Oscar Bisman, pictured with his dad Gavin, is fighting off leukaemia for the second time at just six years old. Photo / Supplied
The baddies are back.
The baddies are in six-year-old Oscar Bisman's blood, zooming around his body and making his family's worst fear a reality — Oscar's cancer is back, and it's come back strong.
After six months cancer-free, Oscar is back on the battle line giving everything he can tobeat his leukaemia just as a sense of normality was about to set in.
It's broken the hearts of his parents, Gavin and Sarah Bisman, Oscar's father shares.
"I'd seen him start to become a normal kid... it's been a kick in the guts."
The Pāpāmoa boy was diagnosed with acute myeloid leukaemia at the end of January last year at just four years old.
His family spoke to the Bay of Plenty Times two weeks after the diagnosis about his battle against what the "baddies" - a word they adopted to help explain his illness.
He spent 217 nights in Auckland's Starship Hospital. Now the family, including Oscar's siblings — a brother and two sisters — have moved back to Auckland for more rounds of chemotherapy, radiation and transplants.
New schools and kindergartens plus a lack of time as a couple are Gavin and Sarah's reality as they split childcare shifts: one of them with Oscar as the other cared for the rest of the brood.
But Gavin said the children cope with it better than they do.
"This time round, before we mentioned it, our oldest was like 'we're off to Auckland then. If that's where he's going, that's where we're going'."
A few strange blood test results led to Gavin and Oscar flying to Auckland the week before Easter, Gavin wasn't taking any risks because if the prognosis was bad, he wanted to know, so they could start fighting.
Oscar's doctor performed a bone marrow aspiration to remove a liquid marrow sample.
"The leukaemia starts forming in there and if you imagine it like a tube, eventually they fill up to the top of the marrow and then spill out into the blood. We were seeing them in the peripheral blood, but only little tiny ones, because that was just the initial overflow."
Oscar was back to 90 per cent leukaemia, Gavin learnt: "It's back and it's back strong," doctors told him.
Gavin cried for a good 30 seconds, he said, before calling his wife.
It was one of the hardest conversations he has ever had.
"We'd had a pretty rough six months and I swear the last three weeks before he got that diagnosis, Oscar was the best he had been in a year and a half.
"He'd just gone back to school. One of the days he wanted me to stay and it was a really special day for me because he was at school finally, and I got to spend the day with him."
Oscar and Gavin returned home for the long weekend where the family spent their last days in Pāpāmoa together, coming to terms with the fresh fight that lay ahead.
Gavin said in those days he was "struggling to keep it together" while also thankful Oscar had a chance to attack the cancer as it was attacking him.
"The worst-case scenario is some kids relapse and there wasn't anything they could do because the treatment itself is so intense they end up dying from treatment than cancer.
"But thankfully, the upside was they said they could do something, and they were going to start doing something."
Now one round of chemo down, Oscar has one more round to go before radiation and another bone marrow transplant.
"He has gone to 90 per cent cancer, to 10 per cent, to 5 per cent already from the first round of chemo."
And if that wasn't good enough news, Oscar is still in high spirits too, meaning that cheeky smile is sticking around through all the poking and prodding of needles.
"He's accepted 'this is what will help me', and he's matured in that way but the cool thing is he is still himself, with that life in his eyes.
"It's pretty horrible what he has to go through, but he's coping a lot better this time round. He's still cheeky, still funny."
Leukaemia and Blood Cancer New Zealand head of support services and operations Emma Barker said around 50 children were diagnosed a year making acute leukaemia the most common cancer in children.
"Overall around 730 people are diagnosed every year this includes acute and chronic leukaemias."
Oscar has acute myeloid leukaemia which is affecting his immature blood cells on the myeloid (tissue of the bone marrow) line.
The cancer causes an overproduction of abnormal blast cells (immature white cells) which crowd bone marrow and prevent it from making normal blood cells. Because the bone marrow cannot function properly, it cannot produce adequate numbers of red cells, normal white cells and platelets.
However, there are several different types and subtypes of leukaemia which is the name given to the group of cancers that develop in the bone marrow.
The terms "acute" and "chronic" refer to how quickly the disease develops and progresses, acute being the faster of the two.
"The most common age is under five-year-olds for acute lymphoblastic leukaemia, but leukaemia can happen at any age," Barker said.
Every diagnosis was different, Barker said, but unfortunately, many blood cancers did relapse, as Oscar's has.
"Often treatment for acute leukaemia is urgent and so families are having to move to areas where the child can receive treatment and this is very disruptive and stressful for them.
"Leukaemia and Blood Cancer New Zealand support families going through this with financial support, education and psycho-social care."
The Bisman family have been overwhelmed with the support from their community. From parcels of books and a "Night for Oscar" held by Golden Sands School to half-marathon fundraisers and surf competitions, the family felt the love constantly around them.
"It's more the fact that people are willing, it means as much, if not more than the dollars and cents because it helps us mentally get through another day," Gavin said.