State’s youngest radiosurgery patient fights off brain tumor Kekaha residents Corey and Leslie Todd beamed with pride when their son Colby was born Dec. 5, 1999. The boy’s mother, a Kaua’i Veterans Memorial Hospital nurse, and his father, an American
State’s youngest radiosurgery patient fights off brain tumor
Kekaha residents Corey and Leslie Todd beamed with pride when their son Colby was born Dec. 5, 1999.
The boy’s mother, a Kaua’i Veterans Memorial Hospital nurse, and his father, an American Medical Response paramedic, embraced bright dreams for their son, hoping he would grow up to become a hard-working, honest and contributing member to society.
The dreams nearly came to an end last December after Colby, 1 year old at the time, was diagnosed with a brain tumor.
Conventional surgery to remove cancerous cells was out of the question because it could have left the child, due to his young age and complexity of the surgery, with brain damage.
Instead, the Todds opted for a procedure they hoped would give their son a second chance at life: Gamma Knife radiosurgery, a non-invasive procedure using radiation to sweep away small knots of cancerous cells.
On July 18, Dr. Michon Morita, a neurosurgeon at Kapiolani Medical Center for Women and Children, successfully performed the procedure at St. Francis Hospital on O’ahu on Colby, believed to be Hawaii’s youngest Gamma Knife surgery patient.
Although it has been nearly two months since the operation, and Colby has gone home and has resumed a normal life, his parents still fret. No one will know the results of the operation until July, when tests will determine whether the procedure killed or neutralized the cancer.
Gamma Knife Radiosurgery is regarded as a revolutionary procedure that gives hope to patients with brain tumors once considered inoperable. Surgeons operate on abnormal areas of the brain without making an incision, dispensing with the risk of bleeding or infection.
Using a technique called stereotactic radiosurgery, the procedure precisely targets and either destroys or halts abnormalities within the head using highly-focused gamma rays.
With the advent of modern imaging techniques, such as the Computerized Tomography (CT) scan and Magnetic Resonance Imaging(MRI), Gamma Knife Radiosurgery has become increasingly popular.
It works like this:
– The patient’s head is fitted with a lightweight frame, which will hold him still during treatment.
– A map is made of the patient’s brain, either by means of a CT scan, an MRI or an angiogram.
– Images of the brain are transferred to a computerized treatment planning system, which isolates the brain abnormality and determines its location.
– The patient’s head is positioned inside a helmet, which has 201 portals through which the gamma rays are sent. The treatment lasts between 15 and 45 minutes, during which the patient is sedated.
Recovery from the procedure is usually quick, and the patient is released from the hospital the next day.
About 100,000 patients throughout the world have been treated with the rays over the last 30 years. The procedure was developed in Europe 50 years ago, and the first Gamma Knife machine was brought to the United States in 1987.
Until the Thanksgiving weekend last year, the Todds didn’t know anything about the procedure. During the week, Colby “started going cross-eyed, was using peripheral vision, was walking sideways,” experienced nausea and vomited, Cory Todd said.
Colby’s condition alarmed his grandmother, Thelma Aana, when he visited her home in Waimea Valley.
Her son had always been in good health, said Leslie Todd. But during a visit to Colby’s pediatrician at Wilcox Memorial Hospital, Dr. Robert Wotring, on Dec. 4, a CT scan showed fluids had accumulated in the boy’s brain.
Colby was flown the same day to Kapiolani Children’s Hospital, where an MRI revealed a tumor the size of a pea in the middle of his brain.
The announcement caught the Todds offguard. Both they and their families had no serious illnesses previously.
“This thing took my breath away, because we (as members of the medical profession) knew about the bad things that could happen,” Leslie said. “I knew my life’s son was at stake.”
On Colby’s birthday, Dec. 5, a ventriculostomy was performed to drain fluid from his brain to guard against blindness or brain damage. When the swelling subsided after the procedure, Colby’s health returned, he went back home and “everything seemed okay,” Cory Todd said.
A biopsy was also done and test samples were sent to Texas Children’s Hospital in Houston, Texas, St. Jude’s Hospital in Tennessee and Johns Hopkins Medical Center in Baltimore, Md., three of the top cancer treatment centers in the world. It was determined the cancer was of a “low grade and non-cancerous,” but also could become aggressive and spread, Cory Todd said.
The experts suggested we “wait and see,” and that followup examinations be done every three months, Leslie Todd said.
Colby’s health was still in good order, but Morita recommended the Gamma Ray procedure to control the tumor, whether it was cancerous or not. The doctor “felt it was the best cure,” Leslie said.
Morita had to get permission from a St. Francis Hospital committee before the operation could be undertaken. The committee rejected the request, citing Colby’s young age and recommendations of cancer research centers to hold off on the procedure unless Colby’s condition worsened.
To help the Todds better understand the procedure, Morita recommended the couple contact the University of Pittsburgh, one of the nation’s leading cancer research centers. Dr. Dade Lunsford, an international authority on pediatric radiosurgery, also recommended delaying the procedure.
But an MRI done in June showed the tumor had grown by 10 percent, prompting the St. Francis committee to approve the operation.
Lunsford offered to have the operation done at his university’s School of Medicine, a nationally-renowned teaching and research facility. But the Todds said they chose to have the operation done in Hawai’i partly because “we were afraid of going through a mainland medical teaching institution where our child might be just a number. In Hawai’i, (medical personnel who treated Colby) knew him personally,” Leslie said.
The Todds also believed Morita had the expertise, and they were heartened by his dedication to their son’s well-being.
“He was there from the beginning for us and lobbied to have the operation,” Cory said.
With his parents by his side, Colby went through a four-hour procedure, including preparation, at St. Francis on July 18. He returned home to Kekaha but will go through a followup checkup at Kapiolani Hospital in October.
There is no guarantee the procedure worked. And if it didn’t, another Gamma Knife operation could be performed, or chemotherapy or other radiation treatment could be used.
Whatever future risk might surface, Cory said he’s glad his son went through Gamma Knife radiosurgery.
“My wife and I have dreams for our child, and this procedure keeps that dream alive,” he said.
Staff writer Lester Chang can be reached at 245-3681 (ext. 225) and mailto:lchang@pulitzer.net
