MERRIMAC — In many ways, Avalanna Routh is just like any other 5-year-old.
The little girl loves butterflies and ladybugs, princess stickers and cupcakes. She likes to wear earrings and bracelets and to give hugs.
She loves her parents and her dog, Charlotte, a Portuguese water dog that she calls her "sister."
Yet, for Avalanna and her parents, Cameron, 45, and Aileen Routh, 40, of Merrimac, much of the past five years has been anything but an ordinary childhood.
Avalanna has cancer and is fighting for her life.
When she was 9 months old, she was diagnosed with a rare brain tumor, called atypical teratoid rhabdoid tumor (AT/RT).
The tumors strike the brain/central nervous system and are extremely rare — and extremely difficult to treat.
She was diagnosed five years ago, on Aug. 18, 2006.
"Just the week before diagnosis, she presented with a slight tilt in her neck," Aileen Routh said. "We were assured that this was minor and not of any concern. However, after five days and no improvement — and an instinctive feeling that this was serious — we brought her to Children's Hospital Boston."
The infant underwent a 12-hour brain surgery. It was followed by countless other surgeries, chemotherapy, a stem cell transplant and radiation.
During the first several years of treatment, which included the stem cell transplant, Avalanna spent about 75 percent of her time as a patient at Children's Hospital. The Rouths temporarily closed their house in Merrimac and moved into Boston.
Today, Avalanna and her parents take weekly trips to the Jimmy Fund Clinic — the outpatient pediatric cancer center at the Dana-Farber Cancer Institute — for transfusions and IV chemotherapy. They make the trip about two or three times each week.
"She's very transfusion-dependent right now," Aileen Routh said.
Since Avalanna has received chemotherapy for an extended period, her bone marrow has "tired," Aileen Routh said. It can no longer make red or white blood cells, or platelets.