A 17-month-old girl battling a brain tumour is to have an ovary frozen. Her family hope the procedure means she will one day be able to be a mum.
Cancer treatment could leave Tallulah Cox infertile and the operation will be carried out before she starts chemotherapy next month. She will be the youngest in the UK to have the procedure, just two months after being diagnosed with the incredibly rare tumour, reports the Mirror.
A delightfully happy toddler, Tallulah has shown her battling qualities during a whirlwind of doctor's appointments, diagnoses, and an operation to remove the tumour itself. But she needs an aggressive form of chemotherapy which risks damaging her ovaries.
So doctors will freeze sections from one ovary so she has the potential to start a family in later years. Her mum Zoe, 36, and technician dad Richard, 35, have been shaken by her plight – which began with what appeared to be a stomach bug.
Zoe says: “We were so shocked when we were told she had a tumour. Saving her is the first thing on our minds, but we are incredibly grateful that they are also thinking about her fertility and preserving her ovary.
“To have the opportunity to still have children in her future is amazing. At 17 months old, she isn’t thinking about being a mum, but she will one day. I’ve always wanted to be a mum and I want her to have that opportunity too.”
Tallulah fell mysteriously ill following a bout of chicken pox. She was being sick after drinking and Zoe took her to the GP, who thought she had gastroenteritis.
Zoe, from Whitburn, Tyne and Wear, says: “They sent her home but she carried on being lethargic for a week. Then she looked as though she couldn’t move her neck, so we took her back to hospital.”
Doctors feared Tallulah had meningitis and gave her antibiotics and a lumbar puncture test. “They had to act quickly as they thought it may be bacterial meningitis, which meant there would be no time to lose,” Zoe reveals.
But an MRI scan the next morning revealed a mass on her brain. Tallulah was sent to the Royal Victoria Infirmary in Newcastle, where more tests showed she had an ependymoma, a tumour which develops in the fluid-filled spaces in the brain.
Zoe continues: “We were devastated. We’d never imagined that it would be anything as serious as a brain tumour. The only positive thing was that they told us it was the size of a grape, and usually when they are discovered they are the size of a plum, so it had been caught very early.”
Tallulah, who has a five-year-old brother named Robert, had an operation to remove the tumour the following day and has now begun pioneering proton beam therapy treatment at the Christie Hospital in Manchester. It targets the cancer directly. Tallulah is one of the youngest to undergo the treatment and is on a European trial.
Zoe says: “They normally only give the proton beam therapy treatment to children over 18 months, but they have given it to her as she has proved she is so resilient. When she had the operation, they thought she would have a long recovery, but she bounced back the very next day. It was remarkable, and it’s her strength that showed the doctors that even though she was much younger, she would cope with the treatment.”
Tallulah will have chemo at the Royal Victoria Infirmary. Before then, her ovary will be removed and cut into slices which will then be frozen.
Cryopreservation freezes the egg-producing portion of the ovary – called the ovarian cortex. The tissue can be transplanted up to 30 years later to make pregnancy possible.
Professor Tim Child – medical director for TFP Fertility and an expert in ovary freezing – says: “It’s an exciting technique and offers a lot of hope to families. It’s still not widely performed and it tends to be in adults and girls who are post-puberty. We know it can work in the older patients. There have been cases where babies have been born after ovarian tissue has been replanted.
“Chemotherapy can damage ovaries, so the tissue is frozen and the idea is that in future it can be put back into the pelvic area to see if it can produce eggs. Much more rarely, it is done in prepubescent girls.
“But even though they are so young, the tissue can still be frozen. By the time those little ones are looking to get pregnant, the research also will have moved forward. Seventeen months is incredibly young to have this done. I haven’t heard of anyone younger than this.”
Prof Child says the difficulty in such a young patient is that the immature egg cells are extremely small. He says: “We use a laparoscopy to remove part of an ovary but before it’s frozen we examine the tissue to find the most mature of the immature eggs, using a microscope to see if there are fluid-filled sacs or follicles which contain them.
“The bit of tissue has thousands of immature eggs but we can’t see them because they are so small. What we are doing is looking for the ones which are slightly less immature. So in the future we hope to be able to transplant the ovarian tissue back to give her a chance to conceive naturally.
“But we are also storing frozen eggs which can be thawed, fertilised and transferred into her womb. So we are using two different approaches to try to preserve fertility and giving women and young girls the hope of one day having children.”
Giving Tallulah the chance to be a mother means the world to Zoe. She explains: “When we were told that the chemotherapy could make Tallulah infertile, it was the biggest thing that scared me, next to the brain tumour. So the fact that she’s been offered this opportunity to have her ovary frozen is brilliant.
“We are hopeful about the future for her. The tumour has been caught early and it wasn’t wrapped around anything which could have affected her walking.
“She’s always smiling, and she just takes everything in her stride. And the fact that she can still have the chance to be a mum means the world to us.”
