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14
April 2022
"Now the son wears an original hairstyle that covers the traces of surgery, goes in for sports, loves cool cars and makes eyes at girls. Everything is like ordinary guys!", - writes Valentina Tedeeva in the comments to the photos of eight-year-old George.
The experience three years ago – the shock of the diagnosis, confusion, months of treatment and recovery – are gradually fading into the past, although they are not letting go completely yet. Georgy and his parents continue to travel several times a year from the polar village of Nickel to St. Petersburg, to the Medical Institute named after him. Sergey Berezin (MIBS) – for a control MRI examination and for a consultation with his radiologist. "It is considered that it is optimal to pass "controls" on the same device. We decided to strictly follow the protocol while there is such an opportunity. The procedure has already been worked out: arrival - a snapshot- a good result – a walk around your favorite city. I hope this will continue!", - says Valentina.
Mom of rapid response
The situation with the child's illness, according to Valentina, "developed as standard": symptoms appeared one after another, as according to a textbook. But in this story, the parents' concentration and readiness for immediate action clearly look out of the box.
Perhaps it's the Tedeevs' professional skills: being entrepreneurs, they are used to round-the-clock responsibility for their small business and to quick decisions. Or, maybe, the rich maternal experience affected, because two more older schoolgirls are growing up in the family. But, one way or another, it took only about three weeks from the son's first complaints of malaise to the surgical removal of the tumor and the establishment of an accurate diagnosis. "I think the fact that we did not let the situation take its course, and our doctors promptly collected the documents, were able to mobilize and reach the operation in the shortest possible time, helped a lot to do everything on time, and George recovered so quickly," the boy's mother believes.
When in April 2019, five-year-old Zhora had a severe headache in the neck area, Valentina, who was always responsible for the health of children, immediately took him to the doctor. The pediatrician did not suspect anything "criminal": he assumed that the neck muscles were blown out after the pool, prescribed ointment and let him go home.
But a few days later, George burst into tears right in kindergarten: his head hurt more and more. This time the therapist wrote out a long list of tests, sent them to an X–ray and to an optometrist - and again nothing was found.
Meanwhile, the disease progressed day by day: the baby started vomiting in the morning. "Like any modern person, I finally got on the Internet, typed "baby, headache, vomiting" and got an unambiguous answer – suspicion of a tumor," says Valentina.
The neurologist of the polyclinic, who was rushed to an appointment the next day, shared her mother's concern and wrote out a referral for a planned MRI. But the parents decided otherwise: there was no time to wait for a few weeks for an examination under the CHI policy, they signed up for a paid tomography. As a result of the study, less than 10 days after the first complaint, a tumor was found in George's head.
From "finding" to surgery – 9 days
The child was getting worse every day: he complained every minute that his head ached "as if his forehead was going to crack." The doctors talked about the need for surgery.
Parents took matters into their own hands again: they began to look for a clinic with extensive experience in neurosurgery in children and the best equipment. After studying the Internet, they chose the Almazov NMIC of the Ministry of Health of Russia in St. Petersburg and sent the documents there. The answer came very quickly: "come, you urgently need an operation!"
It took literally a few days to collect documents and issue a quota for treatment, the regional Murmansk Ministry of Health did their job very professionally and promptly, and, of course, friends and relatives helped, without their irreplaceable participation, as Valentina already understands, everything could have dragged on and turned out differently. Already on April 16, the day after hospitalization, the neurosurgeons of the Almazov Center removed the boy's tumor.
"Our operating neurosurgeons of the children's department Don Oleg Anatolyevich and Kim Alexander Vongievich did everything at a high professional level, they have golden hands! Thanks to them, we came out of surgery without serious neurological consequences. Incredibly, during the 10 days of hospitalization, George became very attached to the attending doctor Oleg Anatolyevich - in addition to his golden hands, he also has a big kind heart," says Valentina.
Soon the results of histology came: the neoplasm in the posterior cranial fossa turned out to be an epindemoma of stage II-III. Epindemomas are quite common, it is the third most common malignant tumor of the central nervous system in children. They are formed from cells lining the fluid-filled ventricles of the brain and the central canal of the spinal cord, and are usually detected before the age of 5 years. In accordance with modern treatment protocols, this type of tumor is subject to surgical removal, and after, in the vast majority of cases, radiation therapy is prescribed for the complete "cleansing" of pathological cells.
A hint from the TV
George was recovering quickly, and a few days after the operation, the boy was discharged under the supervision of an oncologist at his place of residence. The next stage of treatment was to be radiotherapy, which also had to be started as soon as possible, within 2-3 weeks. However, as luck would have it, there were no places in the radiation department of the regional oncology clinic.
Then Valentina remembered that just a few weeks before the first symptoms of her son's illness, she watched a TV program with Arkady Stolpner, chairman of the board of the IIBS, in which he talked about the first Russian proton therapy center recently opened in St. Petersburg.
From the TV story, the most memorable was baby Alice, who, as it turned out later, had the same diagnosis as George. Valentina, with her inherent energy, subsequently found her mother, Julia Strauss, in social networks, and they are still actively chatting with groups of patients with epindemomas, many of whom have also been treated with protons. "And then, watching the show, I just thought: "wow, what a good treatment for children we have! How wonderful that there is a person who does this!" Then it could not have occurred to us that we would soon have to go to this center ourselves," the interlocutor says.
Nevertheless, when George was offered to undergo irradiation on linear accelerators, a TV interview about the advantages of protons immediately popped into his memory. Protons – heavy charged particles – deliver a charge of radiation to the tumor much more accurately than the photons usually used. Arkady Stolpner compared them to a heavy flying bullet hitting directly at the intended target, in contrast to photon beams flying like shot and hitting nearby healthy tissues with radiation.
Clinical studies conducted since the 1990s have accumulated enough data to convince the world cancer community that proton therapy, as more gentle, is in any case preferable for children compared to photon therapy. Unlike conventional radiation therapy, it is less often accompanied by side effects (radiation toxicity, malfunctions of organs and body systems, negative effects on the intellectual and mental development of the child). But the most important thing is that after protons, the risks of secondary cancers that occur in irradiation sites 10-15 years after photon treatment are an order of magnitude lower.
"They go to the doctors to be healthy"
IIBS was invited to come for treatment as soon as possible, and it seemed that everything was going fine, if not for one "but" - the high cost of a course of therapy, at that time amounting to 1.8 million rubles. Then, in 2019, proton therapy was not yet paid for from the funds of the CHI, and only Moscow and St. Petersburg allocated quotas for their residents. "I began to think where to get the money. You can't sell anything that fast. But that was the second question. The main thing is that I needed protons!", - recalls Valentina.
And then – another wonderful combination of circumstances: at a consultation at the proton center, it turned out that the Murmansk region had just signed an agreement with the leadership of the IIBS, and one of the first regional quotas went to George.
It was assumed that Zhora would undergo a course of proton radiation therapy under anesthesia, which is 30 sessions, that is, every day for a month with a weekend break. Patients of such a young age, for the most part, are not able to lie still during the session, and since the accuracy of the proton beam hitting the tumor is of paramount importance, babies are put into a drug-induced sleep. But the psychologist of the Proton Therapy Center Elena Nikiforova, having met the boy, suggested that George was quite ready to behave "like an adult." She told the child about the treatment process, showed video and photographic materials, took him on an excursion to the treatment room with the gentry installation, which most patients associate with a spaceship. And Zhora decided: "I can!"
The boy really went through all the treatment without anesthesia, never acting up or getting nervous. There were practically no side effects either: no nausea, no weakness, no neurological consequences. The only thing is that my appetite worsened, but this was expected.
"Georgy Tedeev came to us after surgical treatment for an ependymoma of the IV ventricle of the brain, after which the child needed to undergo radiation therapy. Due to the location of the tumor near critical brain structures and young age, targeted proton irradiation was the preferred method of radiation treatment. The boy underwent a course of proton therapy without complications and side effects. As confirmed by the control MRI studies, which have been conducted for three years with a frequency of once every three months, the disease is now completely under control," commented the radiotherapist of the Medical Institute who treated the boy. Sergey Berezina (MIBS) Denis Andreevich Antipin.
After returning home, the baby did not remember about the treatment for a long time. But one day, a year and a half later, sitting next to my mother, I suddenly burst into tears. When asked what the tears were about, he replied: I remembered how sick I was, I was at the doctors, I'm scared. "Don't cry! - the wise mother answered. - After all, they go to hospitals not to get sick, but to be healthy."
Mandatory visits to the Proton Therapy Center for MR studies are still ongoing: at first, "controls" were assigned once every 3 months, then once every 4 months. Gradually, if everything goes well, MRIs will be performed less often. But after three years of traveling, George got to know the city well and loved it very much. "I think that after he finishes school, he will go to study in St. Petersburg," suggests Valentina.
In the meantime, Zhora goes to the second grade and is no different from her classmates: she is friends with children, indulges in recess, does not really like English – she has to study with a tutor. There are practically no restrictions for physical activity. He tried himself in football – it didn't go, now he goes to the pool for swimming, and in the summer he also goes hiking with a sports and patriotic club.
Georgy Tedeev came to us after surgical treatment for an ependymoma of the IV ventricle of the brain, after which the child needed to undergo radiation therapy. Due to the location of the tumor near critical brain structures and young age, targeted proton irradiation was the preferred method of radiation treatment. The boy underwent a course of proton therapy without complications and side effects. As confirmed by the control MRI studies, which have been conducted for three years with a frequency of once every three months, the disease is now completely under control," commented the radiotherapist of the Medical Institute who treated the boy. Sergey Berezina (MIBS) Denis Andreevich Antipin
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