A nine-year-old boy with a brain tumour has become the first person in the UK to have testicular tissue frozen in the hope that he can have children later in life.
Nathan Crawford has undergone radiotherapy and chemotherapy to shrink his tumour, which is inoperable, but the treatment could make him infertile. In a groundbreaking procedure, surgeons at the John Radcliffe hospital in Oxford have removed and frozen a wedge of testicular tissue, with the aim that it is one day re-implanted into Nathan.
If the re-implantation is successful, Nathan will have a good chance of becoming a father. He has a type of tumour called a glioma , which develops from the glial cells that support the nerve cells of the brain. The tumour is so close to vital brain tissue that surgeons are unable to remove it without causing serious damage to important brain functions.
Before he started chemotherapy, Nathan’s family, who live in Bude, Cornwall, were offered to take up the chance for testicular tissue freezing, thanks to pioneering work at the John Radcliffe hospital. During keyhole surgery, which was carried out under general anaesthetic and lasted between 20 and 30 minutes, surgeons removed a wedge of tissue from one of Nathan’s testes.
This sample contains sperm stem cells, which remain viable when slow-frozen within the small amount of tissue.
Nathan’s stepfather, Jonathan Alison, 34, said the family first noticed something was wrong in late January: “Nathan was having more headaches than you would expect and also had blurry vision, which we initially put down to too much time on the games console or possibly problems with his eyesight.
“We took him to the opticians who sent us straight to the doctor. We were then sent up to Bristol Royal hospital for children where Nathan underwent an operation within days to remove some of the fluid in his brain. He also needed a second procedure to biopsy the tumour. We have been told the tumour is non-cancerous and is grade two. With this type of tumour, as a child gets older it will quite often grow. It could cause damage that could be life-threatening. Obviously we had been putting this down to possible problems with his eyesight so to be told it was a tumour was very hard.”
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Alison said he and Nathan’s mother, Donna Hunt, 31, have explained the tumour to Nathan and how the procedure to store testicular tissue might help him in later life. “Nathan loves children and so we told him this would increase the chances he can have his own children,” he said.
Hunt said: “Our decision-making process regarding whether Nathan should have chemotherapy was made so much easier thanks to the fact Oxford could offer this storage of Nathan’s cells.”
“Once he’d been up to Oxford to have the tissue removed, he was back home in Cornwall within 48 hours eating fish and chips with us.”
Dr Sheila Lane, a consultant paediatric oncologist who is clinical lead for tissue cryopreservation at the John Radcliffe hospital, said the new technique had been shown to work in animals. It is similar to ovarian tissue freezing, which has already produced live births for women who have undergone the procedure.
Lane said: “During the procedure, you take what looks like an orange segment out to divide into small parts, which then get frozen. You are storing the tissue which contains the stem cells. What happens when you put this tissue back, at a later date, is that it generates its own blood supply and starts producing normal hormones, which restores fertility.”
She said that the fact that Nathan’s tumour is inoperable does not necessarily make it life-threatening. “These tumours can possibly be cured with intensive chemotherapy,” she said. “Patients can have a long and happy life without any problems.”