Rosa Salazar Talks About How Varian's SmartBeam™ IMRT Helped Her Son Recover from a Brain Tumor.

Joshua Chapa is a 10-year-old boy living and attending school in Austin, Texas. He was treated for a brain tumor at Austin Cancer Centers in Austin, Texas.

Describe the type of cancer you have
Brain tumor on pineal gland.

When/how did you discover Joshua had cancer?
In June 2002, when Joshua returned to Austin from a vacation in Mexico he began vomiting, and had diarrhea and a high fever. I took him to the emergency room at the Promed Clinic in Austin, and they thought it was a virus, possibly from something he ate or drank in Mexico. This was his first visit with the doctor outside of his regular check up because he had always been so healthy before. They gave him medicine to control the fever and vomiting, and they put him on an IV for the diarrhea. We took him home and continued with the medicine, but Joshua didn.t seem to be making any progress. Then we noticed that his right eye was turning inward toward his nose and he began to complain more and more about headaches. By this time, we.d visited with our regular doctor and been to several emergency rooms and he wasn.t getting any better. He still had severe headaches and vomiting and his right eye was still turning to the left. The ER folks said he had a stomach virus and gave him antibiotics. (We found out later that spinal fluids that were being blocked by the tumor caused the so-called stomach virus and headaches, backing up in his system and draining through his sinuses.)

Joshua's eye-turning was really starting to become extreme and the antibiotics didn.t seem to be doing him any good -- he was still having headaches and sleeping a lot -- so I took him to Dr. David Hade, an eye specialist, on August 28. Dr. Hade dilated Joshua's pupils to determine what the problem was and after a very quick examination he told me to take Joshua to the Brackenridge Children's Hospital (Austin) emergency room where he had arranged for him to have an MRI.

Joshua spent the next five to six hours having MRIs and being seen by different people including a neurosurgeon. At this point, I suspected something was seriously wrong with him. This was confirmed with the MRI technician told me that Joshua had a brain tumor. This was followed by a visit from Dr. Wilson, the neurosurgeon, who admitted Joshua to the cancer ward. My husband, Steve Cunningham, had arrived at the hospital by this time and we met with Dr. Wilson who explained to us how the brain tumor was putting pressure on the pineal gland and blocking the flow of spinal fluid. He told us that he was going to perform emergency surgery on Joshua to install a tube that would reroute the blocked fluids back to their normal path. Dr. Wilson performed the surgery the next morning, August 30.

At this point, Joshua knew that he had a problem, but he was gathered his strength. Even lying on the hospital bed with his eye turned right into his nose, he told me, .Don.t cry, mommy. I.ll be okay..

Later, after he.d broken the news to us, Dr. Wilson explained to Joshua about the tumor.

What was your reaction?
I took it hard. We both did. At first, I couldn.t believe it and thought that Dr. Wilson was joking with me or had made a mistake because Joshua had always been a healthy child and the tumor seemed to have come out of nowhere. But when Dr. Wilson showed me an image of the tumor, I knew it was serious and called Steve at work. He dropped everything and rushed over to the hospital immediately. I also called my two other children and Joshua's family was at his bedside within the next 30 minutes.

What did you do?
Once the surgery was complete on August 30 and the tube inserted, Joshua was quickly back to normal. He was happy again and had his appetite back. Dr. Wilson told us that he would schedule a series of MRIs to monitor the tumor.

The following month (September 2002), the MRIs showed that the tumor had not grown, but Dr. Wilson felt that it had grown a little and suggested that he schedule surgery for October to remove the tumor.

We took some time to think about this because the surgery was a frightening prospect. Finally, we agreed that it was for the best and the surgery took place on October 29 at Brackenridge Children's Hospital. When Dr. Wilson spoke with us after the surgery, he confirmed that there had been significant growth in the tumor and that a biopsy revealed that it was malignant. He had managed to remove 99 percent pf the tumor and recommended a course of chemotherapy and radiation to eradicate any remaining residue. The chemo would be carried out at Brackenridge, and on October 31, he referred Rosa and Steve to Dr. Stephen L. Brown at Austin Cancer Centers for the radiation treatment.

What other treatment options were you given?
None. Dr. Brown told us that Joshua had a highly recurring tumor but that there was a 99 percent chance of removal with the chemo and radiation therapy.

Dr. Smith from Brackenridge Children's Hospital surgically implanted a Portacath to administer Joshua's chemo. (A Portacath is a small tube that is put into the chest so blood samples can be taken and medicines and fluids can be given easily. It can stay in place for a long period of time.)

Did you do any research about IMRT or other options?
No. We were happy with Dr. Brown's recommendations.

Describe Joshua's IMRT experience.

When did the treatment start and end?

November 25, 2002 through January 10, 2003.

How many treatments did you have in that time?

45 treatments. 5 days a week for 9 weeks.

Was it painful?

No. There was some initial discomfort with the mask and also the tattooing. Joshua weighed 75 pounds before the treatment and had gained 110 pounds because of the steroids, so positioning him on the table was hard. He was also intimidated by the machine in the beginning.

Were there any side effects?

Dr. Brown had told us that the radiation could affect Joshua's hearing and vision and that there could be some vomiting. Joshua did vomit on the first day, but he was fine after that and had no other side effects.

How was the procedure described?

Dr. Brown explained that the beam would be focused like a pencil so it could treat the tumor and not affect the healthy tissue surrounding it.

Are you happy with your decision?
Yes.

How do you feel about your doctor and staff?
They are wonderful. They explained everything and made us both feel comfortable.

How is Joshua doing now?
He is back in school. He had the Portacath removed on February 18, 2004. His weight is down to 72 pounds. He is still affected by the way his eye turned and has double vision, so he is unsteady on his feet from time to time. But he can ride his go-kart.

In September 2003, Joshua received a Bravery award from the American Cancer Society at a ceremony held at the University of Texas.

He has also appeared on various radio and TV marathons to raise money for cancer. And he recently made a Nike commercial.

What's your advice to others?
Leave it to the professionals. Don.t be afraid to try something new. We would definitely recommend IMRT.