Christopher Court - The diagnosis

The diagnosis

Christopher Court in the hospitalThe biopsy results came back indicating that Chris' tumor was an Anaplastic Astrocytoma.  Tumors are graded 1-4 with 1 & 2 being classed as benign and 3 & 4 as malignant.  The determination of the grade is based on how fast the tumor cells replicate and Chris' was diagnosed as 2 borderline 3.  Because the tumor was in an area that could not be operated on, Dr. Phillips decided to treat the tumor as malignant and hit it with everything available which meant radiation and chemotherapy.  Radiation can be very damaging to a child's brain and because of the location of Chris' tumor it would be necessary for the radiation beam to pass through healthy parts of the brain which could cause cognitive problems and quite possibly hearing loss.  Dr. Phillips recommended that Chris be given Proton Radiation.  This form of radiation is more targeted and does much less damage to the tissue it passes through on its way to the tumor.  There are only 5 hospitals in the country that have proton therapy and can handle children.  The University of Pennsylvania Hospital is one of them and shares its proton center with CHOP.  At one point it looked like they would not be able to fit Chris in to their busy schedule and that he would have to travel to Texas or Florida.  Luckily they managed to move things around in their schedule and fit him in, much to the relief of everyone involved.

The first couple of times Chris had an IV inserted, he was very brave and made little or no fuss.  One night, around midnight, they decided to change his IV because they could no longer draw blood from the old one.  He screamed when the new IV was placed and continued to cry long after.  Chris' parents called the nurse back to check the IV and she said it was fine and that he was making a fuss over nothing.  Eventually, he went to sleep.  When he woke in the morning his arm was 3 times its normal thickness from his shoulder down to his hand.  The IV had not been placed in the vein and the saline was being pumped into his arm.  From this point on Chris became terrified of needles.  Because his treatment would require so many injections it is standard practice to insert a "port".  This is a device placed in the upper chest just under the skin which has a small tube leading to an artery in the neck.  A needle can be inserted through the skin into the port and can remain in place for several days at a time.  The process of inserting the needle is referred to as "accessing the port" and is nearly painless.