Brain tumor patient scales new heights

Tom Fox is looking forward to college and a career after UC Irvine neuro-oncologists helped him battle brain cancer

When Tom Fox’s excruciating headaches, vision problems and immobilizing nausea were finally traced to a brain tumor in the spring of 2009, it seemed doubtful that the Fountain Valley teenager would live to see another birthday.

Nearly three years later, Fox is bicycling, rock climbing and reading books about string theory. His tumor is gone and he’s hoping eventually to return to college. It hasn’t been an easy journey, but he credits his “incredible” team of doctors and nurses with UC Irvine’s Comprehensive Brain Tumor Program for his “new lease on life.”

Fox, then 19, had steeled himself against the pain, the double vision and vomiting for months until he collapsed on the job at a big-box retail store and was rushed to a community hospital emergency room in Orange County.

Doctors drained fluid that had been building up for months in Fox's skull, but they told his parents they couldn’t do anything about the tumor lodged in the deepest recesses of his brain. Take him home, make him comfortable and talk to the best brain tumor experts you can find, they told Steve and Mary Fox.

Her research turned up several specialists across the state and country, but the care and concern Mary Fox encountered on the telephone drew the family to UC Irvine's Chao Family Comprehensive Cancer Center, Orange County’s only National Cancer Institute-designated comprehensive cancer center. 

After consultations with UC Irvine neuro-oncologist Dr. Daniela Bota, neurosurgeon Dr. Mark Linskey performed a stereotactic biopsy to extract bits of the one-inch tumor deep in Fox's brain. Dr. Ronald Kim, one of the region’s few neuropathologists, quickly identified the sausage-shaped growth as a rare germinoma.

Although the aggressive tumor was pressing on teenager's pineal gland and brain stem—an area that controls vision, appetite, motor function and memory—Bota told Fox and his parents that germinomas respond well to treatment.

“Of all the ones I could have had, Dr. Bota said it was the ‘Chinese takeout’ of tumors, one she was sure she could get rid of,” Tom recalls. “She said it was going to be tough but that we would get it. That was cool.”

Germinomas are remnant cells left over from a fetus' development in embryo. They usually occur in the ovaries or testes, but they can also appear in other places in the body, usually emerging in the teen years or young adulthood. Of all the tumors found in the pineal region of the brain, germinomas are among the most common, but they can be hard to diagnose accurately without a tissue sample.

The cancer center, located at UC Irvine Medical Center in Orange, is among only a handful in California with a multidisciplinary team of specialists equipped to treat tumors in this delicate region of the brain. The biopsy and pathology test enabled Bota to devise an aggressive treatment regimen. In May 2009, Fox began his first of four rounds of intensive chemotherapy.

“Tommy needed to stay in the hospital four different times over four months,” says Bota, who co-directs the cancer center’s Comprehensive Brain Tumor Program. Radiation oncologist Dr. Jeffrey V. Kuo oversaw six weeks of radiation treatments that followed.

Slowly, Fox's hair began to grow back and he put on some weight. With the help of a UC Irvine trauma psychiatrist and the cancer center’s brain tumor support program, the young man continues to recover from what Bota describes as “the equivalent of going to war.” Survivors often have cognitive deficits after chemotherapy and radiation beamed directly at the tumor. Depression is also common, especially among children and young adults who found themselves suddenly facing an uncertain future.

Fox celebrated his 21st birthday in Las Vegas, where he tried indoor skydiving. Now 22, his memory is improving as is his ability to concentrate, which he works at by reading books on military history and physics. Besides bicycling and driving, he volunteers at the medical center, helping to cheer up patients. Lately, as his balance has returned, he’s taken up indoor rock-climbing.

“That is a very hopeful sign,” an elated Bota said of Fox's new sport. “It means that his brain is starting to regenerate. And he is getting out and trying new things. We are always encouraging our patients to live their lives to the fullest.” 

Next, Fox wants to return to ice hockey, a contact sport prohibited because of the shunt put in his brain to relieve fluid buildup when he was first diagnosed. “That would be a third brain surgery for me, and doctors don’t like to risk it. But I’m working on Dr. Linskey.”