Jessi Buchanan

Stephanie Buchanan

When Jessi Buchanan’s mother took her to the doctor on April 28, 2025, she expected a stomach bug. What they found instead was a mass the size of a cantaloupe on Jessi’s right ovary. Within weeks, the then eigth-grader from Kentucky would be navigating one of the rarest pediatric cancers in the world — and insisting, with kind but unwavering conviction, that she be included in every decision about her own body.

She was 13 years old.

A Diagnosis Nobody Saw Coming

Jessi was an otherwise healthy girl who enjoyed horseback riding, volleyball, and coloring. Her symptoms – bloating, nausea, diarrhea and an inability to get comfortable – developed rather suddenly, only days before her diagnosis.

At the hospital, doctors considered her constellation of symptoms to be from a stomach virus, infection, or pregnancy. However, given her degree of discomfort a CT scan was ordered, which showed a large pelvic mass.

Jessi’s doctors privately told her parents about their concern for cancer. Jessi remembers not being in the room.

“I feel like I should have been present, because it’s my body. I wanted to be part of that conversation,” she told me. Jessi’s preference is supported by data. Though limited, research shows that when children are involved in decision-making, they experience decreased anxiety, increased sense of value and control, and improved communication between children, parents, and clinicians. Understandably, many parents and clinicians may wonder if a child is too young to discuss such heavy news. However pediatric clinicians suggests that as early as nine, children can begin to make informed treatment decisions, and by the time they are adolescents, many have developed decision-making competence, including the abilities to reason, understand treatment options, and express rational preferences.

After Jessi’s CT scan, further imaging, labs, and a referral to Vanderbilt Children’s Hospital followed. Her mother, Stephanie Buchanan, shared that Jessi’s tumor markers were elevated which raised suspicion for malignancy. A subsequent surgery removed her right ovary, part of her fallopian tube, the tumor, and her omentum, the tissue that coats abdominal and pelvic organs, because the mass had a two-centimeter rupture at its top, leaking into her abdominal cavity. In other words, this was no small surgery for a child.

Pathology confirmed mucinous adenocarcinoma of the ovary, a cancer where the median patient age at presentation is 55 years.

"Only around 13 children under 15 in the world have been diagnosed with it,” Stephanie tells me. Given the rare nature, tumor boards at Vanderbilt, MD Anderson, and St. Jude’s were consulted. Even among the experts, there was no consensus on whether chemotherapy was the right path in designing the treatment plan. Robust data simply didn’t exist.

Jessi had her own opinion. At an age when most teenagers are navigating high school drama, Jessi was researching chemotherapy protocols, weighing the risks of treatment against the uncertainty of watchful waiting.

Stephanie asked Jessi what she wants. "It doesn’t matter what I want — no one’s going to listen to me, because I’m a kid,’" Stephanie recalls. They offered her clarity and a reminder, "This is your body. Your opinion matters.” Jessi’s nanny also encouraged her to develop a sense of advocacy.

When Jessi met with her oncologist at Vanderbilt, she came prepared. "My thought process was: if I go through chemo, I know I did something," Jessi explains. "Rather than just sitting by and watching." Her parents chose to support rather than override her.

Her oncologist was reportedly taken aback, not by her age, but by her knowledge. He assured that if this was truly how Jessi felt after understanding everything before her, they would move forward with chemotherapy.

From that moment forward, she made her position clear to her parents and her medical team: she wanted to move forward, not as an observer, but as an active participant of the medical decisions.

Jessi weighed in who treats her. They postponed a medical procedure because Jessi wasn’t comfortable with the surgeon available on a specific date. Stephanie learned that a knowledgeable and intellectual child should “help make some of those decisions.”

Jessi also asked for a therapist. “I wanted help to cope,” she says. "and have better mechanisms to talk about feelings I couldn't talk about with my parents."

Her parents are learning too. Darrell, her father, shared that after her diagnosis he initially became overprotective, restricting her social life out of fear. "Once I realized that was starting to bother her," he says, “I backed off. And once we let her start doing those things again, her whole attitude changed. She felt somewhat normal.”