patient names: James and Matthias Hoffman
patient ages (at diagnosis): 2 and 1
condition: DICER1 Syndrome, pleuropulmonary blastoma
seen in: hematology oncology
providers: Lionel Chow, MD
Twice the Courage: James and Matthias' journey through cancer, resilience and hope
James and Matthias Hoffman were just busy being kids. James was known for his endless curiosity, always asking, “What’s that?” as he explored the world around him. Alongside his baby brother Matthias, he filled his days with adventure, laughter and discovery. Their parents, Zach and Hannah, never could have imagined how much that curiosity, resilience and love for one another would help guide the boys through one of the most difficult chapters of their lives.
when everything changed
In January 2025, at just two years old, James was admitted to Dayton Children’s Hospital for a serious Haemophilus influenzae infection that affected his lungs. While James was being treated for the infection, tests showed something more serious: James was diagnosed with pleuropulmonary blastoma, a rare form of childhood cancer that forms in the lungs. James would need chemotherapy and surgery.
The news was overwhelming. The Hoffman family suddenly found themselves navigating appointments, scans and conversations no parent ever expects to have. Yet from the beginning, they found reassurance in the support from their family and friends and the team at Dayton Children’s.
“I broke down hearing the initial plan of needing 10 weeks of chemotherapy,” Zach shared. “That was just part one until surgery, then 26 weeks of chemotherapy post-surgery. As a nurse, I understood what this journey could look like for my son, which made it all feel very real. It was an absolutely overwhelming amount of feelings and fear.”
Despite the overwhelming diagnosis, the Hoffman family found comfort in the expertise and compassion of James’s care team. “When we met Dr. Chow on the day of diagnosis, he spent nearly two hours walking us through every medication, every possible side effect and every question we had. He answered everything with clarity, compassion and honesty. In that moment, we knew our son was in the right hands.” For Zach and Hannah, Dr. Chow’s knowledge was matched by his kindness and genuine care for his patients, helping the family face the difficult road ahead with greater confidence.
facing treatment with courage
James’s treatment journey included chemotherapy, surgery and frequent hospital visits. While each phase brought its own challenges, his family was continually amazed by his resilience.
Through it all, James found reasons to smile. He embraced each day with a determination that inspired everyone around him. He didn’t know this wasn’t how life was supposed to be. He simply trusted that his family and doctors loved him as they fought alongside him every day.
James participated in a clinical trial, an option made available by Dayton Children’s participation in the Children’s Oncology Group. After the first two rounds of chemotherapy, James’s scans showed his tumor decreased in size and activity. His doctors, encouraged by his response to the medications, moved his lobectomy – surgery to remove one of the lobes of the lungs – up to an earlier date.
another unexpected challenge
As Zach and Hannah focused on helping James through treatment, another difficult chapter began to unfold.
Their one-year-old son, Matthias, needed emergency bowel surgery at Dayton Children’s. The surgery was successful, but pre-surgery imaging revealed three lesions on his lungs that looked just like his brother James’s.
“Once again, the oncology and care teams at Dayton Children’s showed up, ready to fight for another one of our sons,” said Zach.
Just days before James’s lobectomy, Zach and Hannah heard the word they never expected to hear again: cancer. Matthias was also diagnosed with pleuropulmonary blastoma. Further testing revealed that James, Matthias and their father all carry the DICER1 gene mutation, a rare genetic condition that increases the risk of developing tumors in the lungs, kidneys, brain and thyroid gland.
Throughout their medical journeys, the brothers found comfort in one another.
One memory Hannah will never forget came after James woke up upset following a scan. As he cried, Matthias immediately ran to his bedside, sat next to him and gently patted his head until he calmed down. “Their relationship is very close and special,” Hannah shared. “Their love and compassion for each other is amazing.”
Matthias’ lobectomy was performed at Nationwide Children’s Hospital as part of a collaborative cancer, blood disorders and bone marrow transplant program with Dayton Children’s. The surgery was a success, and unlike James, Matthias did not require chemotherapy. Today, Matthias is cancer-free, bringing immense relief to a family that had spent months navigating the reality of two childhood cancer diagnoses.
the moment they had been waiting for
When a child is facing cancer treatment, finishing treatment and ringing the bell are moments families dream of.
For the Hoffmans, that moment came in January 2026. A year after their journey began, James stood before friends, family and his dedicated Dayton Children’s care team to ring the bell. The room was filled with the people who had helped carry the family through one of the most difficult years of their lives.
“As I looked around, I recognized so many people,” Zach shared. “Some nurses and providers had even come in on their day off just to be there for James. In that moment, it became clear that it truly took a city of people to help James through his battle.”
Hannah remembers thinking about everything James had endured throughout treatment and how proud she was of his determination and courage. It wasn’t just a celebration of completing treatment. It was a celebration of every appointment, every procedure, every difficult day and every person who helped make that day possible. It was a celebration of the days and years to come.
“Watching James ring the bell was honestly unbelievable and amazing,” Hannah shared. “His father, our families and I were there every step of the way. To finally be at the finish line felt like I could breathe again for the first time since diagnosis.”
James, meanwhile, was focused on something else. He simply wanted to ring the bell as loudly as he could without anyone telling him to stop!
Before leaving, Hannah added James’s name to the platform alongside other children who have faced cancer at Dayton Children’s. Seeing all those names together was a powerful reminder that every child, every family and every journey matters.
“Now, one year later, I know that the bell was not rung too early. It was perfect. James’ scans have continued to come back clear, with no new growths,” added Zach.
looking toward the future
“James and Matthias are running through the house, laughing and shouting with the joy only children can bring while two grateful parents watch with full hearts,” said Zach.
Today, the Hoffman family is embracing the everyday moments they once feared might never come.
James began preschool, and for Zach and Hannah, attending their first parent-teacher conference became a meaningful reminder of how far he has come. He quickly made friends and settled into the routines of childhood. His hair has even grown back just as it was before chemotherapy, complete with the unique swirl pattern that makes him unmistakably James.
During treatment, the Hoffman family postponed many outings and celebrations, as they spent months navigating scans, chemotherapy, surgeries, transfusions and hospital admissions while carefully protecting the boys’ immune systems.
Today, their lives look much different. The family has embraced what Hannah calls their “year of saying yes.” Besides James starting preschool, he joined a sports team and loves spending time at the pool. Matthias is talking more every day and eagerly follows his brother on every adventure.
Together, the boys spend their days swimming, exploring playgrounds, climbing, reading and discovering the world around them.
“This year is the complete opposite,” Hannah said. “It’s been a blast to watch the boys grow and blossom since finishing chemotherapy and surgeries.”
“We thank God every day for giving the amazing gifts and talents to the staff at Dayton Children’s. When I look back now, I see the long hospital stays, the surgeries, and the transfusions. But I also see something powerful. I see the unwavering support of the Dayton Children’s team and our community. I see the nurses, doctors, and medical staff who lifted our spirits, stood beside us, and carried us through both of our boys’ battles with cancer.”
“And for that, we are forever grateful.”
