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Promise and Progress - In Lauren's Head

Faces of Childhood Cancer

In Lauren's Head

Date: June 1, 2004

In her mind, 13-year-old Lauren Murphy could see herself dancing across a Broadway stage.  She could visualize a future filled with new experiences and opportunities. But, not even in her wildest dreams did she imagine a cancerous brain tumor or the ensuing battle she would have to wage to rid her mind of this invading foe.

Lauren Murphy had been dancing for as long as she could remember. Almost instinctively in step with the beat of the music, the 13-year-old was a natural, earning the lead in many community plays and even being invited to perform with the Moscow Ballet.  February 2003 was different though. She stood in her dance class, feeling unsteady and nauseous. As she sat down, leaning against the wall, the subtle rhythmic vibrations of the music and the dancers’ feet upon the floor that had once brought her such great pleasure now rumbled in her head with the chaotic discord of an earthquake.

She had suffered headaches before and even bouts of nausea and vomiting. But this time was much more severe. As instinctive as her movement on the dance floor was the nagging feeling in her gut that something was seriously wrong. She sat on the bathroom floor of her dance studio and cried until she mustered up enough energy to call her mother.

Because of her prior bouts of dizziness and vomiting, Lauren had already undergone a variety of tests, from blood work to an eye exam. Her pediatrician had explored everything from low blood sugar to mononucleosis, but could find nothing wrong other than a need for eyeglasses. This could be the cause of the headaches, Lauren thought, but could it be enough to cause the severe symptoms she experienced in dance class? With no other medical explanation for Lauren’s continuing, and now worsening, symptoms, her pediatrician ordered a CAT scan.

That night as she lay in her bed chatting with her sister and friends about the CAT scan to be done in the morning, she uttered, almost jokingly, what in reality was her greatest fear: “I hope they don’t find something like cancer.”

Her Worst Fear Realized

The day after her CAT scan, Lauren’s pediatrician sent her for another test known as an MRI (magnetic resonance imaging) that would provide a more detailed image of her brain. Though she was a bit concerned that another test was needed, she was feeling upbeat.

With the ring of her mother’s cell phone, however, Lauren’s whole life would change. Her mother listened in disbelief as Lauren’s pediatrician explained that the CAT scan and MRI had revealed a brain tumor and instructed her to take her daughter directly to Johns Hopkins. Lauren saw tears begin to stream down her mother’s face and started to cry herself. Without a single word being spoken between them, she knew that her greatest fear was coming true. Stopping the car in the middle of traffic, Ruth and Lauren embraced and cried, oblivious to the passing drivers’ blaring horns. The drivers were just as oblivious to the significance of this traffic jam and the life-changing event to which they were unknowing witnesses.

Ruth and Lauren changed direction, and headed for Johns Hopkins.

Is This Really Happening to Me?

One of the first things that goes through a person’s mind when she learns she has cancer is, Am I going to die? When she learns the cancer is in the brain, there are added worries: Even if I survive, will I ever be the same? After all, the brain is the sanctuary for all that is truly human—our thoughts, our dreams and aspirations, our personality—the very core of who we are and what we can ever imagine becoming. 

As director of the Kimmel Cancer Center’s pediatric neuro-oncology program, Ken Cohen is all too familiar with this scenario. From the vicious and virtually incurable brain stem gliomas to the typically more manageable medullablastoma and ependymoma, he has been a witness to the many ways cancer can attack a child’s brain and has been on the front lines developing national studies to combat these cancers. “We do everything we can to make sure we send parents home with the same child they brought us,” says Cohen. To do this, he works with a team of specialists, including neurosurgeons, radiation oncologists, pediatric oncologists, neuroradiologists and neuropathologists. 

Tests indicated that Lauren’s spinal fluid was free of tumor cells, and there did not appear to be other lesions outside of the main tumor in her brain, so Cohen felt confident the team would be able to cure her.

Still, it would not be an easy journey for the young teen. School, dance lessons, chats with friends and trips to the mall would be replaced with surgery, chemotherapy and radiation treatments.  Her beautiful, honey brown hair would soon be gone as first, in preparation for surgery, a portion of it was shaved off. She would lose the rest later as her hair cells became innocent victims of the radiation therapy and anticancer drugs that would circulate through her bloodstream to seek out and eliminate the real enemy—any remaining cancer cells that broke away from the brain tumor.

Medulla What?

Lauren’s golf-ball-size tumor was a medulloblastoma, located in the middle of her cerebellum, the balance center of the brain. As the tumor grew, it began to cut off the flow of spinal fluid from her brain, explaining Lauren’s worsening symptoms of dizziness and nausea, even her declining vision.

“Medulloblastomas are fairly aggressive tumors that usually make their presence known quite quickly,” says Cohen.  Though brain tumors are among the most common of childhood cancers, they are still quite rare in the general population, with about 2,500 new diagnoses each year. “For every thousand children who show up at the doctor’s office with symptoms like Lauren’s, only one will have a tumor like this,” explains Cohen.

It was all happening so quickly, Lauren barely had time to think. Within days of learning about her tumor, she would be facing brain surgery to have the tumor removed.

“When dealing with the brain, the surgeon doesn’t have the luxury of cutting extra tissue around the tumor just to be sure he’s gotten all of the tumor cells,” explains Cohen. It was a nerve-wracking, five-hour tug of war as Children’s Center neurosurgeon Jon Weingart navigated the narrow margin between Lauren’s tumor and healthy brain tissue. Like other vital organs, the brain is necessary for life. But unique to the brain is its control over both the physical and emotional elements that are the very essence of living. As a result, each cut is planned and mapped out with mathematical precision.

Lauren’s surgery was successful. Weingart got the tumor with no apparent permanent damage to any other area of Lauren's brain.

Just four days later, she went home to recuperate before returning for radiation therapy. That night, despite being weak from the surgery, she was determined to return to her normal life and decided to go see a school play. Donning a hat to cover her scar, Lauren had planned to sneak in quietly to watch the play. But, friends who had not seen her since her diagnosis soon crowded around her, their good intentions somehow suffocating. She excused herself to escape to the restroom, but even this proved difficult as temporary double vision caused by the surgery made her feel blind as she stumbled through the dark auditorium, tripping over wires and running into chairs. This would be part of the harsh reality of her disease and the struggle to recover. In addition to the double vision, Lauren would also have to battle continuing nausea and vomiting. Her body, now 20 pounds thinner, was beginning to show the signs of her struggle, and she knew she would have to slow down.

Looking Ahead

After a six-week rest at home, Lauren returned to the Cancer Center for radiation therapy. From May through July, Lauren came to the Cancer Center daily for 31 radiation treatments. Her last treatment was on Independence Day 2003. Her next challenge would be eight cycles of chemotherapy to clean up any cancer cells hiding in her body.

Independence Day 2004 held still greater significance for Lauren. With her chemotherapy complete, she can at last see the light at the end of the tunnel. Though she will continue seeing Cohen for follow-up care, her active therapy is done. It will never be life as usual for Lauren, though. This teenager has the life experience and wisdom of an adult. “One year ago, I was like every other girl my age,” she says. “Hair and make-up were all that mattered. I don’t care about that kind of stuff anymore. I realize there are things that are much more important.”

With a spirit that is uniquely Lauren, she is ready to look ahead. Whether it be returning to dance or on to another challenge, not even a brain tumor can daunt her. She says with a smile, “I’ve been thinking about taking up soccer. Yes, I think I’ll give soccer a try.”