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Laparoscopic Surgery and Experimental Chemotherapy for Neuroblastoma

Hattie Piglowski

Like most 4-year-olds, Hattie Piglowski can be a bit bossy, but that’s just fine with her parents, Pamela and Anthony, and her two older brothers. That’s because Hattie has come a long way since early 2004 when she was diagnosed with neuroblastoma, a primitive form of childhood cancer that strikes the developing nerve cells.

The Piglowskis’ experience came unexpectedly after a routine doctor’s visit for an ear infection and what they thought was related dizziness. But what started as a simple childhood ailment quickly took a turn for the worse, resulting in shaking and severe problems with Hattie’s balance and with her eyes. An initial CT scan at their hometown emergency room came up clean, but the attentive physician still suspected her condition was serious enough to warrant an immediate two- and-a-half-hour ambulance ride to Children’s Hospital of Pittsburgh of UPMC.

“That first time we went to Children’s, they couldn’t find anything on the scan, so we went home,” Pamela says. “But after a week or so, her condition got even worse. She couldn’t walk, it was difficult to understand her speech, and she was shaking. Something was very wrong.”

A second trip to Children’s resulted in a full body scan, which revealed a golfball-sized tumor on her kidney. “We were totally shocked,” says Pamela. “The doctor, who was a fellow at that time, was absolutely wonderful. She explained that Hattie’s body was fighting the cancer through her neurological system. We were given a huge binder that explained childhood cancers, and it was wonderful. It was full of resources, such as names of books, phone numbers and short stories of people who had gone through the experience of having a child with cancer.”

Through laparoscopic surgery, which is less traumatic and allows the body to heal faster, the surgeon successfully removed the entire tumor and put Hattie on intravenous (IV) therapy to boost her immune system. The Piglowskis then were presented with two options for treatment: traditional chemotherapy or an experimental chemotherapy with a monoclonal antibody called Rituximab, a drug being tested by Jean Tersak, MD, which had been proven to be less harsh on the body. They chose the experimental chemo.

Hattie remained at Children’s as an inpatient for 10 days, during which time Pamela literally camped out in her room and didn’t leave her side. Anthony was able to stay at the Ronald McDonald House, thanks to the efforts of Hattie’s social workers. “The nurses were wonderful,” Pamela says. They were concerned not only about Hattie, but about the impact it was having on the family, as well. “Jen, a nurse in the ICU, even kicked me out of the room and made me go lie down because she knew I hadn’t eaten or slept. I had camped out in Hattie’s room and never left her side, but I felt comfortable leaving her with Jen.”

Following Hattie’s discharge 10 days later, she was required to return as an outpatient once a week for five weeks to get her daylong IV chemotherapy treatments. Now in total remission and off all medication, Hattie is outgoing, eager to learn and enjoys her dolls, coloring, and going outside to play — particularly with her two older brothers, who are very protective of her. She still requires physical, occupational and speech therapy, each one time a week at home, to improve some of the residual neurological effects. And she continues to visit Children’s as an outpatient every six months for a thorough multidisciplinary evaluation.

“I learned that I was a lot stronger than I thought because, as a mother, you never know how much you can handle until you get it,” Pamela says about her experience. “But I also learned that Hattie is even stronger than I am!”

Last Update
January 7, 2014
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Last Update
January 7, 2014
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