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February 28, 2018

Light at the End of the Tunnel After Proton Beam Therapy

By SharingMayoClinic

Intensive treatment for brain cancer has given Nicholas Sloan the opportunity to continue exploring and enjoying life's adventures.

Intensive treatment for brain cancer has given Nicholas Sloan the opportunity to continue exploring and enjoying life's adventures. 


Last September, Nicholas Sloan went sky diving for the first time.

"It was awesome. We jumped at 13,500 feet and fell for 60 seconds. It was amazing to watch the world come closer," Nicholas says. "It feels like total freedom. I'd do it again in a heartbeat."

The experience was something of a celebration for being in remission from brain cancer. That remission is thanks in large part to a team effort at Mayo Clinic that offered Nicholas an intensive treatment regimen to control his tumors. And even though his cancer isn't gone, he is happy to have an opportunity to continue moving forward.

"There's a light at the end the tunnel," Nicholas says. "I just need to keep running toward it."

Facing a difficult diagnosis

Four months before his sky-diving adventure, 30-year-old Nicholas had completed 30 proton therapy radiation treatments over six weeks to treat two cancerous glioma tumors. The tumors were in his brain's right frontal lobe and near the left brain stem. They were likely induced by radiation Nicholas had received to treat another type of brain tumor called a medulloblastoma when he was 9 years old.

The new tumors were discovered on a CT scan when Nicholas went to an emergency department near his home in Scottsdale, Arizona, in April 2017. He'd been experiencing numbness on the left side of his face and irritation in his left eye.

"My left eye was only closing 50 percent," Nicholas says. "It would stay open at night, and get red and dried out and irritated."

One morning Nicholas woke up unable to move his left cheek. He was diagnosed with Bell's palsy, a sudden weakness in the facial muscles. The condition was caused by compression of his nerves from the two brain tumors. After reviewing his scans, his primary care doctor referred him to Mayo Clinic's Arizona campus.

Consulting a team of experts

At Mayo Clinic, Nicholas met with Bernard Bendok, M.D., chair of the Department of Neurosurgery, who performed a brain biopsy and confirmed the tumors were gliomas.

"After the biopsy, it was important for Mr. Sloan to have access to a multidisciplinary team whose expertise rounded out the needed skills to successfully treat his tumors," Dr. Bendok says.

Nicholas then consulted with neuro-oncologist Alyx Porter, M.D., and radiation oncologist Terence Sio, M.D., to discuss his treatment options.

"The brain stem is the most critical part of the brain. When a tumor is nearby, it's hard to treat," Dr. Sio says. "His brain and spine received a significant amount of radiation in the past, and further radiation could easily cause more brain damage if not performed properly. It was essential for us to make sure that his normal brain tissue would be protected while trying to treat his tumors."


"It's been an amazing experience. If anyone got sick, I would recommend Mayo in a heartbeat." — Nicholas Sloan


During their first meeting in May 2017, Dr. Sio discussed proton therapy with Nicholas. He explained how this therapy would pinpoint the radiation beam at the tumor while avoiding high levels of radiation to surrounding healthy brain tissue as much as possible.

"With proton beam radiotherapy, I was more confident that I could deliver an adequate amount of radiation to his tumors while still protecting the critical organs in his skull, such as the brain stem and visual structures," Dr. Sio says.

During his proton therapy from June through August 2017, Nicholas also received oral chemotherapy, which he still continues.

"Given the malignant nature of his tumors and disease that was seen along the nerve roots of the spinal canal, we decided to introduce a chemotherapy agent known to be synergistic with radiotherapy to achieve the maximum potential benefit to Mr. Sloan," says Maciej Mrugala, M.D. Ph.D., Nicholas' medical oncologist.

Making good progress

A scan in November 2017 showed one of Nicholas' tumors was shrinking, and the one located next to the brain stem was stable in size. The scan revealed no new cancerous masses elsewhere in his brain or spine.

"Dr. Sio came into the exam room and gave me a hug," Nicholas says.

"Dr. Sio; my brain surgeon, Dr. Bendok; my oncologists, Dr. Mrugala and Dr. Porter; and all of the nurses are the most professional people I've dealt with in medicine," Nicholas says. "It's been an amazing experience. If anyone got sick, I would recommend Mayo in a heartbeat."

A paraeducator for special needs classes and physical education, Nicholas was a week from starting his teaching credentials program at a community college when he was diagnosed with the gliomas. Now he plans to work toward his teaching certificate and travel around the country in the RV he shares with his dad.


"His quality of life is excellent. This is one person's life that we have changed." — Terence Sio, M.D.


"We've gone to the Pacific Northwest since we have a lot of family in the Seattle area," Nicholas says. "We're planning to go to the Daytona 500 and to see the Alamo in Texas. I'd also like to go to Ireland to learn more about my family's roots."

He's also excited to get back to teaching and return to his favorite outdoor activities of fishing and hunting.

Although Nicholas still has symptoms from Bell's palsy, including facial weakness and numbness, the treatment he's received so far has kept his aggressive brain cancer from progressing.

"His quality of life is excellent," Dr. Sio says. "This is one person's life that we have changed."


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Tags: brain tumor, Cancer, Dr. Alyx Porter, Dr. Bernard Bendok, Dr. Maciej Mrugala, Dr. Terence Sio, Mayo Clinic Cancer Center, Neurology & Neurosurgery, Proton Beam Therapy

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