In 2017, Isabella (Bella) Snow Fraser was celebrating clean scans. In 2020, however, the tumor reemerged in her lungs.
Like many teenagers, Isabella (Bella) Snow Fraser, 15, enjoys immersing herself in action role-play games online. Her favorite, Genshin Impact, allows participants to join an interstellar traveler as they seek their lost twin across a mysterious world of danger and unforeseen challenges.
This futuristic fantasy in many ways mirrors Bella’s own life. After being diagnosed at age 6 with a soft-tissue tumor known as Alveolar soft part sarcoma (ASPS), she too faced challenges, including numerous surgeries and the tumor’s reemergence in her lungs. There was also plenty of travel, as her family sought an effective treatment to slow her ASPS — which is extremely rare in children.
Even in the hospital, Bella remained a fervent gamer.
In 2020 they found it, through a clinical trial available in the Solid Tumor Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. The trial of an immunotherapy drug called atezolizumab stopped the growth of Bella’s tumor and brought her ASPS under control. Now, after five years of traveling from her family’s Vermont home to Boston every three weeks for IV infusions, she is continuing on the trial closer to home in consultation with her Dana-Farber/Boston Children’s oncologist Natalie Collins, MD, PhD.
“I’ll never forget when Bella’s doctor back home said, ‘We found a trial for Bella at Dana-Farber, and I really think she would benefit from it,’” recalls Bella’s mother, Emily Graton. “It was the hope we had been reaching for every day.”
From bathtub to Boston
Bella’s cancer journey began in an unusual locale: the bathtub. In the spring of 2016, while reaching over the tub to grab something, Bella hit her arm and developed what Graton remembers as “an egg-like bump.” She iced it for a day or two, but it didn’t go down.
“We went to the pediatrician to get it checked out, and he figured it was just one of those bruises hidden deep in the bone that might take a month to heal,” explains Graton. “So we waited a month, and when it still didn’t go down I took Bella to Dartmouth Hitchcock Medical Center, just over the New Hampshire border from us. They said they had never seen anything like it.”
Bella with her grandmother Susan before both were diagnosed with cancer in 2016.
Doctors at Dartmouth Hitchcock performed an ultrasound, discovered a mass, and performed a biopsy. About a week later they called to inform the family that the mass was malignant, and Bella had ASPS. For Graton, the news came during an already tumultuous period. Her mother, Bella’s grandmother, had recently been diagnosed with stage IV lung cancer that had moved to her brain. Now her kindergarten-bound daughter, her only child, was facing a rare sarcoma almost never seen in children.
“It was a very scary time, but we just stayed strong,” says Graton. “They removed Bella’s whole tumor, plus some extra nerve tissue, and for four years we had clean scans. We didn’t even need chemo, and the doctors told us it was likely that Bella was now cancer-free.”
Despite this optimistic outlook, Graton spent enough time chatting with other families on ASPS online forums to know the cancer could stay undetected for long periods and then show up in another part of the body. She lobbied the hospital for more frequent scans, which led to the 2020 discovery of the tumor in Bella’s lungs. The family tried several chemotherapy regimens, including oral chemotherapy, but none worked.
“Bella’s doctor at Dartmouth Hitchcock was looking all across the East Coast for clinical trials that might help Bella,” says Graton. “When he found one at Dana-Farber/Boston Children’s that Bella qualified for, we couldn’t wait to get started.”
Ready for more adventures
That first long drive to Boston for a meeting with Collins, and what would become Bella’s team at Dana-Farber/Boston Children’s, only further solidified Graton’s confidence.
“I think I surprised Dr. Collins because I had done so much of my own research into the disease, but I was just so excited to find a doctor who really understood what ASPS was all about,” Graton recalls with a laugh. “Having a doctor and a team that was so knowledgeable, and that we could really trust, provided a lot of relief. They could not have been more caring or inviting.”
Since her diagnosis, Bella’s mom, Emily Graton (left) has been her biggest supporter.
Clinical trials involve testing new treatments in people – drugs, diagnostic procedures, and other therapies – to ensure their safety and effectiveness. Almost every cancer drug starts out in a clinical trial, and by enlisting in trials patients can both (hopefully) benefit themselves as well as provide key insights to doctors seeking better treatments for all patients. Confident in Collins and her team at Dana-Farber, Graton enrolled Bella on the trial.
In the months and years to come, mother and daughter developed a ritual. Each third Thursday they would wake up at 3:30 am and travel by car and bus to Boston, where Bella would get her 30-minute infusions and check-ups with Collins at Dana-Farber/Boston Children’s. To make the trips more fun, they would cap off each with different treats from nearby restaurants.
Bella’s response on the trial was the best treat of all. The tumor stopped growing, and she experienced none of the side effects (hair loss, loss of appetite, extreme exhaustion forcing her to miss stretches of school) she endured on previous treatments. By early 2025, Collins felt strong enough about Bella’s response to recommend the family move Bella’s infusions to Dartmouth Hitchcock.
A big fan of action role-play games online, Bella (center) got into the spirit at the 2024 PAX East gaming convention in Boston.
“The participation of children like Bella in this trial led to FDA approval of this medication in children,” says Collins. “It was this approval that allowed Bella to be treated closer to home. Participation of children and adolescents in clinical trials is important in bringing new drugs to pediatrics.”
These days Bella is looking forward to her freshman year of high school, and is still playing plenty of Genshin Impact. She says her favorite part of the game is saving innocent creatures she encounters during quests, and she hopes to someday turn her love of gaming into a career. She’s already taken part in one event where she and other gamers raised money for cancer research.
No matter what she ends up doing, however, Bella is planning for many more adventures, real and imagined.
Written by: Saul Wisnia
Medically Reviewed By: Natalie Collins, MD, PhD