The 4-year-old daughter of a Florida officer was made an honorary state trooper in Pennsylvania this week amid a cancer diagnosis that landed her at Children’s Hospital of Pennsylvania (CHOP). Rose Ramirez, who was diagnosed with high-risk stage 4 neuroblastoma in October, smiled from her stroller as a trooper hat was placed on her head.

“The Troop K family would like to present this little trooper with her first campaign hat,” Lt. Joseph Altieri said in the special ceremony. “We hope her first big hat will keep her strong and determined through this extremely difficult fight.”

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Nicole Ramirez, Rose’s mother and a former Florida prosecutor who has been keeping supporters updated on the “Team Princess Rose” Facebook page, said that the family feels “so blessed” to have support while away from home, Fox 29 reported.

“I really feel so blessed to have so much support up here because I really felt so alone when I first got up here,” Ramirez said at the ceremony. “And then law enforcement started reaching out to us and it’s just really great to be in a big city not knowing anyone, the hospital is huge, not knowing anyone, just having support and love come in, it means a lot to us.”

Ramirez said she first brought her daughter to the pediatrician in October after she noticed the then-3-year-old had lost her appetite. She said she “never in a million years” thought her daughter had cancer.

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Neuroblastoma may cause a lump or swelling in a child’s abdomen, swelling of the legs, chest, neck and face, enlarged belly, problems breathing or swallowing, weight loss, loss of appetite or feelings of fullness, problems with bowel movements, pain in bones, bumps in skin, drooping eyelid, eyes that appear to bulge, or problems being able to move or feel parts of the body, according to the American Cancer Society.

The cancer starts in early forms of nerve cells most often found in an embryo or fetus, and typically occurs in infants or young children. Some grow and spread quickly while others develop slowly. Treatment typically is determined by assessing risk group, age, and other factors.

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The family, which includes Rose’s younger brother, relocated from Florida to CHOP for the duration of her treatment, which includes surgery, seven rounds of chemotherapy, stem cell transplants, proton therapy and immunization therapy.

Rose has already undergone four rounds of chemotherapy and a surgery to remove most of a large tumor in her abdomen, as well as her left kidney, Fox 29 reported.