Cancer Treatments Change for the Better Over the Decades

When Eddie Timanus’ son Evan was born in 2004 the new father’s joy was overshadowed by the genetic factor that he and the boy’s grandfather both carried and had become a virulent form of cancer. It had threatened their lives and stolen their eyesight. Would his child suffer the same fate?

“Luckily we knew to be on the lookout for problems with our son’s eyes,” said Mr. Timanus of Northern Virginia. Six months later William Deegan, MD eye specialist at Georgetown University Hospital and Arlington Hospital, detected the tiny cancerous tumors called retinoblastoma. Little Evan would begin chemotherapy at Lombardi Comprehensive Cancer Center at the tender age of 6 ½ months. But his treatments proved to be quite different from his father’s and his grandfather’s.

Eddie’s journey with the disease began in 1970, when before the age of 2, he was diagnosed with retinoblastoma. Eddie had chemotherapy and radiation but in the end, doctors had to remove both of his eyes to save his life. His father had the same cancer in one of his eyes in the 1940’s. The elder Timanus lost one eye but is still living in the DC area.

“This experience with our son has shown me how far cancer treatments have come in the past thirty years, since I was treated and even longer in my father’s case,” said Eddie Timanus. “I had chemo, radiation and surgery to remove both of my eyes and it was an arduous process. Evan had laser eye surgery to shrink his two tumors and then chemotherapy, which he handled very well.“

Dr. Deegan used laser surgery to shrink Evan’s tumors. “The way we treat this disease today has changed a great deal. This is in part because of what we have learned over time and because of new technologies. Now we only use radiation as a last resort because we know that radiation has significant side effects. In Evan’s case he was able to maintain his visual acuity because the tumors were outside of the macula, the light-sensitive layer of tissue at the back of the eye.”

Amal Abu Ghosh, MD, one of the pediatric hematologist oncologists at Lombardi was Evan’s primary oncologist. “Right now Evan’s prognosis is great. He has done very well with laser surgery and chemotherapy and has not had to have his eyes removed. The fact that his tumors were diagnosed at an early stage enabled us to effectively treat them with chemotherapy and laser therapy. Unfortunately, even today, when patients come with extensive disease or if local treatment fails, we have to give radiation therapy and sometimes recommend removal of the eye. Our goal in treating those children at an early stage is to preserve vision as much as possible and avoid radiation, as it is associated with a significant increase in secondary cancers later on in life. Evan’s retinoblastoma is the hereditary type that is transmitted from parent to child in an autosomal dominant pattern with 90% penetrance. Some cases of hereditary retinoblastomas are a result of a rare genetic mutation and thus are the first reported for that family and are usually diagnosed at a later stage.”

“I’m very grateful that my son has had a much easier treatment course than I had,” said Eddie Timanus.

Aziza Shad, MD, Director of Pediatric Hemotology-Oncology, Blood and Marrow Transplantation at Georgetown University Hospital and Lombardi, also directs the Cancer Survivorship Program that follows childhood cancer patients into adulthood, monitoring them for late effects of treatment.

“Because pediatric oncologists have followed these patients years after their treatment, we now know for example, that not every child with retinoblastoma needs radiation to the eyes,” Dr. Shad said. “Evan didn’t”.

Eddie Timanus is enrolled in Dr. Shad’s Cancer Survivorship program and will be followed yearly to keep track of possible side effects to the treatments he had 30 years ago, including bone cancer and soft tissue cancers. His son will be enrolled in the same program once he is two years off treatment.

Retinoblastoma can also occur in patients with no genetic pre-disposition to the disease. Eddie Timanus and his wife Kelli have since met dozens of parents whose children were not being watched for the disease and some who died because it was found too late.

“I would like to see this simple dilatation of the eyes be something all children get at the doctor’s office at their checkups,” said Kelli Timanus. “We were lucky that Evan’s case was caught early enough that he will have a good outcome. But other parents who are not on the lookout for it might find that their child’s disease has spread too far to save their eyesight or their life.”

According to Retinoblastoma International 350 new cases are diagnosed each year in the United States and affects one in every 15,000 to 30,000 live births. It is seen in children of all races and in both boys and girls. Seventy-five percent of the cases involve one eye, 25-percent of cases affect both eyes. Even though it can run in families, 90-percent of retinoblastoma patients do not have a family history.

Media Contact: Marianne Worley
Phone: 703-558-1287
Email: WorleyM@gunet.georgetown.edu

Patient Contact: 202-342-2400