At 14, she thought she had her first period, but when the bleeding went from monthly to daily, a Chicago teenager was diagnosed with a rare vaginal cancer typically found in women after menopause

Chicago, IL – September 17, 2025 – At the age of 14, during the height of the COVID pandemic, Liliana “Lili” Castaneda thought she had her first menstrual cycle. At first, she was actually excited about it, but then, the monthly bleeding turned into daily bleeding. Castaneda was bleeding so much that she would soak through menstrual pads in 15 minutes and would get dizzy when standing up.

Castaneda went to a local doctor, who told her it was just stress due to the pandemic. But Castaneda insisted that something was wrong, and one month before her 15^th birthday, she was diagnosed with a rare vaginal cancer called clear cell carcinoma. When viewed under a microscope, the cancer cells look clear. It’s typically found in the female reproductive system in postmenopausal women. 

“In my 15 years of practicing medicine, Liliana is the youngest patient I’ve treated for clear cell carcinoma – most of my patients are in their 60s,” said Dario Roque, MD, a gynecologic oncologist at the Lurie Cancer Center at Northwestern Medicine.

Since clear cell carcinoma of the vagina isn’t a childhood cancer, pediatric hospitals in Chicago wouldn’t accept Castaneda as a patient. On top of that, her mom only speaks Spanish, so it was important to have a physician who could communicate with Castaneda’s mom during appointments. 

Northwestern Medicine was ready and willing to take on her case. Dr. Roque, who is from Cuba and speaks Spanish, was easily able to communicate with Castaneda’s mom during the course of treatment which included chemotherapy and radiation.

Jonathan Strauss, MD, was Castaneda’s radiation oncologist at the Lurie Cancer Center, and oversaw both external beam radiotherapy and brachytherapy, a specific type of internal radiation therapy where a radioactive implant is put inside the body to deliver radiation directly to the tumor. 

“Liliana’s tumor was about the size of a golf ball,” said Dr. Strauss. “At the time of her diagnosis, the tumor was too large for us to surgically remove it, so we had to use external and internal radiation therapies to help shrink it. It took a lot of radiation to get rid of her tumor, along with chemotherapy.”

Certain cancer treatments, like chemotherapy and radiation, can negatively impact a patient’s ability to have children, which is why fertility preservation prior to the start of treatment is essential for many patients. But, since Castaneda was born with Turner Syndrome, a genetic condition that affects females and causes infertility, preserving her fertility was not an option or a choice the family had to make. Castaneda’s doctors also don’t believe her Turner Syndrome diagnosis had anything to do with her cancer diagnosis. 

 Thanks to the chemotherapy and radiation, Castaneda had tremendous results and was officially declared cancer-free in March 2021. Inspired by her Northwestern Medicine medical team, Castaneda, who is now 19 years old, is going to college and taking nursing classes.

“I can’t wait to become a nurse and help other kids navigate their medical journey,” she said.  

“We knew Liliana was going to do great things no matter what, but when she told us she wanted to go to nursing school, the entire Northwestern Medicine team that took care of her was very touched,” said Dr. Strauss.

Castaneda and her doctors also want women to know that they should contact their physician if they’re experiencing abnormal bleeding, bleeding between periods or after menopause, along with pain or urinary symptoms. Those are the first signs of clear cell carcinoma of the vagina.

“If you feel like something is wrong, don’t hesitate and get it checked out,” said Castaneda.

For more information on gynecologic cancer care at Northwestern Medicine, visit nm.org.