BY JIM HOWE
A run of severe headaches over a couple of weeks in 2015 led to an Oneida teen’s diagnosis of brain cancer.
“I would throw up a lot and couldn’t eat. It hurt really bad,” describes Breonna Popluhar, 17, a junior at Oneida High School.
A computerized tomography scan at an urgent care center led to an ambulance ride to Upstate, where further tests revealed a cancerous tumor that had likely been present since birth. It was causing headaches because it had no more room to grow, she said.
Surgery two days later revealed the growth to be oligodendroglioma (see below). Further surgeries followed in August and October 2015.
“Breonna has a type of infiltrating brain tumor that is not amenable to total surgical removal without causing significant deficits,” explains Zulma Tovar-Spinoza, MD, Upstate’s director of pediatric neurosurgery, who performed the surgery.
“While most of her tumor was successfully removed, surgery is only one part of the treatment,” Tovar-Spinoza notes. She and the other specialists on Popluhar’s multidisciplinary team at Upstate recommended chemotherapy as the next step to stop the tumor’s growth. Popluhar would take a monthly pill and be monitored every three months with a magnetic resonance imaging scan.
Chemotherapy left her tired, less motivated and often nauseated. She got her first break from chemo in late 2016 and began to feel better in the weeks that followed.
“We want to wait and see right now what the tumor will do off of chemo,” Popluhar says.
She continues to attend school full time. Many of her fellow students are not aware she has cancer, “because my hair is OK, and I don’t talk about it a lot,” she says. She also works part-time washing dishes and takes weekly dance classes – although she can’t do upside-down moves at the moment and sometimes has to write down new dance steps because of poor short-term memory.
She knows the rest of her life will include medical appointments, and she knows she may face more surgery.
In the meantime, she and her family want to spread awareness of childhood brain cancer, a disease not always visible to others and that does not receive the attention some other cancers do.
Her pediatric oncologist agrees. “The public should know that brain tumors are the second most common cancer in children (after leukemia) and are now the No. 1 cause of cancer-related death in children,” says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology.
“Despite this fact, the prognosis for brain cancer in children is, overall, good and very different from the prognosis for adults with brain cancer. This is due to the fact that the types of brain cancers in children are quite different that those found in adults,” Comito adds.
Popluhar’s mother, Dawn Heffron, describes the emotions the family has gone through, from initial shock to obsessively seeking information to maintaining optimism and patience while constantly awaiting test results.
Meanwhile, as Popluhar thinks about college options and her future, she doesn’t focus on brain cancer.
A cancer with a long, strange name
The brain cancer called oligodendroglioma develops from oligodendrocytes, one of the types of cells that make up the supportive, or glial, tissue of the brain.
This cancer is relatively rare in adults and even rarer in children, and often is “silent” — growing slowly and gradually, says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology.
Treatment generally involves surgical removal, if possible, along with radiation and/or chemotherapy, then monitoring for recurrence with MRI scans.
Comito notes that headaches are common in both children and adults and rarely mean a brain tumor. Headaches that persist and get more frequent and severe are a concern if associated with other complaints, such as seizures, changes in personality, vomiting, changes in walking or vision or decreased school performance.