Only 10, Patsy Parker can tell you all about acute lymphoblastic leukemia, from the drugs you have to take to the side effects of chemotherapy. Last September, she was diagnosed with the disease. She went through three months of radiation and chemotherapy, and a bone-marrow transplant that kept her in the hospital for two straight months during the Christmas season. Her bones are so weak she can't walk much and has to get around in a wheelchair. She was tutored at home for her fifth-grade year at Kapalama Elementary.

But through all this, Patsy has remained positive. She's got a goal in mind: to turn 14 and volunteer to help other children with cancer.

"I want to tell them that it's OK to have cancer," said Patsy, who loves to shop and swim at the beach — two things she can't do as much now. "Before, when I didn't have it, I didn't know much about it, and I didn't really care ... I feel special (now), but I wish I didn't have it in the first place."

Patsy is not alone.

Cancer is the leading cause of death by disease in children between birth and age 14, according to the Hawaii Children's Cancer Foundation, the state's only organization dedicated exclusively to providing services to children with cancer and their families. In Hawai'i, about 82 children are diagnosed with cancer each year. The survival rate for all childhood cancer is about 68 percent.

At any given time, there are more than 200 children in treatment in Hawai'i.

September is Childhood Cancer Awareness Month, and supporters and advocates hope to raise awareness that cancer can strike anyone, even kids.

"Cancer is not only an adult disease but also a children's disease," said Lei Rol, a volunteer HCCF board member who helped organize Jungle Adventure, an awareness-building fundraiser Sunday at the Honolulu Zoo (see box, Page E1).

For families, cancer can be devastating, both emotionally and financially, Rol said. It's common for parents to take unpaid leave from work — or quit entirely — to take care of their child during treatment, which is longer for kids than adults. They can be in and out of hospitals for up to three years.

Since health insurance doesn't pay for everything, HCCF steps in and provides financial assistance to Hawai'i families. Last year, it gave more than $100,000 to families, often cutting checks directly to creditors. There are no income restrictions.

The foundation has helped the Parkers make ends meet. Debbie Parker, 36, left her job at a preschool to take care of Patsy and their two younger daughters. Her husband, Kip, continued to work as a paint tinter and part-time caricature artist in Waikiki.

"It's been hard for us as parents," said Debbie Parker, watching Patsy eat chicken katsu — something she couldn't do for months after her bone-marrow transplant — in their Kalihi home. "I would think, 'Why her? Why us? We're good people. And she's a good girl. Why did this have to happen to us?' But we said it's OK, we have to go through it and fight it. We always tell Patsy whatever you have to go through, don't give up. Fight."

A DIFFICULT BATTLE

Taja Koch was just 21 months old when she was diagnosed with non-Hodgkin's lymphoma.

She spent a little more than two years in treatment, starting with intense chemotherapy for about a year. Like Patsy, Taja lost all of her hair.

The chemo got rid of a tumor in Taja's chest the size of a tangerine. It was compressing her heart and airway, causing a heart murmur and an unusual cough.

Today, Taja is a happy, active 5-year-old who plays soccer, dances and just started kindergarten at Ma'ema'e Elementary. She already knows what she wants to be when she grows up: a doctor, she said, so she can help people. "It's such a blessing to have her here with us," said her mother, Nalani Koch, 37.

Koch had to take a leave from her job as a teacher to take care of Taja. "In the beginning it was really stressful," Koch said. "I used to think my life before was stressful. Now I wish I could go back to my life then, having a normal, healthy family."

Though her lymphoma is in remission, Taja's not entirely in the clear yet. She still has to visit her doctor every three months.

"Right now, I still worry," Nalani Koch said. "It's always in the back of my mind."

SAVORING LIFE

Like many families, the Parkers never saw it coming.

Last summer, Patsy started complaining about being tired. All the time. The girl who loves to shop couldn't walk for very long at the mall without feeling exhausted. Her appetite worsened. Her mother immediately took Patsy to the doctor.

"She was pale-looking," Debbie Parker said. "The doctor said, 'Look at her hands.' The blood in her palms didn't want to come back."

The next day, Debbie Parker got a phone call. Something in Patsy's blood wasn't right.

"As a mom, you have an instinct something is wrong with your child," Debbie Parker said. "I just knew something was wrong with her."

Patsy was diagnosed with leukemia. Cancer. The word hung in the air for awhile.

"I didn't know anything about leukemia," Debbie Parker said. "I was thinking she would never make it. Cancer is a death kind of word to me."

But when Patsy was told she had leukemia, Debbie Parker was surprised that her daughter already knew what it was. Patsy asked her mother, "Is that cancer?" Parker started to cry.

"She thought she was going to die," Parker said. "It was hard."

Patsy immediately underwent aggressive treatment. The radiation made her sick; the chemo took away her straight, silky hair.

Three months later, she needed a bone-marrow transplant.

The ideal match was Patsy's sister, Keisha, then only 6 years old and already a surgery survivor: At age 2, Keisha had open-heart surgery to fix a heart murmur that might have killed her before she reached adolescence.

"(Patsy's) body isn't working good," Debbie Parker told Keisha. "She needs new blood, and you have to give it to her."

The transplant was successful, but Patsy had to spend two months in isolation at the hospital with only adult visitors. Her father stayed with her the entire time.

As she recuperated, Patsy drew pictures of animals, crediting her artistic father for her talent. Her artwork was selected for the poster for Sunday's fundraiser.

Patsy may be done with treatment, but she has regular check-ups twice a week. She takes two different drugs every day. Two tubes protruding from her chest — this implantable port is how medicine is injected into her bloodstream — are daily reminders of her battle with leukemia.

But Patsy does have a lot to look forward to. She's going to a cancer support camp in Makaha again this year. She's traveling to Disney World with her family in November. And she will most likely reunite with her classmates at Kapalama Elementary.

Oh, and she loves her new hair. Short and curly.

"The hardest part was in the beginning when I found out I had leukemia," she said with a shy smile. "Now, I feel good."

Reach Catherine E. Toth at ctoth@honoluluadvertiser.com.