(STANFORD, Calif.) — On October 17, 2013, Jennifer and Ken Zimmerman got the life-altering prognosis that their 7-year-old daughter, Emily, had a tumor the size of a golf ball in her brain and doctors suspected it was an aggressive cancer.
“At the time, we didn’t know if it was a death sentence,” said Ken Zimmerman.
What they did know is that the doctors weren’t wasting any time. Only moments after receiving the diagnosis, Jennifer Zimmerman was instructed to bring Emily directly to their local Reno emergency room so she could be transported by Life Flight to Lucile Packard Children’s Hospital Stanford 250 miles away.
“I don’t even remember driving there,” said Jennifer, who bundled her daughter into the car, drove to the nearest Life Flight pad and called her husband at work to tell him to meet them at Stanford — there wasn’t enough room on Life Flight for the three of them.
Emily’s symptoms had started in August following an Alaskan vacation. When they got home from the trip she complained of headaches. At the time, the Rim Fire in Northern California raged and Emily’s pediatrician initially thought smoke from the blaze could be causing the headaches, Jennifer said.
But even after the fire was out, Emily continued to have the headaches and would wake in the middle of the night with sweats. When Jennifer found her daughter vomiting one morning, she took Emily back to the doctor and insisted that they run tests, including an MRI. That’s when the doctors found the tumor.
By the time Jennifer and Emily arrived at Stanford that same day, Gerald Grant, MD, chief of pediatric neurosurgery at Stanford Children’s Health, and his team were waiting to discuss treatment.
“At this point we didn’t know if the tumor was operable,” Jennifer said. “We didn’t know if they would try to shrink it with chemotherapy or radiation. We didn’t know what was going to happen to our daughter.”
Grant, also an associate professor of neurosurgery at the Stanford University School of Medicine, didn’t give them time to wonder.
“That thing is coming out on Saturday,” Jennifer remembered Grant telling her. “I can’t explain the wave of emotion that came over me. Here it was Thursday and they planned to take the tumor out in two days. I felt so much relief when he said this and had total confidence in Dr. Grant and his team.”
Yet, the parents knew that the operation had risks.
“This kind of surgery is one of the most difficult surgeries we do as pediatric neurosurgeons,” said Grant, adding that typically the operation takes six to eight hours and if the tumor is malignant, and if the cancer has infiltrated into critical areas of the brain, the risks of removal grows. “We can be very aggressive with surgery, although there is always a cost which may negatively impact Emily’s quality of life.”
The risks include losing cognitive skills, such as speech called mutism, problems with coordination, or movement and double vision. “These types of surgeries are routinely performed by our team at Stanford since we specialize in pediatric brain tumors,” Grant said, citing an 85-90 percent success rate. “We are limited by the unfortunate spread of the cancer into areas of the brain which we cannot safely enter without causing permanent harm. We therefore need to love the child more than we hate the cancer to perform the safest operation possible.”
Grant and his neurosurgery team successfully removed Emily’s tumor and ultimately concluded that she had medulloblastoma, a fast-growing cancer, located in the cerebellum, the lower, rear area of the brain. It is most commonly diagnosed in children younger than 10, although doctors don’t know the cause. Grant said the Zimmermans got to Lucile Packard Children’s Hospital just in the nick of time. Although the cancer hadn’t yet spread, doctors feared other complications, like water on the brain.
“Emily’s symptoms were signs of increased water on the brain due to the blockage of the normal spinal fluid drainage pathways in the brain. Emily was so fortunate that she had the MRI scan before she got even sicker. Some children arrive in a coma from the hydrocephalus alone and the prognosis for recovery can be very guarded,” Grant said, adding that Emily was nearing that point, but that the use of high-dose steroids helped counteract the symptoms of the hydrocephalus until she went to surgery.
Since the surgery and numerous chemotherapy and radiation treatments that followed, Emily remains cancer-free. Jennifer said it was not all easy going. For a short time after the operation, Emily lost her speech and had to learn how to walk again. But the third-grader has put that behind her now, going back to her pre-cancer world, when family vacations, Barbies and social clubs like Brownies consumed her life.
“She’ll need to have MRIs for the rest of her life,” Jennifer acknowledged.
Because Lucile Packard Children’s Hospital conducts cutting-edge brain tumor research in association with the School of Medicine, it will continue studying Emily’s specific case. On the day of surgery, Emily’s tumor was frozen down and cultured in a dish so we could implant the tumor in mice to better understand how these tumors grow, why they form, and continue to find novel treatments to cure these malignant tumors.
“I’m so eternally grateful to Dr. Grant and his team,” Jennifer Zimmerman said. “To have this level of care for our daughter is our greatest relief.”
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Stanford Children’s Health, with Lucile Packard Children’s Hospital Stanford at its core, is an internationally recognized leader in world-class, nurturing care and extraordinary outcomes in every pediatric and obstetric specialty from the routine to rare, for every child and pregnant woman. Together with our Stanford Medicine physicians, nurses, and staff, we deliver this innovative care and research through partnerships, collaborations, outreach, specialty clinics and primary care practices at more than 100 locations in the U.S. western region. As a non-profit, we are committed to supporting our community – from caring for uninsured or underinsured kids, homeless teens and pregnant moms, to helping re-establish school nurse positions in local schools. Learn more about our full range of preeminent programs and network of care at stanfordchildrens.org, and on our Healthier, Happy Lives blog. Join us on Facebook, Twitter, LinkedIn, and YouTube.
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- Robert Dicks
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