Joshua’s Journey

In 2008 Joshua’s parents were given the devastating news he had stage 4 neuroblastoma which had spread all over his body.

With Joshua’s prognosis described as “unfavourable”, he began treatment at Great Ormond Street Hospital in January 2009. Joshua endured 70 days of induction chemotherapy, which had a dramatic effect on the cancer, removing all eleven areas of bone disease and shrinking the primary tumour by 5cm. Joshua then had surgery to remove the tumour in his adrenal gland. After examining his liver and intestines the doctors found no further evidence of the neuroblastoma.

Before Joshua could continue with treatment and receive the high dose chemotherapy so essential in preventing relapse, doctors needed to harvest a minimum of 3 million stem cells. These cells would be used to repopulate his bone marrow so Joshua’s body could produce healthy blood products. After two unsuccessful attempts, and with time running out to begin the high dose chemotherapy, stem cells were collected directly from Joshua’s bone marrow under general anaesthetic. Joshua began the next phase of treatment in June 2009 with three weeks of radiotherapy at University College Hospital.

Despite the best efforts of Great Ormond Street Hospital, the likelihood of Joshua suffering a relapse remained dangerously high. With no standard treatment path for relapsed neuroblastoma, Joshua’s parents chose to participate in an antibody clinical trial available in America at a cost of over than $500,000.

Thanks to the amazing support of their local community, who donated and raised over £200,000, Joshua was able to fly to America for treatment. He and his family flew to New York’s Memorial Sloan Kettering Cancer Center in October 2009. He began the monoclonal 3F8 antibody therapy after being given GM-CSF to stimulate the production of white blood cells.

For the best possible chance of beating neuroblastoma, Joshua would need at least 6-8 cycles of the antibody treatment. However, after only two rounds of the antibody treatment Joshua developed a reaction to the antibody called the HAMA response, which decreases the effectiveness of the treatment. At this time, the immunotherapy was put on hold until Joshua stopped reacting.

In November of 2009, Joshua started six months of oral chemotherapy that aimed clear any microscopic neuroblastoma cells left in his body. Since then Joshua has put on weight, and took his first steps in January 2010.

At the beginning of 2011, Joshua started having immunotherapy treatment in Greifswald, Germany, funded by the Neuroblastoma Children’s Cancer Alliance UK, (NCCA UK). Now this is complete, Joshua is back home and showing now evidence of disease. He will be tested regularly in case the neuroblastoma returns.