As 10-year-old stares down leukemia, procedure fights to preserve his future ability to have children
It started with what everyone thought was a sprained ankle.
Riley Balcita was jumping around in his family’s driveway, the day after his 8-year-old well visit with the doctor. By all accounts, he was a healthy kid: the doctor told his mother they would see him in a year.
But he woke up the next morning with a pain in his foot so severe that he was unable to walk. He went back to the doctor, who said it was probably a sprain; wait a week, and it will probably be fine.
A week later, Riley was still in pain, and he’d developed a strange rash on his foot that looked like marbling under his skin. His mother, Barbara Dreves, brought him to an urgent care center, thinking perhaps he’d been bitten by a spider. The doctor looked at it and said, “You’ll probably laugh at me, but I think you need to go to the ER at Children’s Hospital.”
The next thing Barbara knew, she was talking to an oncologist and the hospital was scheduling a biopsy for her son. The result was a diagnosis of leukemia — and a two-year treatment plan that included nearly 20 rounds of chemotherapy.
“I never really knew anybody who had cancer,” she says. “So this was a whole different realm.”
Riley, now a precocious, outgoing 10-year-old boy who collects giraffes and loves Harry Potter, endured his chemo treatments with uncommon maturity, focusing on his studies and acing his standardized tests. He was declared cancer-free on Oct. 10, 2018.
But three months later, he relapsed, setting him up for more chemo treatments and the possibility of a bone marrow transplant. Barbara steeled herself for the next step, until the oncologist said the treatments might leave Riley sterile.
Immediately, she thought of her empathetic, intelligent, outgoing son, who might one day want to become a father — the kind of kid who wanted to put seat belts on his stuffed animals in the car. And she balked.
“I said, ‘No, you can’t take that away from him,’” she recalls. “Riley is an amazing child. I would find it heart wrenching if he would not be able to have a kid.”
Hearing her concerns, the oncologist directed her to Dr. Kyle Orwig’s group at Magee-Womens Research Institute. Orwig is pioneering a technique that harvests testicular tissue samples from childhood cancer patients, preserving it for future use, when it can be re-implanted in the same patient as an adult and matured to restore fertility.
Riley underwent the surgery in early February 2019. In addition to the tissue, doctors also took two vials of plasma for future testing against currently unknown conditions that might affect fertility. The tissue was divided into four samples that were stored separately, so that he will have four shots at fertility when he is ready.
“That was really important to me, to make sure that it’s not all for naught,” Barbara says.
She was also pleased that 25 percent of the tissue that was removed during the surgery is retained by Orwig, with the family’s permission, for research to develop the next generation of reproductive technologies that might be available to Riley in the future.
“Hopefully that 25 percent will help somebody else in this same situation,” she says.
For his part, Riley remains focused on homework, including a children’s book he wrote that originated with a create writing assignment, while he awaits word of a possible bone marrow transplant.
“I’m OK. It doesn’t hurt or anything right now,” he says.
As they prepare for the roads that lie ahead — both short- and long-term — Barbara says she is grateful for the possibilities that Orwig’s research creates: “It gives me some hope that Riley’s beautiful personality will continue on.”