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Meet Our Survivors: Jacob Ralston

Family learns of proton therapy weeks before toddler diagnosed with cancer

“If anyone in our family ever gets cancer, they need to have proton therapy.”

That’s what Susan Ralston’s father-in-law concluded after attending a business meeting at a proton center and learning how proton technology can precisely treat some cancers. No one guessed that a month later, cancer would strike one of the Ralston family’s youngest members – Susan’s 2-year-old son, Jacob.

Jacob Ralston“I was devastated,” Susan remembers. “I thought, ‘He’s 2. What would cause a 2-year-old to have cancer?’”

The Ralstons’ plight began with what appeared to be some temporary soreness in Jacob’s back. Jacob’s daycare providers informed his parents that he’d complained about a pain in his back. Assuming he may have simply twisted it during play, they watched him closely the rest of the day, as did the Ralstons when they picked him up later that evening. He seemed fine the next few days until the morning when Susan went to get him from his crib, and he couldn’t stand.

Susan and her husband, Jim, rushed Jacob to the local children’s hospital in their Virginia Beach community. After days of testing and physical exams, the Ralstons were told something they never expected to hear.

“Your son has a tumor on his spine,” Susan said. “I thought, ‘Are you sure?’ And they were. Our son – little Jacob – would need surgery within a day to remove a tumor from his spine.”

Jacob was diagnosed with Ewing’s sarcoma, a rare cancer that occurs primarily in the bone or soft tissue. Ewing's sarcoma cells also can spread (metastasize) to other areas of the body, including the bone marrow, lungs, kidneys, heart, adrenal gland and other soft tissues.

The quick and collective thinking of Jacob’s doctors and the subsequent surgery saved his spine, as the tumor’s growth could have permanently paralyzed him. Fortunately the cancer had not metastasized, but his treatment plan included 14 rounds of chemotherapy and radiation to give Jacob the best chance of beating cancer.

The Ralstons’ entire family went into overdrive researching the options – specifically the option of proton therapy that Jim’s dad had become an advocate of just weeks before Jacob’s diagnosis. The couple and their extended family sifted through tons of information, including information from the proton center where Jim’s dad originally learned about proton technology. But the family determined they would seek care for Jacob at the MD Anderson Proton Therapy Center. “We wanted to come to MD Anderson because it was the no. 1 cancer center,” Susan said. “They have a sarcoma specialty, and we were very impressed with the percentage of cases treated there.”

Because of sarcomas’ rarity, most oncologists have treated few patients with these tumors, if any. MD Anderson treats more sarcoma patients than any other cancer hospital, enabling doctors to build on their expertise with the disease and discover new therapies and diagnostic methods.

“Jacob’s tumor was very close to his spinal cord and required specialized treatment that would allow us to deliver the most precise radiation possible,” explained Dr. Anita Mahajan, medical director of the Proton Therapy Center and director of Clinical Pediatric Radiation Oncology at MD Anderson. “With proton therapy, we can target radiation to the sub-millimeter – the width of a human hair – in order to spare surrounding tissues. In Jacob’s case, that precision allowed us to give the maximum dose to the tumor while protecting his lungs, heart and esophagus.”

The Ralstons also were compelled by the availability of Dexrazoxcane, a drug used to prevent heart damage during cancer treatment. Because MD Anderson was conducting clinical trials with Dexrazoxane Susan felt reassured it would be available for Jacob during his treatment, although it was not yet available elsewhere.

“When patients choose MD Anderson for treatment, they are not just choosing a hospital that specializes in treating cancer but also a research institution with an army of people who are committed to improving health outcomes,” Mahajan explained. “As in Jacob’s case, part of that commitment means that many of our patients have access to clinical trials and treatment protocols that give them access to special therapies for their disease.”

After an initial consultation at the Proton Therapy Center, Susan, a community bank president, and her chef husband, moved to Houston for the two months of Jacob’s treatments, which included a combined regimen of chemotherapy and proton therapy. The reassurance the family received when they arrived at the Proton Therapy Center was encouraging.

“The (radiation oncology) nurse and the anesthesiologist came over to us, gave us a big hug and said ‘We’re going to take care of your son like he’s our son,’” Susan recalled.

The family also was thankful for MD Anderson’s intake specialists who helped navigate the red tape of getting the treatment covered by their insurance provider. With the help of intake specialists, the Ralstons were able to schedule a consultation at the Proton Therapy Center within two weeks of Jacob’s initial diagnosis. “The intake specialists really worked with our insurance to get Jacob into the center – they were real warriors for him.”

Jacob endured dozens of rounds of treatment, but the family found many ways to make the time in Houston enjoyable, visiting nearby parks, beaches and the aquarium. Jacob had proton therapy treatments early in the day and was able to play and enjoy the family outings in the afternoons.

As Jacob excitedly approaches his fifth birthday, the family’s journey is becoming a distant memory as Jacob explores new adventures. Although he wears a small back brace, he’s an advanced swimmer who loves going to the local beach and riding his bike. He’s graduating pre-school and recently debuted in the starring role in his first play.

Having learned so much from the experience, Susan and her family have become strong advocates of proton therapy for pediatric cancer treatment. The Ralstons began the Pediatric Proton Foundation to promote awareness and educate other families and to “pay it forward.”

“We want other parents to know that proton therapy may be a viable option for their child because many health care providers are simply not educated about the benefits,” Susan said. “Proton therapy is not only advantageous in the treatment plan, but helps preserve the quality of life for our children and reduce the risks of later secondary cancers caused from radiation exposure. We credit proton therapy for helping to save our son’s life and hope to help others.”

Meet Our Survivors

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Since treating our first patient in May 2006, the dedicated team at the Proton Therapy Center has helped countless patients overcome cancer and get back to living their lives. Click here to read our patient survivor stories.


© 2014 The University of Texas MD Anderson Cancer Center