April 29, 2005

From proton beam patient to Junior Olympian

In 2002, 14-year-old Kristin Dewey was a patient at the MGH, battling an unusual bone form of Hodgkin's disease, a cancer that typically strikes the lymphatic system. This February, the now 17-year-old high school junior was named a member of the 2005 United States Junior Olympic Nordic ski team — a year ahead of the goal she set for herself as a young girl and a mere two-and-a-half years after her final treatment at the MGH's Northeast Proton Therapy Center (NPTC).

A long-time Vermont resident and avid Nordic — or cross-country skier — Dewey developed pain in her right hip in the fall of 2001 that at first was attributed to a muscle pull. When the pain persisted, her parents, Keith and Marion Dewey, brought her to a local doctor who referred her to the MGH where tests revealed a cancerous growth on the right side of her sacrum — the shield-shaped bone structure at the base of the spine that makes up the back portion of the pelvis. By the time Dewey was diagnosed, her case was advanced. However, Nancy Tarbell, MD, director of the Radiation Oncology unit at MassGeneral Hospital for Children, thought the young skier was an ideal candidate for proton beam radiation therapy, rather than standard radiation treatment.

Hodgkin's disease generally is treated with a combination of chemotherapy and radiation therapy. While most Hodgkin's patients are cured, they run the risk of later developing secondary cancers brought about by the radiation treatment. In standard radiation treatment, X-rays continue to pass through the body even after they reach their intended target, irradiating healthy tissue as they exit. Protons, by contrast, enter patients at a low and uniform rate and rapidly release their energy when reaching their target, sparing surrounding tissues. "Because of the location of Kristin's malignancy, protecting her pelvis and surrounding organs from the effects of radiation was a concern," Tarbell says. "We made the decision to use chemotherapy followed by 10 doses of proton radiation therapy, with no traditional radiation. To our knowledge, this was the first time a patient with Hodgkin's has been treated with protons rather than the use of X-rays."

Twelve weeks after Kristin's final proton treatment, a bone scan revealed no sign of Hodgkin's disease. And within five months, she was back on her skis, working to get back to competition level. She competed in her first race that winter, placing seventh. It wasn't long before she was back to winning race heats. This March, she finished fifth in the Junior Olympic sprints in California, helping her New England team win the national championship. On March 21, she left with her teammates — including younger brother, Kyle, also a Junior Olympian — for Finland and Sweden, where she represented the United States in competition against northern Europe's best skiers.

Keith Dewey marvels at what he calls his daughter's "will of iron" and credits Tarbell along with David Ebb, MD, of MGH Pediatric Oncology; Francis Hornicek, MD, of MGH Orthopædic Oncology and the NPTC staff for giving Kristin back her skiing dream. "There is a photo from a Junior Olympic race that highlights Kristin's hard-earned muscle tone and her long re-grown hair, which streams out behind her," he says. "That photo is powerfully moving to me, because there was a period during her treatments when she had neither muscle tone nor hair. Kristin carries the second chance the MGH gave her in her heart every day."