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JEFF GAMMAGE

In August, the Trump administration informed Maria Perez and Josue Hernandez that they had 33 days to get out of the country — with or without their cancer-stricken, 8-year-old daughter, Jonayra.

Two weeks later, the ground shifted again: They were told the federal government would examine their case, potentially allowing them to stay in the United States for treatment.

Then last week came the news that they and other undocumented migrant families facing dire medical circumstances could be considered for relief.

It’s been a whipsaw for parents who worry that a forced return to Mexico could mean the end for their child, an American citizen by birth.

“Hopefully, we’ll get to stay,” Hernandez said.

After an uproar from community advocates, families, medical professionals, and elected officials, U.S. Citizenship and Immigration Services (USCIS) announced last week that it would resume processing applications for “deferred action,” a small humanitarian program that lets undocumented families stay and work in the country while fighting serious or life-threatening illnesses.

Immigrant advocates caution, however, that accepting applications does not mean USCIS will approve them.

“We might be back in the same boat two months from now,” said Audrey Allen, a Conshohocken immigration attorney who represents the Hernandez family. “It’s literally just wait and see at this point.”

The ACLU of Massachusetts called the government’s restoration of the deferred-action program “an encouraging development” but said that, at least for now, it was leaving in place a lawsuit it filed over the matter.

Questioned about the policy shift, USCIS referred to its earlier statements. In a letter, acting USCIS Director Ken Cuccinelli said the agency had been directed by the Department of Homeland Security to ensure that the procedure for handling requests was “consistent” and that “discretionary, case-by-case deferred action is granted only based on compelling facts and circumstances.”

Hernandez, 38, and Perez, 35, crossed the border in 1999, and today live in Vineland, a city of 61,000 in South Jersey, where he works a construction job. He has had one contact with law enforcement: In 2006, he was stopped for driving under the influence, and entered the New Jersey Pretrial Intervention program, which offers an alternative to prosecution.

Like Jonayra, her 12-year-old brother, Josue, who also has health problems, was born in the United States.

The big trouble started in February, when Jonayra came home from school with a swollen right knee.

Had she bumped into something? her parents asked. Maybe fallen and banged her knee? Jonayra insisted she had not.

Her parents took her to a doctor, who immediately referred the girl to Cooper University Hospital in Camden, which two days later transferred her to St. Christopher’s Hospital for Children in Philadelphia.

Surgeons removed part of Jonayra’s back and neck, excising a mass nearly two inches wide. She was diagnosed with stage 4 large B cell lymphoma, which had metastasized to her liver, spleen, kidney, and bones.

Jonayra didn’t leave the hospital for three months. Today, after intensive chemotherapy, she is home and healing, able to return to school, but weary and confronting follow-up care.

She misses the long black hair that once reached the center of her back.

The family’s deferred-action saga started last month, when USCIS informed undocumented families that the agency would no longer consider applications, even for those fighting terrible illness. They were given little more than a month to leave or risk deportation.

Amid the ensuing public outcry, USCIS announced on Sept. 2 that it would “complete the caseload” of about 400 deferred-action cases that were pending on Aug. 7. That created its own complications, because people in similar situations would be treated in different ways:

Families who had not applied before that date were out of luck.

Those who already had been granted deferred action, but were not yet due to renew, could stay in the country for now. But they could be removed once their protection expired in weeks or months.

Then there were those like the Hernandez family, who in August were denied deferment — then granted consideration because their application was among those pending as of Aug. 7.

The family had filed in April, about a month before Jonayra was able to leave the hospital. Technically, only the parents are in danger of deportation, but the children are fully dependent on their mother and father.

A deferment grants no immigration status, but prevents removal by U.S. Immigration and Customs Enforcement. It also provides permission to work, so families can get jobs and employment-sponsored health insurance.

“In my 20 years in the immigration field, I have never seen the government reverse itself in the span of one month,” said Shoba Sivaprasad Wadhia, a Penn State Law professor who directs the university’s Center for Immigrants’ Rights Clinic. “Such victories often take years or generations.”

Ending the program served no one, she said, not even the Trump administration, which eliminated its own flexibility in these cases.

For decades, both Republican and Democratic administrations embraced use of that discretion, recognizing that individual cases can require nuanced responses. Deferments had been commonly sought and granted for children with leukemia, spina bifida, cancer, burns, autism, and cerebral palsy.

In many cancer cases, staying in America is crucial, because relapse rates are much higher in developing nations, even when patients get similar treatment, studies show.

In this country, a child with cancer could spend three years in treatment amid inpatient, outpatient, and emergency-room visits, said oncology social worker Robin Capecci, who has worked 30 years at St. Christopher’s Hospital. Those young patients need ongoing lab work, follow-up care, and medical monitoring, even as they recover.

“You worry about children being sent back to another country in the middle of care,” she said. “Can they get the follow up, get the treatment, at the right time?”

Hernandez and Perez never married, but have lived together as a family since the birth of their son in 2007.

Josue was born with immunodeficiency, which prevented his body from fighting infections and diseases, making him vulnerable to viruses and bacterial infections. Every three months, Josue had to have his blood checked by sticking a needle into his stomach.

Doctors trained Perez and Hernandez to perform that test at home. By the time Josue turned 3, his parents could manage his immunodeficiency and were ready to have another child.

Jonayra was a healthy baby, but at age 4 began to suffer constant fevers and colds. At 5, her parents learned that she, too, had immunodeficiency — specifically, common variable immune deficiency.

CVID patients have low levels of immunoglobulins in their blood, resulting in a loss of antibodies and a decreased ability to fight invading microorganisms and toxins. They’re more prone to develop certain forms of cancer.

Hernandez and Perez worry for Josue’s future. And for Jonayra now. She takes about 10 medications a day, gets a monthly checkup, and undergoes a CT scan every three months.

“Some days, she feels good,” Hernandez said. “Other days, not so well.”

The parents try not to show their apprehension, hiding fears that their children’s health could collapse if the family must go to Mexico.

“I pray to God,” Perez said, “to protect them.”