Ronal Salvador Says "Checkmate" to Cancer

Life is funny – one day you are perfecting your game as the leader of your high school chess club, the next day you are battling one of life’s fiercest opponents – cancer.

Lifelong New Orleans resident Ronal Salvador, now 19, was the happiest of teens enjoying his junior year of high school when he felt something that didn’t seem right.

“I felt something on my left testicle. It felt larger than usual, but I didn’t have any reason to think it wasn’t natural. I thought it was just growing. Then I talked to my mother,” Ronal said. “She told me immediately that it didn’t sound good, and she took me to the doctor.”

A visit to his local physician proved upsetting to both Ronal and his mother, Glenda. After hearing he would likely lose his left testicle to surgery, and possibly his right, they sought a second opinion at Children’s Hospital New Orleans.”

With her son interpreting for her, Glenda said she had never been more scared in her life and couldn’t get him to Children’s Hospital’s Emergency Department fast enough. Once there, Ronal was seen by Children’s Hospital pediatric urologist, Christopher Roth, MD. His examination and imaging studies were concerning for a mass adjacent to the left testicle and he underwent removal of the left testicle and mass two days later.

“When we met with the doctors at Children’s, they promised me they would do their very best to save his right testicle. I was very impressed with their confidence and agreed to go ahead with the surgery,” Glenda said, with her son translating her rapid native Spanish.

Ronal’s pathology examination demonstrated rhabdomyosarcoma which is a rare type of cancer that affects soft tissue. “It accounts for approximately 2.7% of cancer cases among children aged 0 to 14 years and 1.4% of the cases among adolescents and young adults aged 15 to 19 years,” according to the National Cancer Institute.

While rhabdomyosarcoma may occur anywhere in the body, the most common primary sites are the head and neck region and the genitourinary tract. Having this type of cancer in the genital area is quite rare; only about 110 cases per year in the United States are reported.

Once the type of cancer was identified, multispecialty care was led by Pinki Prasad, MD, MPH who specializes in pediatric hematology and oncology. Because of his cancer type and age, Ronal required a retroperitoneal lymph node dissection, which is an extensive surgery that removes the lymph nodes adjacent to the aorta and vena cava. These lymph nodes represent the typical first site of spread for testicular tumors.

Ronal remained positive and said he was relieved after talking with Dr. Roth and Dr. Prasad. “The doctors told us that additional surgery would be needed and that I could make a full recovery,” he said. “That’s all I needed to hear. I want to live a long time and I just wanted to get rid of the cancer.”

The next step in his treatment proved to be one of the more challenging phases of his care. He underwent a nine-hour surgical procedure to implant a vascular access port for administration of chemotherapy and the retroperitoneal lymph node dissection.

This all occurred in December 2020, only months after the start of the COVID-19 pandemic. Hospitals were on high alert, taking every precaution possible. At CHNOLA, parents were allowed to visit so, unlike so many patients who were unable to have loved ones around them in hospitals around the country, Ronal was lucky. His mother and stepfather were able to take turns visiting every day.

The nurses at CHNOLA had him up shortly after surgery. It wasn’t easy, Ronal recalled, but “they told me I couldn’t leave until I could get up and use the bathroom myself. That motivated me! Even though moving felt uncomfortable, I wanted to walk. It took about 10 days until I felt like I was walking normally.”

Treatment After Surgery

The pathology report from the lymph node resection indicated that the cancer had spread to one of the lymph nodes near his left kidney. Now diagnosed with metastatic cancer, the degree of treatment was expanded to include both chemotherapy and radiation and the hematology/oncology team oversaw Ronal’s chemo and radiation treatment plans “Chemo was not fun. I wasn’t feeling great and couldn’t really walk around because of the nausea. I knew I had to eat to stay strong, but I really didn’t feel like it. The nausea was bad.”

Thankfully, it’s hip to wear hats these days but Ronal said he “couldn’t care less” about losing his hair from the chemo treatment. “I just wanted to get better. I did whatever they told me I had to do,” he said.

The next thing he “had to do” was radiation. In the summer of 2021, Ronal underwent a month of radiation concurrent with his ongoing eight months of chemotherapy treatment.

By the fall, the doctors told him he had made it through the treatment. But he wasn’t out of the woods…yet. He would have to get re-scanned every four months for two years – which brings him to early summer 2024. That’s when the scans will be every six months for a few years.

In the middle of 2022, Ronal underwent another surgery to get a prosthetic testicle and have the chemo port removed.

“I knew I would get over the cancer. I was staying positive about it. It was a matter of patience and time. The doctors were saying I would recover, and I would be back to my normal self. I just had to get through the struggle. I was never scared. I just believed and I just knew I would be fine. I’m 19 now and they tell me that I can be considered cancer-free when I’m 25 years old,” Ronal said.

Mom’s Perspective

Ronal is a super positive guy. In fact, even when he heard his cancer diagnosis, he said, “I knew I would be OK in the end.”

Glenda wasn’t always so sure. She was worried about her son’s health and the possibility of the cancer growing and spreading. She was also concerned that the cancer would prevent Ronal from having children someday. Her fears were calmed after meeting Dr. Prasad and Dr. Roth.

“I am incredibly thankful to CHNOLA’s doctors. They are the very best. They are caring, friendly and knowledgeable. I trusted them from the very beginning and think they are the smartest people in the world,” she said. “I really liked Dr. Roth because he said he would do the operation like he was operating on his own son. What more could I have asked for?”

Ronal couldn’t agree more. “Dr. Prasad and Dr. Roth have been with me the whole way. They have been great. They have answered every question we had. They have been with me the whole way.”

While Glenda has a nagging fear that the cancer could come back, she prays it won’t and trusts that CHNOLA will be there for Ronal if it ever does. “I always ask them if there is a chance it will come back. They say they can’t guarantee it won't, but they reassure me. They say, ‘We are doing our best to make sure Ronal remains cancer free. But if it ever does come back, we’ll be ready.’”

Dr. Salvador, We Presume

Ronal is feeling great and is focused on his future. He is now a sophomore majoring in biology/pre-med at the University of New Orleans.

“I want to be a cardiologist. I know it’s a long road ahead,” he admitted. “But just like getting rid of the cancer, I am focused on what I have to do to succeed. I’ve always been a happy guy. I don’t let things get me down.”

In fact, Ronal said, he feels lucky. “I played chess with cancer – and won!”

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