A four-year-old girl was diagnosed with Wilms tumour, a form of kidney cancer, after her mother noticed changes in her behaviour and escalating disputes at pre-school sparked a hunt for answers.
Katie Cullen grew worried when symptoms began appearing gradually in her daughter Ayla throughout 2025, though they initially seemed like typical childhood ailments or growing pains that could easily be dismissed. The youngster would periodically mention tummy aches, battled with constipation, developed hives, and frequently appeared exhausted. Staff at her pre-school observed she was clashing with classmates, which was out of character.
Lump found during bedtime routine
It wasn't until the beginning of this year that parents Katie, 30, and David, 31, discovered a sizeable lump in her abdomen while preparing her for bed one evening. They were informed it was constipation again – but her mum remained unconvinced.
Katie, from Sydney, Australia, said: "Something didn't sit right with me, but I never imagined it could be cancer. We'd taken her to an urgent care clinic that night after finding the lump, but were told it was likely constipation and sent home. I booked a GP appointment for the following morning and we were immediately referred to the emergency department."
Within hours, scans revealed an 11cm tumour on her kidney. Katie said: "Nothing prepares you for hearing the words 'your daughter has a tumour'. One moment I thought I was taking my little girl to hospital for constipation, and the next I was being told she had a tumour the size of a grapefruit."
Behaviour changes and symptoms
Young Ayla was described as a "happy and active" child who loved dancing, singing and spending time with her six-year-old brother Elijah. Katie recalled: "Ayla has always been a social butterfly, full of confidence and personality. Towards the end of 2025, we started to notice her personality change, and looking back, I believe the tumour was making her increasingly uncomfortable."
She became noticeably more irritable and easily frustrated, which was very unlike her. At pre-school she started arguing with other children over things that normally wouldn't have bothered her. At home she was quicker to become upset, had less patience, and wasn't her usual happy, carefree self. Alongside these behavioural shifts, Ayla began sleeping later in the mornings, showed little interest in playing, occasionally developed hives and rashes, and had red under her eyes.
Katie added: "We saw doctors and specialists multiple times throughout the year as different symptoms appeared. I was always trying to find an explanation, but because each symptom seemed relatively common on its own, cancer wasn't suspected. The two blood tests she had in 2025 also came back completely normal."
Diagnosis and treatment
At the beginning of 2025, Ayla suffered from a UTI that proved stubborn to treat, while an abdominal ultrasound likewise revealed nothing out of the ordinary. Katie explained: "As the months went on, she continued to have intermittent symptoms including abdominal pain, fatigue and bloating. We saw our GP, had multiple blood tests, saw specialists and continued investigating her symptoms. Everything continued to come back reassuring."
Everything changed when she discovered the lump in January 2026, resulting in the diagnosis of Wilms tumour – kidney cancer. Young Ayla started chemotherapy almost straight away, undergoing four rounds, which shrank the tumour by approximately 70%. She subsequently had surgery to remove her kidney along with the tumour.
During the operation, doctors found that the tumour had burst prior to surgery, with local spread to nearby tissues including her bowel, pancreas and diaphragm – escalating her condition to stage three and necessitating more intensive treatment. Since that time, Ayla has completed 10 days of whole abdominal radiation, plus an additional six days of targeted radiation to the tumour bed, and is presently receiving a 27-week chemotherapy protocol with vincristine and actinomycin D. During her treatment, she has required a central line, a feeding tube, blood transfusions, platelet transfusions and numerous hospital stays due to infections and low blood counts.
Katie said: "She has been incredibly brave. There have been days she's too exhausted to play, days she doesn't want to eat, and days where she's lost feeling and strength in her hands and feet because of chemotherapy-induced neuropathy. She's lost her hair, spent weeks in hospital and endured more needles and procedures than most adults ever experience. Despite everything, she still finds reasons to smile, sing and make people laugh."
She added: "We remain hopeful. But one of the biggest things I've learnt is that childhood cancer doesn't always look the way people expect. I hope that by sharing her story, we can help raise awareness that childhood cancer symptoms are often vague and can easily be mistaken for common illnesses, while also encouraging parents to trust their instincts if they feel something isn't right. If our story encourages even one parent to seek a second opinion, trust their gut, or helps raise awareness for childhood cancer, then sharing it is worth it."
