The driver extends one gloved hand past the open door of his cream-colored stretch limo and grasps the manicured fingers of the guest of honor. Karina Moreira emerges slowly onto the Waltham street: silver thong sandals, bare legs, a black dress with rhinestone neckline, a shy smile in hot pink. Her shadow of dark hair looks sleek, as if she, and not chemo, had chosen this style.
Her 12 best friends, young women with an abundance of long hair, follow her out of the limo and into La Campania, an Italian restaurant. Tonight, they are celebrating Karina’s 16th birthday, laughing and posing for pictures. They sing “Happy Birthday” in English and Portuguese, talk about the World Cup and the virtues of Neymar, a celebrity in their home country, Brazil.
Karina gives her friends iPhone cases that say “chic by karina,” the fashion blog she began writing in 2012, when her bone cancer was in remission. She continued to blog last year, when the cancer returned. But her optimism, her joy in daily life, and her playful fashion advice have catapulted her to fame, especially among Brazilians.
In less than two years, she has attracted 133,000 Instagram followers. Dana-Farber Cancer Institute , whose doctors are treating her osteosarcoma, has asked her to video blog on its YouTube channel. Last December, superfan Gisele Bundchen , who is also Brazilian, made a surprise visit to the Moreiras’ Malden apartment and made a video with her.
Bundchen taught Karina an expression she had never heard. She thinks about it often because it comforts her.
“So my life right now is lemons because I have cancer,” Karina said a few weeks ago, sitting in her bedroom. “But I made it a lemonade with my blog. I made it more sweet.”
“You made something good,” said her mother, Daniela, smiling at her.
“Yeah, I made something good,” Karina said softly.
She won the limo ride that delivered her and her friends to La Campania. The restaurant’s owner donated the birthday dinner. Afterwards, the limo driver took the group to Boston’s Public Garden, where they posed for pictures in the city’s glow. They didn’t want to forget this night.
Karina’s second round of cancer has been aggressive. Even as she receives chemo, via an oral pill, her tumors continue to grow. Her doctors have told Karina and her parents that they don’t expect her to survive.
Her parents were considering a clinical trial at a Texas hospital but last month, her lungs collapsed. Doctors implanted a tube in each lung to drain blood and other fluid. Last week, she was back in the hospital so doctors could replace the tubes, which had clogged.
Even as a young child, Karina loved makeup, annoying her mother by wearing her lipstick. Later, Karina distracted herself from the world of sickness by reading fashion magazines in the hospital. Now, makeup soothes her and takes her to a place of beauty, far from her weakening body.
“I thought it would be a blog for people that are going through something difficult in their lives, with makeup and beauty tips,” she said. “I wanted to share with the girls that they can feel beautiful.”
Karina contributed several videos to Dana-Farber’s YouTube channel, including one on how to style a bald head with scarves and headbands, made last winter, after she lost her hair for the second time.
Karina, who arrived in America with her parents and older brother when she was 3, writes and speaks on her blog in English and Portuguese. Her popularity surged after Bundchen posted an Instagram photo of herself with Karina.
“You are [a] warrior, an inspiration of positivity and courage,” Bundchen wrote. “I will be praying for you. Sending you love and light always.”
In January, Karina attracted more followers after she appeared on a popular Brazilian news show called “Fantastico.”
She talks openly about her health as she gives fashion advice. In a recent video about summer makeup, she told viewers that she had just returned from the hospital. “So I’m home and I decided to do makeup because what better thing to do than sit at your own table filled with makeup and record a video for you guys?” she said. She blew viewers a kiss, as she always does. And then she turned to the makeup.
When Karina first went bald, she worried what people would think of her new look, so she ordered a wig that resembled her hair. She wore it once, to a wedding. It itched. She stashed the wig in her closet and never wore it again.
“I realized that I didn’t have to wear the wig, that people already knew I had cancer,” she said. “I didn’t have to cover it. You know, bald is beautiful.”
She has been chosen as a 2014 Boston Marathon Jimmy Fund Walk Hero, and matched with a team of walkers raising money for cancer research at Dana-Farber. Karina’s photo will be displayed at mile marker 25 during the Sept. 21 walk.
She has always been shy in larger groups, but since she started blogging when she was 14, she has become more confident, more open. “She’s definitely growing into herself,” said Pillar DeSouza, 21, a friend from Malden.
Karina was diagnosed with bone cancer in 2011, when she was 13, after her right leg began aching and bruising during exercise. Doctors at Dana-Farber gave her chemotherapy and radiation. They removed the diseased bone and replaced it with healthy bone. Her shins still bear the long vertical scars of the incisions.
In late 2012, her doctors announced that she was in remission. Last July, she celebrated when her parents threw her a traditional festa de 15 anos, a 15th birthday party for girls, with nearly 200 guests.
But the remission didn’t last long. Her hair, which was growing back, fell out with more chemo. Karina’s current chemotherapy is kinder to her follicles, and her hair, once long, is growing back again.
Daniela sold her housecleaning business to care for her daughter, and the family has struggled with the income loss. Karina’s father works in construction. Karina has MassHealth, the health insurance program for low- and middle-income families, because her family is documented.
She tries to stay positive for her family, friends, and followers, some of whom are sick, too. Many of her friends are Christian; her family goes to Life Church in Medford. They pray for Karina and believe that God can still bring about a miracle.
“You would never know that she is as sick as she is,” said Dana Brown, principal of Malden High School, who visits her regularly at home. “She’s not down. She’s not depressed. She’s not feeling sorry for herself.”
Karina believes staying upbeat can only help herself and those who look to her. But she also recognizes the perilous state of her health. Her bucket list includes creating her own makeup line. If she can make it happen, Romero Britto, a Brazilian pop artist from Florida, has agreed to donate his design services.
Karina’s favorite book is “The Fault in Our Stars,” by John Green, about a 16-year-old girl with incurable cancer. The novel, which made her cry, felt realistic. She identified with the unique sorrow of bearing a fatal disease: bringing suffering to the people you love the most.
“Whenever I’m with her, I really try not to cry,” said Eduarda Pereira, also a sophomore at Malden High, who has known Karina since second grade. “I get teary-eyed.”
Karina hates to see her mother cry. When she saw her brother weep after a friend was killed in a car crash last winter, she imagined him crying over her own death.
“I try to spend as much time as I can with her,” said Lorena Ferraz, 17, of Brockton, who met Karina last year. “I try to remember the good times. If it’s not her plan to stay longer, I’ll at least have good memories with her.”
At a recent appointment at Dana-Farber’s Jimmy Fund Clinic, Karina’s miracle hadn’t arrived, at least not yet. The cancer was still growing. Daniela pushed her in a wheelchair because her legs ached.
Karina has started taking morphine for the pain. The doctors talked with Daniela and Karina about procedures that might ease the pain — either more radiation, or cryoablation, where extreme cold is used to kill cancer cells — although they won’t stop the cancer from advancing.
Her oncologist, Dr. Jennifer Mack, had promised to finish the appointment in time for the World Cup semifinal. Karina and her mother barely made it, but they slid into a tall booth near a television at a Fenway sports pub, where Karina’s father was waiting, minutes before the game began.
Karina had wrapped herself in the Brazilian flag, a blanket of green, yellow, and blue, white stars streaming over her shoulder. She tipped her head and made her trademark peace sign with her right hand, her wrist still shackled with the white hospital bracelet.
The Brazilian team would go on to lose to the Germans, 7-1, in a heartbreaking game. But Karina didn’t know that yet. She smiled as her mother took her picture. She still had hope.