Brief Medical History of Ari (Aryeh Noam Chaim ben Devorah Chana) Grashin
from October 2001 to present,
SUMMARY OF ARI GRASHIN’S RECENT MEDICAL HISTORY: Ari is a 16-year-old young man
who has been diagnosed with a cerebellar medulloblastoma. Despite surgical
excision, radiation, one course of CCNU, cisplatin and several courses of
vincristine, the tumor recurred and continued to grow. He is being treated at
Children’s Hospital in Seattle. When the tumor reached 3cm he was treated with
gamma knife for a 3cm and approx 1.5 cm new tumor (metastatic) on June 10, 2002.
He received cytoxin(mid June) in order to harvest stem cells. The stem cells
were harvested in late June. He began taking oral etoposide July 3, 2002. The
regimen is 3 weeks on and one week off for as long as he tolerates it or until a
different plan is decided. We have started some nutritional support through Dr.
Labriola an oncology naturopath, and are considering contacting Jeanne Wallace a
nutritionist who specializes in brain tumors. The young man has a web site
www.arigrashin.com so you can see more of the history.
DETAILS OF ARI GRASHIN’S RECENT MEDICAL HISTORY: During basketball practice (Oct
2001), Ari felt his shot was off and his strength had diminished.
After some practices during pre-season, he came home not feeling well. At school
he would get headaches, but nothing terrible. As the practices progressed, we
could see he wasn’t feeling well. In early November he developed a mild case of
shingles (h. zoster – related to chicken pox). We thought that was perhaps why
he wasn’t feeling well. We went to the doctor but nothing was overtly telling us
to what was going on.
The first scheduled game of the basketball season was on a Saturday night in
early December. Earlier that day we walked to a friend’s house for lunch. It was
extremely noticeable that Ari was having difficulty walking and maintaining his
balance. He also tried to shoot some hoops and he kept missing them.
To make a long story short, he started the game that night, tried to play, but
was unable to for more than two minutes. It was pretty scary. A good friend of
ours, whose son was also on the team, and who happens to be a doctor at
Children’s Hospital, saw the distress Ari was in. She did a quick visual exam
and suggested we immediately see a neurologist. She was able to get us an
appointment for that Wednesday with a neurologist. It was obvious that night
that there was something very seriously wrong with Ari.
We visited the neurologist. From his visual exam, he could see that Ari’s right
side was affected. He thought that most likely it was an inflammation of the
cerebellum. Just to be sure, he recommended an MRI to rule out anything more
The MRI was scheduled for late on Monday December 10, 2001. On Tuesday, there
were messages at home, work and on our cell phones to please call the
neurologist’s office. They asked us to come in the afternoon and that we should
also bring Ari.
After viewing the MRI, the tumor was obvious. The impression the doctor had was
that it was most likely a benign cerebellar astrocytoma – a tumor usually cured
with surgery alone. He gave us the name of a surgeon at Children’s Hospital that
he highly recommended.
We met with the doctors (Neurosurgeon: Richard Ellenbogen and Neural Oncologist:
J. Russell Geyer) at Children’s and they recommended taking out the tumor
surgically. The tumor (1.5 cm) was successfully removed 12/21/02. However, a
review of the biopsy showed it was a Medulloblastoma in the cerebellum,
An ultrasound taken during surgery and an MRI 10 days post surgery showed no
signs of any residual tumor. (The spine was scanned and an LP was also done
12/31; both were negative)
Beginning in mid January: radiation was given:
13 treatments to brain and spine
18 treatments to tumor bed
(the last day of treatment was March 4th)
Chemotherapy: Vincrinstine was given once a week for 6 weeks during the
PEG (feeding) tube was implanted in Ari on March 18, 2002
Beginning on April 11th, his chemotherapy regimen began.
He had an overnight stay in hospital: where he received CCNU, Cisplatin and
Vincristine. He then received Vincristine for two additional weeks.
The original plan was to have 8 – six week cycles of the above chemo series.
(i.e. have all the chemo the first week, followed by vincristine for two more
weeks, then 3 weeks off.)
On April 19, the first follow-up MRI was done. There appeared three small
nodules at the original tumor site (partially connected). A PET scan was done
May 6. The PET suggested tumor.
An MRI done on May 14 showed no change in what was apparent on the 4/19, but
showed a new nodule (approx 1 cm.) outside of the tumor bed – indicating a
recurrence. (Before, we held out hope that the regrowth in the tumor bed was
part of the original tumor, and the radiation just hadn’t kicked in to shrink
and destroy the tumor.)
An MRS was included on May 14th. (The PET scan, which was done the week earlier,
showed no signs of the new tumor.) .
The new tumor was located in an easy position to remove surgically. The surgeon
felt it would be ok to do surgery in the original tumor bed-but could be risky
due to the proximity of the tumor to the brain stem. Plus the area had already
been insulted once before.
The option was taken away when we received the results of an additional MRI on
June 7th. The tumors had grown to 3 cms. and 1.5 cms. respectively and we were
advised that we needed to remove the tumors immediately and he advised against
surgery because the size of the tumor and the rate that it was growing (he had
never seen a Medulloblasyoma grow back so large so quickly.) could cause severe
damage to his motor skills. Consequently, on June 10th, Ari underwent the Gamma
Knife C (stereotactic or radiosurgery) at Harborview Medical Center. (See
http://www.washington.edu/medical/hmc/gk/). The Gamma Knife is basically
neurosurgery without incisions.
Ari was admitted to Children’s on June 13th for chemo treatments to prepare him
for stem cell harvesting in case he will need them in the future (if we decide
to do high dose chemotherapy, we would need to have healthy stem cells
available. Thus, we are harvesting them now). He was released on June 15 and
tolerated the treatment quite well. The next Friday Ari was admitted to the
hospital with an infected G tube. His blood counts dropped which makes infection
likely. He responded immediately to the antibiotics and because his counts
already had risen he was released on Saturday. Thankfully he did not develop a
fever or any other complication.
The stem cells were harvested at the Hutch over two days at the end of June.
Previous Prognosis: from the original surgery we were in the best risk category.
We were told this type of tumor has a 70-80% chance of a cure.
Current Prognosis: whatever we do—surgery, radiosurgery (gamma knife), heavy
dose chemo w/own stem cell replacement, or oral chemo (etopocide) would probably
only extend life for 1-5 years. Cure, with conventional medicine, was not given
as a possibility with what they currently know about Medulloblastoma. Instead,
the doctors want to prolong life as long as possible in order to be there when a
new treatment becomes available. This, of course, is predicated on the tumors
responding to chemo or radiosurgery. If they don’t (as would have been the case
had there been no intervention on the tumors), our Oncologist - after very
direct questioning from Ari- told him he would probably have less than a year…
For a few weeks Ari took Pau D’arco Bark tea.www.pau-d-arco.com (he began soon
after 4/19 MRI and continued until 5/14) (We met a 90-year old woman on a plane
that told us about it. Her doctors told her that her cancer was incurable. She
had no chemo or radiation. She used the tea for 3 months, survived the cancer,
and is now 90. We might begin using the tea again, but we got nervous that the
new spot came about during the time he was using it (although the original tumor
site was unchanged))
Last month, Ari began taking two different derivatives of wormwood/artemesia
(thought to cross the blood-brain barrier). A research professor from the
University of Washington advised us on the dosage and the procurement of the
herb. There are several studies indicating that this medicine, which has been
used for malarial treatment, shows great promise in killing cancer cells. Our
doctors ok’d its use (in conjunction with conventional methods). If you look at
arigrashin.com you will see some links to articles about artemesia. To get the
scientific info, you need to dig a little or I can send you some links.
Ari still has right-sided weakness (leg and arm/hand) which he has had since
before the surgery. He stopped PT when the MRI showed new problems, thinking he
wasn’t improving much because of the growth. The doctor indicated that the
tumors were not large enough to cause him the continued coordination problems he
was experiencing at that time.
He is very thin (5’8” and 115# soaking wet). He had been receiving g-tube
nightly feeds until he began the artemesia. (He takes it at night and can’t eat
thereafter for at least four hours). He is a very picky eater—diet changes would
be very difficult on him. He would rather not eat.
Interestingly, for the past two years he had decided that he was lactose
intolerant and suffered with stomach pain. The most he weighed was 125#. The
doctors here are very protective of weight loss. The PEG was implanted to take
the pressure to eat off of Ari. During radiation he was unable to eat most of
the time. When the PEG tube was implanted, he was also diagnosed with chronic
gastritis. He was put on Prilosec. The last few weeks he decided to try dairy
again and, with a little Lactaid, has had no problems. Lately he has eaten
enough ice cream to make up for the past few years! (FYI, one of his brothers
has Crohn’s disease).
We have consulted with Dr. Dan Labriola and Dr. John Sherman. They are
naturpathic doctors specializing in complementary treatments for those
undergoing conventional treatments. We will also be contacting Jeanne Wallace an
expert in Brain Tumors and nutrition. We have adjusted Ari’s diet to try and
adjust his body chemistry to bolster his natural immune system.
He hasn’t attended school since December.
He is in OK spirits despite all he is going through. His friends are extremely
caring and supportive. He loved playing sports and continues to enjoy watching
sports (and minimally playing a little). He was a very talented athlete and has
hopes to recover enough to play again. Chai Lifeline sent him to the Super Bowl
in January and he became a buddy of the Sonic basketball player Desmond Mason.
What we are hoping and praying for:
To find where they are doing something totally innovative. Our doctor is Jeffrey
Russell Geyer. He is a pediatric neuro-oncologist. He is extremely competent,
qualified, compassionate and caring. The problem is that he is limited in the
options he has with conventional medicine. He is part of a brain tumor
consortium that includes many other well-known doctors. His recommendation at
this point is to use etopocide in order to preserve quality of life. (the high
dose chemo brings with it a lot of suffering, and possibly could be fatal, and
comes without greater promise of prolonging his life). He began taking oral
etoposide on July 3, 2002. The regimen is 3 weeks on and one week off for as
long as he tolerates it or until a different plan is decided
Any advice, recommendations, or referrals we will gladly investigate. I have
given you the history in detail except for the actual reports, which I can
We appreciate your time and energy. Thank you for caring
David and Debbie Grashin and Family
206.650.5758 Debbie Cell
206.850.5802 David Cell