Robert Woodward stood at the pinnacle of success in both academics and athletics. Then a brain tumor called ependymoma tested his bravery, strength and determination.
In 1999, Robert Woodward became the first boy in history to sweep all Class 7 events in the Oregon state gymnastics championships. Soon after this triumph, the diminutive 9-year-old set his sights on a loftier goal: the U.S. Olympic team. He knew that he would have to log tens of thousands of hours in the gym, fine-tuning his muscles and building super-human stamina. He expected to twist, vault, stretch and somersault across the challenges and competitors in his way.
Then Robert met an obstacle more unyielding than the pommel horse and more unpredictable than the rings: a rare brain tumor called ependymoma.
A whirlwind of wins
The terms “mediocre” and “average” have never been used to describe Robert, but the labels “genius,” “talented” and “driven” have been applied by many of his admirers. Born in Korea and raised in Maryland and Oregon, Robert was counting to 40 and reciting the alphabet by the time he turned 2. While most of his peers were stacking blocks and playing in the sand box, Robert was already exhibiting intense intellectual curiosity, uncommon determination and outstanding athleticism. His parents were not surprised when, in the third grade, Robert scored in the top 1 percent in state-administered intelligence tests.
Recognizing that their son was physically and intellectually adroit, Ju and Woody Woodward made a commitment to encourage his interests. Robert has taken dozens of classes in areas ranging from swimming and fencing to high-powered rocketry and animation. Other moms might find shoes and toys scattered on their kitchen floors; Ju is more apt to find a 7-foot-tall rocket standing in the middle of hers. “If we can scrape the money together to let him try what he’s interested in, then we do so,” says Woody. “If he likes it, we let him decide whether he wants to continue.”
When Robert was 5, he decided to study taekwondo; two-and-a-half years later, he had earned a black belt and had won numerous gold medals in state and international competitions. With aplomb and a deep calm, he competed in front of 20,000 cheering people in an NBA arena. “You can’t believe how incredible he is about focusing,” marvels his dad. “Most kids get real nervous when they compete, but Robert gets better when he competes. He rises to the occasion.”
At age 6, Robert began studying piano, whizzing through the musical curricula at such velocity that people began to whisper “virtuoso” when he attacked the keys. But he decided that piano was not his passion, so he changed direction. He channeled his musical energies toward classical guitar, an instrument that has intrigued and inspired him ever since.
Robert took a similar attitude toward taekwondo; in spite of his phenomenal success in the martial arts, he opted to pursue gymnastics, where he could capitalize on his innate flexibility, agility and precision. Like a child layering winter coats, he constantly piled on more activities—playing soccer and chess, choreographing elaborate aerial ballets for stunt-kite competitions and wielding bows and arrows with finesse. In July of 2000, Robert entered his first archery tournament, the Oregon state championship. Once again, he prevailed—vanquishing all opponents to win his division.
A new opponent
The highly competitive fourth-grader accrued a seemingly endless river of blue ribbons, trophies and gold medals, winning the all-around, or top honors, in every gymnastics meet. Then, early in 2000, he began to lose his edge. The differences were subtle, practically imperceptible, but they affected his scores. “At the beginning of the season, he was winning every all-around,” says Woody, “but by the end of that season he didn’t get a medal in any of the seven events at the statewide competition.”
In late summer, Robert began to suffer occasional dizziness during gymnastics practice. In early fall, he began having episodes of nausea and vomiting. When Ju and Woody took him to the local emergency room, the doctors found nothing wrong and sent him home. The symptoms escalated, culminating in a weeklong bout with what Robert assumed was the flu. This “flu,” however, was accompanied by monolithic headaches. “I just felt like I wanted to pull my hair out or kick a hole through the wall or something like that,” says Robert.
This time, a visit to the doctor yielded a definitive diagnosis: a tumor was growing in Robert’s brain. “First, I asked my dad, ‘Does that mean I have to have brain surgery?’ He said, ‘Yeah.’ And so we both cried a little,” recalls Robert. But the 10-year-old did not expend much effort in mourning his situation. With characteristic focus, serenity and determination, he marshaled his inner resources and approached the challenge head-on.
Robert’s ependymoma was successfully removed by surgeons at a hospital in Portland, Oregon. Afterward, the physicians recommended that Robert undergo radiation treatment, and they listed its side effects. “They were talking about things like permanent hearing loss, stunted growth and loss of mental capacity,” says Woody. “One of the side effects was that the radiation could cause cancer.” Unable to accept that their brilliant and talented son must undergo this potentially devastating treatment, the Woodwards began researching radiation options.
One name kept reappearing in their Internet searches: St. Jude Children’s Research Hospital.
Technology and technique
On the Internet, Woody read about Thomas Merchant, DO, PhD, of the Radiation Oncology department St. Jude Children’s Research Hospital. Through a scientific treatment plan called the RT-1 protocol, Merchant and his colleagues are testing a new way of delivering radiation treatment to pediatric brain tumor patients.
As radiation destroys tumor cells, it can also damage nearby normal tissues. Physicians in Oregon were planning to treat Robert conventionally, radiating a moderately wide region of his brain. At St. Jude, clinicians would use magnetic resonance imaging (MRI), computed tomography (CT) and other measures to pinpoint the exact area—the tumor bed and a small margin around it—that must be treated. Then they would use a technique called 3-D conformal radiation therapy to focus radiation beams from several directions onto that area.
“The best way to picture 3-D conformal radiation is to imagine the spotlights or searchlights outside a movie theater at night,” explains Larry Kun, MD, chair of Radiation Oncology. “Where the beams of light overlap or intersect, it’s brighter. That bright beam where they intersect is what you’re doing with 3-D conformal. You’re entering multiple trajectories, and the dose occurs within the boundaries where they overlap. That’s what makes it 3-dimensionally conform to the tumor.”
By limiting the radiation dose applied to the normal tissues, St. Jude clinicians can avoid many harmful side effects. With the RT-1 protocol, they are treating a much smaller area than has been treated in the past. “You don’t want to treat the tumor area too tightly, because you might actually miss some of the area that needs to be treated,” Merchant says. “So we’ve determined the smallest volume that can be safely treated without compromising tumor control.” The protocol includes extensive evaluation before and after therapy to identify the treatment’s impact on such areas as school performance, growth and development, hearing and neurological functioning.
Merchant says the technology used in the RT-1 protocol is widely available, but the experience levels at St. Jude are unrivaled. “The capability is there at other places, but the experience is not,” he says. “The RT-1 protocol is one of the largest single-institution brain tumor studies ever conducted. We have treated 185 children in just five years. With a rare tumor like ependymoma, even the larger centers will treat only one or two children a year. Over the course of five years, we’ve treated 80.”
Robert underwent six-and-a-half weeks of radiation treatment at St. Jude. As usual, he practiced good time management, mastering a new skill between appointments. He had always wanted to learn to juggle; now he had the time to learn.
“He’s an unbelievable juggler,” says Christy Bosley, RN, Radiation Oncology nurse. “He’s one of those children who makes up his mind he wants to do something and it just sort of happens.”
Robert makes things happen. A week after he returned home from St. Jude, he braved residual dizziness and nausea to resume practice. Five weeks later, he entered a five-state gymnastics tournament and won the pommel horse event. When he returned to Memphis for his next appointment, he presented his blue ribbon to Merchant.
That blue ribbon represents the success of the RT-1 protocol—not only to Robert, but to many other children with life-threatening brain tumors. “Robert’s doing fantastic,” Merchant says. “And he’s not the exception. Most of the kids on RT-1 are doing as well after the treatment as they were before.”
Today, Robert has resumed his frenetic schedule, constantly setting, reaching and exceeding new goals. An accomplished classical guitarist, he has attracted the attention of such luminaries as Lily Afshar, PhD, one of the United States’ most accomplished classical guitarists. “He’s very serious about his guitar,” says Afshar, who adds that she was “very impressed” with Robert when she met him at a national guitar festival last year. In addition to the guitar, Robert also is learning to play the alto saxophone and the oboe. He recently auditioned to play oboe for the Metropolitan Youth Symphony.
Robert was the lead programmer and team captain in a robotics tournament last year; he received the 2002 President’s Gold Medal for academic achievement; and he is currently plying his skills at woodworking and wood burning. At the 2003 state music evaluations, he scored 322 out of a possible 330 for classical guitar performance. The evaluator actually asked him if he had an album out that he could buy.
“What’s impressed me the most about Robert has been his motivation to continue working really, really hard,” says Susan Chattin-Helton, EdS, Robert’s psychological examiner at St. Jude. “He never let the fact that he had a brain tumor or was going through treatment get him down. Robert’s own motivation has played a key role in his recovery.”
In spite of all his activities and accomplishments, Robert still finds time to say “thank you” to St. Jude. When his school participated in the St. Jude Math-A-Thon®, Robert created a videotape chronicling his radiation treatment. He visited each classroom, explaining why the children should participate in the fund-raising event. The school tripled its level of participation that year.
Woody becomes emotional when he contemplates his family’s experiences at St. Jude. “St. Jude is a heaven on earth,” he says, his voice cracking with unshed tears. “I don’t know where we’d be without the people there. Truly there are miracles in this world, and my son is one of them.”
What is left for Robert to accomplish, now that he has reclaimed his future? “My dream is to go to the Olympics in gymnastics,” he says. Robert is well on his way to meeting that goal, after winning two events in the 2002 Oregon State Gymnastics Championships. And after the Olympics? “I want to be a robotics engineer,” he says, “and a concert guitarist on the side.”
If Robert Woodward makes his mind up to do it, be assured: it will happen.