcare of Atlanta, and was diagnosed with Langerhans cell histiocytosis, or LCH.
Children's Healthcare pediatric oncologist Dr. Sarah Mitchell says LCH is a rare, tissue-damaging disorder in which a type of immune cell, or white blood cell, begins to multiply and grow too quickly, causing lesions or masses to form.
"For Charles, for example, he had a lump by his ear that was causing pain and swelling," Dr. Mitchell says. "Sometimes it's a skin rash. Other times it can be actually a tumor or a mass."
What is Langerhans cell histiocytosis?
Sometimes LCH will disappear on its own, if you just watch and wait, Mitchell says.
Unfortunately, that was not the case, because 3 days later I woke him up from a nap and he had a huge mass in his neck as well as his bump got even bigger," Strunk says. "I called his oncologist, sent in a photo to her, and she said, "No, we need to start chemo immediately.'"
It is not clear if LCH is a true cancer or an immune disorder that acts just like a cancer, Dr. Mitchell says.
Treatment for both is the same.
"So, he received chemotherapy for about a year," Dr. Mitchell says.
"He did really good," Heather Strunk says. "He didn't lose much hair because he was a baby, which made it a little easier. "
Today, 13 months out, Charles Strunk is finished with his treatment.
"He is completely done," his mother says. "He actually just rang the bell last month."
He will continue to get regular scans until he is 6, but the latest, in April, was clear.
"He still has 3 tumors," Heather Strunk says. "They have shrunk dramatically in size. Right now, he's in remission, which means that the tumors are not growing, they are not active."