As 3-year-old Kirk Bryan launches into the song “All About That Bass,” you can’t help but notice his impish grin, his Harry Potter-esque glasses—and the truck-festooned patch covering his left eye.
At 12 weeks old, Kirk was diagnosed with retinoblastoma, a fairly uncommon but treatable pediatric cancer of the retina. Thanks to well-informed parents and innovative treatments at University of Minnesota Masonic Children’s Hospital, he’s flourishing.
Fortunately for Kirk and his family, treatment regimens for retinoblastoma have changed greatly over the years—and now have progressively better outcomes, said Pediatric Ophthalmologist Jill Anderson, MD, his physician. Kirk’s grandmother, for instance, was diagnosed with retinoblastoma at age 2 and had her eye removed.
But not Kirk. Anderson discovered a retina tumor at Kirk’s 3-month checkup and gave him laser treatment that very week. Unfortunately, Kirk’s eyes developed additional tumors, including one that required leading-edge treatment: intra-arterial chemotherapy, also called chemosurgery.
“This used to be a last-resort treatment,” said Anderson. When it was first developed, chemosurgery was only employed as an alternative so specialists didn’t need to remove the eye. Gradually, though, surgeons realized that the theoretical risks they anticipated from the therapy didn’t occur. “It was safer and more effective in some cases,” Anderson said.
The procedure begins with an incision in the femoral artery in the leg. Specialists send a tiny catheter into the femoral artery, through the heart and into the ophthalmic artery, which supplies blood to the eye. There, the chemotherapy is delivered directly to the eye.
That precise placement is why chemosurgery can be far superior to traditional treatments. Systemic chemotherapy can damage healthy cells and cause serious side effects, while radiation can cause disfigurement and increase the child’s chance of developing bone cancer later in life.
For one tumor, Kirk received chemosurgery treatment twice from Masonic Children’s Hospital Radiologist David Nascene, MD; for his other four tumors, Anderson provided laser therapy. “Chemosurgery is a really nice option to offer,” Anderson said. “In some cases, it’s the obvious choice.”
It’s a choice that wasn’t available when Kirk’s mother, Anne Bryan, also had the inherited form of retinoblastoma, for which she received cryotherapy and radiation.
Coincidentally, Anne’s medical team included Pediatric Hematologist-Oncologist Joseph Neglia, MD, MPH, who now treats her son.
“Bringing Kirk to the U felt like going back home, because there was Joe,” Anne Bryan said.
Kirk and his family travel from their Wisconsin home to Masonic Children’s Hospital every three months for checkups, and Kirk often wears a patch to ensure that his eyes and brain are working together. The Bryans are thrilled with his progress and hope for even greater advances in retinoblastoma therapies for future patients.“I would hope that a future treatment is even simpler and more effective,” Anne Bryan says. “If people continue to financially support research, it will be.”