Monthly Archives: June 2014

Five Question Friday: Kris Ann Schultz, MD

Five Question FridayIn this week’s Five Question Friday, we catch up with Kris Ann Schultz, MD, as she talks about her work in our Cancer and Blood Disorders program and the many memories she has made working with children and their families.

During her first two years in college, Kris Ann Schultz, MD, wanted to be editor of Ranger Rick magazine or a pediatrician.

During her first two years in college, Kris Ann Schultz, MD, wanted to be editor of Ranger Rick magazine or a pediatrician.

How long have you worked at Children’s?

I’ve worked at Children’s for six years.

What are some of the conditions you treat?

I care for children with cancer and blood disorders, usually brain tumors, solid tumors such as kidney or ovarian tumors, and leukemia.

You are the principle investigator for the International Ovarian and Testicular Stromal Tumor Registry. Can you tell us more about that project?

We started the International Ovarian and Testicular Stromal Tumor (OTST) Registry in December 2011 to try to understand more about what causes these rare tumors in children and young adults around the world, and how to best treat them. We suspected that these tumors were related to another kind of rare tumor we study here called pleuropulmonary blastoma (PPB). We knew we needed to understand more about that connection to help us find both kids of tumors in their earliest and most curable form.

Editor’s note: The OTST and PPB registries were recently featured in an NBC News story about a baby whose lung tumor was found early thanks to the research of the registries and the bravery of his mom.

Do you have a favorite memory from working at Children’s?

My favorite memories at Children’s are all about the kids and families I’ve cared for. I love watching the kids have fun at the Pine Tree Apple Tennis Classic to raise funds for children’s cancer research. I love watching doctors, hospital staff, parents and siblings shave their heads in honor our young heroes at our annual head shaving event to support St. Baldrick’s. Both the Pine Tree Apple Tennis Classic and St. Baldrick’s Foundation support the OTST and cancer research at Children’s.

Subscribe to MightyWhat’s one interesting fact about you?

During my first two years in college, I wanted to be either editor of Ranger Rick magazine or a pediatrician. I decided that I wanted to be a doctor when I was in a small village in rural Tanzania. I was studying giraffe during the day and spending time in the village in the afternoons and evenings when it was too hot to track giraffe. Working with the amazing people there made me realize I wanted to work with people in a direct “hands-on” way and pediatric oncology has been a great way to do that.

At home, I love spending time with my family, my husband and our three kids.

Laser in action: See how Gavin’s tumor met its match

Gavin Pierson (left) and Joseph Petronio, MD, visit during a photo shoot at Children's – St. Paul on Monday, June 16, 2014.

Gavin Pierson (left) and Joseph Petronio, MD, visit during a photo shoot at Children’s – St. Paul on Monday, June 16, 2014.

In the two years since Gavin Pierson’s brain tumor, which he calls “Joe Bully,” was discovered, he has undergone 17 surgeries. A combination of craniotomies and the Pfizer drug, palbociclib, had been managing the growth of Joe Bully, but not decreasing its size. Gavin and his family were growing tired and frustrated with invasive surgeries, and Gavin wasn’t bouncing back as well as they hoped.

Enter Visualase.

Visualase is a laser used for neurosurgery and is guided by MRI images to precisely target areas of the brain that were previously thought inoperable. After making a 3-centimeter incision, Joseph Petronio, MD, and his team guided a small laser fiber directly to Gavin’s tumor. Children’s is the only pediatric hospital in the Midwest using Visualase, and Gavin is the only patient in the country to use this technology to treat a mature teratoma brain tumor.

Learn more about how Dr. Joseph Petronio used the Visualase laser:

Subscribe to MightyNot only did this technology target and dissolve a significant portion of Gavin’s tumor, it’s also prohibiting re-growth – stopping Joe Bully in its tracks. The laser is so targeted that the brain tissue surrounding the tumor was unharmed, making for a quick recovery. Within 12 hours, Gavin was sitting up, eating and laughing with his siblings and parents. Gavin went home the next day and was back to school within four days.

These types of minimally invasive surgeries have incredible benefits for Children’s patients. Since obtaining Visualase in October 2013, Children’s has treated patients as young as 12 months for epilepsy and other types of brain tumors. Tools like Visualase are making tumors we once thought were inoperable – operable.

Making magic happen: The infant-toddler brain

Anna Youngerman is the director of advocacy and health policy at Children's Hospitals and Clinics of Minnesota and a proud parent of her 2-year-old son.

Anna Youngerman is the director of advocacy and health policy at Children’s Hospitals and Clinics of Minnesota and a proud parent of her 2-year-old son.

By Anna Youngerman

For many parents, sleep-deprived might be how we choose to describe the first three years of a child’s life — at least it has been for me. But as I look through the haze of too few hours of sleep, there’s also magic to these early years. I frequently find myself in a state of awe and wonder at my growing child. The first time your baby catches your eye and holds your gaze, the first time he says “mommy,” the cobbling together of phrases to describe his day and even the frustration-driven tantrums — those are all magical moments.

It turns out there’s a reason the awe-inspiring moments come fast and furious during these earliest years. The brain wiring is on hyper-drive:

  • 80 percent of brain development happens by the time a child is 3 years old.
  • 700 new neural connections are made every second in the first few years of life.

This naturally occurring development can serve as a springboard for a productive, healthy life. Yet, just as a magician must carefully prepare for a trick so it appears both astonishing and seamless, helping every child realize the powerful potential of these years also requires intentional support.

Inspiring action

Though our paper, “Foundation for Life: The Significance of Birth to Three,” we want to inspire more robust discussion and action around the value of investments in and attention to our youngest children. We want to invite the tough questions and – more importantly – be part of answering them:

  • What can we do, collectively, to reach the most vulnerable children?
  • How do we mitigate toxic stress factors that tear away at a child’s potential?
  • What’s the community’s role in ensuring that no child lacks the positive relationships so crucial to healthy development?
  • How do we build a coordinated system that focuses on what a child needs and not what the system needs?
  • Subscribe to MightyHow do we reach children at an age (0-3) when they often are cared for by family, friends and neighbors and not always tied to existing systems?

These aren’t easy questions, but just because they’re tough doesn’t mean we shouldn’t take them on and figure out how to work together toward getting answers. The stakes are just too high and the opportunity too great.

Like most parents, I’ll gladly navigate my sleep deprivation in exchange for giving my kiddo every opportunity he deserves. That’s the hope and dedication we want to inspire. I hope you’ll join us.

Anna Youngerman is the director of advocacy and health policy at Children’s Hospitals and Clinics of Minnesota and a proud parent of her 2-year-old son.

Gavin vs. Joe Bully: First-of-its-kind laser surgery shrinks tumor by more than 40 percent

The Piersons (from left), Steve, Gavin, Nicole, Grace and Gage, have been through a lot in the past two years.

The Piersons (from left), Steve, Gavin, Nicole, Grace and Gage, have been through a lot in the past two years.

If you’ve been following 8-year-old Gavin Pierson’s story, you know he and his family have been through a lot. In 2012, Gavin was diagnosed with a mature teratoma brain tumor.

Since then, he has undergone numerous craniotomies and he and his family have dealt with big drug companies to fight his brain tumor, which Gavin refers to as “Joe Bully.” Unfortunately, Joe Bully is a particularly tough tumor, located in an area that is difficult to operate on and comprised of hard, “concrete-like” tissue. While Gavin’s prior treatments made progress, Joe Bully kept growing back.

give_gavin_blogBut it appears that Gavin’s neurosurgeon, Joseph Petronio, MD, may have found Joe Bully’s weak spot. Over the past eight months, Gavin has undergone two Visualase laser surgeries, an MRI-guided procedure designed to incinerate the tumor. He’s the first patient with a mature teratoma to ever use Visualase – and it may have stopped Joe Bully in its tracks.

Children’s and the family also successfully petitioned pharmaceutical company Pfizer to grant Gavin access to an experimental drug, palbociclib, to help control the tumor’s growth. Gavin is the youngest patient to use palbo.

We’re happy to announce that a recent MRI scan showed Gavin’s formerly peach-sized tumor has shrunk more than 40 percent. Even better? There are no signs of regrowth.

Gavin’s courage and strength inspire us every day. Thank you, Gavin, and congratulations.

Learn more about Gavin’s story and surgery:

Meet Red-Vested Rockstar Debbie Closmore

Debbie Closmore is a St. Paul volunteer with nearly 200 hours of service.

Debbie Closmore is a St. Paul volunteer with nearly 200 hours of service.

Children’s volunteer Debbie Closmore truly lights up a room with her laughter and positive energy. She isn’t afraid of a challenge and loves stepping up to the ever-changing needs in the surgery department.

Why she rocks

Debbie is a volunteer on the St. Paul campus; she was a float volunteer and currently serves as a peri-operative escort in our surgery department. She’s energetic and fun. Debbie serves as a trainer for new volunteers, passing on her knowledge and expertise. See why she got into volunteering at Children’s:

“I got into volunteering with hopes to ease the anxiety for children and their families during a stressful time,” Debbie said. “Spread a little joy!”

What’s your favorite thing to do outside of volunteering?

“I love spending time with my husband, family and friends. I also enjoy biking, hiking, yoga and walking, staying active.”

Do you have any kids or pets of your own?

“I have a stepson, daughter-in-law and five grandchildren.”

If you could create a new candy bar, what would be in it and what would you name it?

“My candy bar would be made with raw pecans, dates, figs, sunflower seeds and dark chocolate. I would name it ‘Healthy Me.’ ”

Share a favorite volunteer experience or story.

“I spent many hours rocking and holding an infant boy. Every week I went to his unit to rock and talk with him; we really had a connection. When he smiled at me, my heart sang.”

Thank you, Debbie, for your bright, positive energy and true commitment to Children’s Hospitals and Clinics of Minnesota!

Tech Spotlight: A look at Visualase, a minimally invasive laser surgery system

Visualase's workstation interfaces with an MRI to allow temperature control and monitoring in real time during a treatment.

Visualase’s workstation interfaces with an MRI to allow temperature control and monitoring in real time during a treatment.

Gavin Pierson, now 8, of Ramsey, Minnesota, underwent two Visualase procedures in October and February.

Gavin Pierson, now 8, of Ramsey, Minnesota, underwent two Visualase procedures in October and February.

The story of Gavin Pierson, the 8-year-old Ramsey, Minnesota, boy battling a brain tumor, includes a number of key players: his doctors, parents, siblings and care team, and the thousands of people who have followed his two-year fight against the aptly nicknamed “Joe Bully.”

But one of Gavin’s most important allies doesn’t have a degree, voice or personal Facebook page.

Visualase, an MRI-guided, minimally invasive laser system, has been the Kryptonite to Gavin’s tumor since he became the first person with a mature teratoma brain tumor to undergo the procedure. His first laser surgery took place on Oct. 29, 2013, at Children’s Hospitals and Clinics of Minnesota and his second four months later on Feb. 20, 2014.

“There are many things that make this procedure unique. One is the use of MRI, which allows us to monitor the temperature of both the tumor and the normal brain during the laser treatment,” said Joseph Petronio, MD, medical director of pediatric neurosurgery at Children’s and the doctor who led Gavin’s Visualase procedures. “The composition of (Gavin’s) tumor is unusual, including elements of bone and skin that makes it conduct heat very broadly. By being able to monitor temperature that closely, we are able to target the tumor more precisely without damaging other tissue.”

Founded in 2005, Visualase, Inc.’s system is a minimally invasive laser procedure that allows surgeons to pinpoint and treat lesions and tumors with extreme precision.

So, how does Visualase work?

  • Visualase Cooled Laser Applicator System: The system features a disposable fiber optic catheter with a built-in cooling mechanism that prevents overheating near the surface of the applicator. This laser catheter is placed through a small opening in the scalp and skull and into the center of a tumor using advanced MRI technology. Laser energy is then used to heat the tumor carefully. The system was engineered to allow for the use of higher laser powers to destroy tumors with shorter exposure times.
  • Laser generator: The generator produces light energy that is used to thermally ablate, or destroy, soft tissue.
  • Workstation: The workstation interfaces with an MRI to allow temperature control and monitoring in real time during a treatment. It also provides on-screen visuals of the tissue as it turns into a solid or semi-solid state. Because of the in-depth monitoring, the procedure results in a high level of precision and control.
  • Temperature: The time it takes to destroy parts of the tumor depends on the temperature of the laser. When set to 113-140 degrees Fahrenheit, tumor cells eventually get destroyed. Cells and tissue are destroyed immediately when the laser is between 140-212 degrees. Anything above 212 degrees, though, can cause water in the tissue and areas inside a cell to vaporize, and leads to ruptured cells and tissue components.
  • According to Visualase, once soft tissue is destroyed, or ablated, it is considered non-viable and is reabsorbed, leaving little evidence that a tumor or burn existed.

After getting its start in treating liver and prostate problems, the Visualase Thermal Therapy Subscribe to MightySystem was cleared by the Food and Drug Administration in 2007 for the ablation of soft tissue in neurosurgery. Visualase’s first minimally invasive neurosurgical procedures were performed in 2006 in Paris as part of a study for treating brain tumors.

The Visualase laser system is in use at more than 40 hospitals, nationwide, including 15 pediatric hospitals. In pediatric patients, including at Children’s Hospitals and Clinics of Minnesota, Visualase has also been used to address brain lesions that cause epilepsy.

“What’s exciting to me is the path this technology opens to areas of the brain that were closed to us before,” said Petronio. “To think we could reach a day when the term ‘inoperable brain tumor’ in children is obsolete is extraordinary.”

Source: visualaseinc.com

Five Question Friday: Janay Moore

Senior talent acquisition assistant Janay Moore has been with Children's since February 2012.

Senior talent acquisition assistant Janay Moore has been with Children’s since February 2012.

Janay Moore, senior talent acquisition assistant, has a job she loves – helping others find jobs they love at Children’s! Get to know Janay in this week’s Five Question Friday.

How long have you worked at Children’s?

I started working at Children’s as a contractor in August of 2011 but I applied for a regular position and was hired in February 2012. Therefore, I just celebrated my two-year anniversary in February.

Describe your role.

I’m a senior talent acquisition assistant. My primary responsibilities include: recruitment for the clinical support associate positions, the MNA internal bidding process, pre-boarding our RN travelers, and supporting our new grad training program and external nursing recruitment.

What’s your favorite memory from working at Children’s?

My favorite memory working at Children’s is an ongoing one. As a part of the Talent Acquisition Team we are involved in a number of student internships in the community. It’s a blast to see the growth of our student interns from Cristo Rey, Project Search and the Step-Up program mature into young working professionals. Just another reminder of why we do the things we do.

Subscribe to MightyWhen you were a kid, what did you want to be when you grew up?

Funny enough when I was a kid I always thought I wanted to be a veterinarian. As I matured, I realized that I loved the idea of working with animals but couldn’t live with the idea of working with ailing or dying ones. It’s important to know your strengths and weakness and emotionally it was too much for me.

How do you spend your time outside of work?

I love spending time with my husband and our two daughters, Aarylin, age 6, and Milaya, age 3. We really enjoy going to the park, shopping and traveling!

The road to recovery: Pediatric cancer services

Each year, close to 12,500 children in the U.S. are diagnosed with cancer. Among them who live in the Upper Midwest, more than 70 percent are treated by Children’s Hospitals and Clinics of Minnesota. This week we shared Jenna Carnes’ cancer journey on Twin Cities Moms Blog. Jenna is one of many teens we see in Children’s Cancer and Blood Disorders Clinic each week, and just like every pediatric cancer patient, her journey is a unique one.

Jenna Carnes (left) and her mother, Barbara, enjoy a Minnesota Twins baseball game at Target Field in Minneapolis. (Photo courtesy of Barbara Carnes)

Jenna Carnes (left) and her mother, Barbara, enjoy a Minnesota Twins baseball game at Target Field in Minneapolis. (Photo courtesy of Barbara Carnes)

“Like all of our patients, we want Jenna to still be a kid and not to have to grow up too quickly because of the disease she’s dealing with,” said Dr. Joanna Perkins, Jenna’s treating physician in the Cancer and Blood Disorders Clinic at Children’s. “With the suite of treatment options we offer, Jenna’s been able to get back to being a normal teen.”

Beginning with the Child Life department, Jenna utilized many of Children’s support services to help her in her healing journey. From how to talk about cancer with her friends at school to going to surprise Minnesota Twins baseball games with her family, Jenna said her child life specialists made each day that she was at the hospital just a little easier. This was a welcome relief for her family.

“What makes Children’s different than any other hospital are the services we offer that go above and beyond standard inpatient care,” said Dr. Perkins. “From the supportive care – ranging from physical therapy, psychology and nutrition specialists, music therapy, massage and pain and palliative care – to special events geared towards the whole family, we try to make the time kids and families have to spend in the hospital as good as it can be. A lot of kids appreciate the simple things, too – big TVs and video games.”

In addition to Children’s in-house services, many patients (including Jenna) go to Camp Courage in Maple Lake, Minn., to “just be a kid” for a week each summer. The camp also provides patients’ families with a much-needed break. With Children’s staff physicians and nurses, onsite, to administer medication and keep close watch on their patients, patients and their siblings take part in time-honored camp traditions and let loose for the week.

“Kids of all ages are there, and we’re all going through something really similar,” said Jenna. “There are no strange looks.”

As Jenna and her family prepare to celebrate the end of her chemotherapy treatments, Jenna’s care team at Children’s will be by her side, cheering her on at her end-of-treatment party on June 12. Soon, Jenna will be a part of Children’s Destination STAR (Surveillance and Testing After Recovery) Clinic, which assists her with the transition to life after cancer therapy. She’ll work with Children’s Health and Wellness Team, consisting of staff members from oncology, nutrition services, physical therapy, psychology and child life, as well as her primary care physician for wellness visits to make sure the cancer does not return.

“Going to the hospital for cancer treatments will never be fun,” said Jenna. “But, I’m honestly going to miss coming to Children’s – it’s almost become a second home.”

Visit Children’s Hospitals and Clinics’ Cancer and Blood Disorders Clinic for more information. Children’s first annual Shine Bright Bash on Sept. 13 is to celebrate and support the advancements in pediatric cancer and blood disorder care.

NBC News: Sharing the story of Children’s cancer and blood disorders expertise

Michael and Megan Flynn with sons Andrew, 7 months, and Thomas, 5, and daughter Olivia, 3 (Photo by Julie Ratkovich Simply Bliss Photography)

NBC News shared the story and collective work of Children’s Hospitals and Clinics of Minnesota’s blood and cancer disorders team, including Dr. Kris Ann Schultz, Dr. Yoav Messinger, Gretchen Williams, CCRP, and Anne Harris, MPH, among others, who have led the way in enabling the early detection and effective treatment of children in families affected by rare genetic cancers.

via NBC News: One rare cancer leads to another: Cancer registry saves baby’s life

In 2009, while trying to understand pleuropulmonary blastoma (or PPB, a rare early childhood lung cancer), researchers leveraging data from Children’s International Pleuropulmonary Blastoma (PPB) Registry uncovered an unexpected cause: a mutation in DICER1, a master controller gene that helps regulate other genes. By leveraging those learnings and coupling it with new data from the International Ovarian and Testicular Stromal (OTST) Registry – a “sister” registry of the International PPB Registry – Children’s has recently discovered that the DICER1 gene mutation may underlie many additional rare childhood genetic cancers and could tell us something fundamental about how most cancers arise.

Children’s presented its promising findings this weekend at the American Society of Clinical Oncology (ASCO) Annual Meeting, advancing the potential for early diagnosis and proactive treatment of children in families affected by PPB, as well as other rare genetic cancers such as certain ovarian, nose, eye and thyroid tumors.

With the establishment of the International PPB Registry in 1988 and the International OTST Registry in 2011, Children’s, along with our partners, have become the world’s leading experts on how to care for children with PPB and other cancers marked by the DICER1 genetic defect. As a result, PPB could be among the first cancers routinely curable before it progresses to a deadly form.

Children’s work and ability to follow the science continues to be made possibly entirely by philanthropy, including the St. Baldrick’s Foundation and the Pine Tree Apple Tennis Classic.

Congratulations to the Children’s cancer and blood disorders team!  Thank you for your commitment and your amazing, groundbreaking work.