At only four years old, Aarev Shetty has had much to contend with.
But things are eventually looking up for the Dubai-based youngster, two years after he was diagnosed with leukaemia.
Aarev's response to blood transfusions and round after round of chemotherapy means doctors are now optimistic that he can end his gruelling daily treatment later this year.
The hair he lost has fully grown back and the spring in his step has returned as he marches confidently through the gates at Gems Legacy School in Garhoud.
That progress, alongside his appointment as a school ambassador, has given hope to parents Anu Rai and Sushant Shetty that their son has a bright future ahead.
“Every day we give him chemotherapy at home, and every month he has an intensive treatment in hospital, so it is not easy for him,” said mum, Anu, a medical co-ordinator in Dubai.
“He finds it hard for two or three days after his treatment, so we have to take him out of school. He gets angry and tired and this lasts for around 10 days, but it is something we are learning to deal with.
“All the teachers knew his story and wanted to get to know him; he is quite charming with them and tells them how pretty they are.
“Aarev has got to know all the doctors well, too. It has made him want to become one himself."
Leukaemia is the most common cancer in children aged up to 14, followed by brain cancers, lymphomas, neuroblastoma, kidney tumours, and malignant bone tumours.
The World Health Organisation recorded 939 cases in the UAE between 2015-2020.
Every month Aarev has a high-intensity chemotherapy session at Mediclinic City Hospital, and is so weak afterwards he needs therapy to recover.
Doctors have revised their timescale for when he is due to finish his treatment.
His final session is now planned for December — two months ahead of schedule.
He will undergo a five-year monitoring period, with regular blood tests every few months, but the prognosis is looking good.
The family are travelling to the US in January for some follow-up care. So far, medical fees are around Dh100,000 a year, with each chemotherapy session costing Dh8,000-9,000. There are further costs for Aarev's rehabilitation.
The family recently moved to a villa in Warsan near International City, to afford more outdoor space for Aarev to play in when he recovers after treatment.
Chemotherapy works by targeting rapidly developing cancer cells that divide and multiply faster than normal cells in the body.
The drugs used are powerful, so can also damage other healthy cells, leading to side effects such as sickness, hair loss and mouth sores.
The treatment often leaves particularly young children exhausted.
Donations made treatment possible
Aarev’s blood cancer was first spotted in August 2019 when he showed signs of muscle weakness.
As treatment costs soon began to escalate and exceeded the cover on Anu’s health insurance, Al Jalila Foundation, cancer charities and other well-wishers stepped in to help to pay his fees.
They are likely to eventually exceed Dh700,000 once he has completed his rehabilitation.
To compound matters, Aarev’s dad lost his human resources job during the Covid pandemic and has only recently returned to work.
Since starting school, the youngster has really begun to shine, and thrives on the new friends he makes every day.
“We are surviving somehow, and it is still difficult to see other children like Aarev at the hospital where he is treated,” said Anu, who is from Delhi.
“Their parents often do not have adequate health insurance, either, so I try to give them advice.
“Aarev speaks to the children and tells them to be brave.
“He is a good listener, and he tries to be a good example to other children at school by making sure they wash their hands and behave properly.
“When he started school, it was a big step for him, but he loves it.
“The school has made him an ambassador, which he is very proud of.”