Thanks to a novel treatment, this Bay Area high school QB beat a tumor and led his team to the playoffs

SARATOGA — Quarterback Payton Stokes did not follow much of the conversation when doctors discussed his medical condition one day last March.

“I didn’t understand what they were saying except for that word,” he said.

The word was: “tumor.”

Stokes, 17, suffered from osteoid osteoma, a benign bone tumor that he worried would keep him from playing his senior football season at Saratoga High School.

But Stokes has enjoyed a special season after Stanford University doctors helped him return to competition by using an innovative procedure involving high-intensity sound waves to burn away the pain-causing tumor, located in a challenging area of the left hip.

Stokes, the leading passer in the Central Coast Section, led Saratoga into the Division IV playoffs, completing 67 percent of his passes, for 3,020 yards and 36 touchdowns. Friday night he threw for more than 300 yards, but the Falcons’ season ended with a 62-43 defeat to third-seeded Carmel High School.

Saratoga quarterback Payton Stokes (7) fakes a handoff to teammate Tyler Chaffin-Price (21) in the second quarter of a high school football game against Cupertino on Nov. 8. (Anda Chu/Bay Area News Group) 

Stokes said that after sitting in a doctor’s office in March, wondering if he would ever play again, he has been grateful for every moment he’s spent on the football field this year.

“There were points, even on Advil, that he couldn’t even stand or walk,” said Dianne Stokes, Payton’s mother. “There were moments of pure pain.”

The tumor, which has no known cause, is most common in patients under 25 years old, according to the UC San Francisco medical school website.

The soreness began in September of 2018 after football practice, said Stokes, who is named after NFL great Walter Payton. By the end of last season, the pain had increased despite stretching and other treatments. Still, Stokes threw for 3,168 yards and 36 touchdowns.

“We thought it was a hip flexor,” Saratoga High football coach Tim Lugo said.

Once Stanford physicians identified the tumor, four months after his last game of 2018, they gave the Stokes family some options.

Osteoid osteomas usually dissolve on their own within three to seven years with the use of anti-inflammatory medications, said Robert Steffner, an orthopedic surgical oncologist who was part of the Stanford medical team that helped Stokes.

But Stokes wanted immediate relief so he could rejoin his football teammates.

This is a CT scan of a patient with osteoid osteoma. The image shows the bones and muscles around the right hip joint. The tumor is located at the relatively clear round area within the bone anterior and superior to the hip joint. (Photo courtesy of Stanford University Hospital) 

Traditional treatments involve either surgery, with a long recovery period, or a less invasive procedure called radiofrequency ablation. The latter would have required drilling into the bone from the back to pass electrical current to the area of the tumor and burn it out. Physicians were concerned about trying radiofrequency ablation because the unusual location of the tumor posed a risk to the surrounding nerves and arteries.

Stanford radiologist Pejman Ghanouni suggested a third option, called high-intensity focused ultrasound. The outpatient procedure directs sound waves at a single location to heat and kill a targeted area of tissue. Ghanouni said it is like taking a magnifying lens and focusing on a leaf.

He said physicians can quickly get the bone hot enough to destroy the lesions that cause the pain without leaving a mark on the skin.

But the Food and Drug Administration has not approved the technology for the treatment of osteoid osteoma tumors. In the past five years, it is approved for killing prostate tissue and the treatment of some other diseases and tumors.

Without FDA approval, it is difficult to get insurance companies to pay for the procedure that costs about $50,000 to treat Stokes’ condition, Stanford physicians said.

Stanford doctors are collaborating with UC San Francisco radiologist Matthew Bucknor in a clinical trial to determine the effectiveness of the procedure for osteoid osteoma. The four-year study is expected to be completed in a year. Physicians hope the study will lead to FDA approval of the procedure.

“It is a technology that is slow to enter the United States in terms of its adoption,” Steffner said. “Stanford has been open to integrating it into treatment approaches.”

Saratoga High School quarterback Payton Stokes underwent a nine-hour procedure July 18 at Stanford University Hospital where physicians burned away a benign bone tumor in the left hip that had jeopardized his senior season of football. Stokes, 17, was able to return after two weeks to play injury free and lead the Falcons into the Central Coast section playoffs. (Courtesy of Dianne Stokes) 

Stokes did not qualify for the trial that compares the results of the ultrasound procedure with those of radiofrequency ablation because doctors could not guarantee that Stokes would be randomly selected for the ultrasound treatment.

The next step was to get approval from his insurance company. Dianne Stokes said the company wanted the teen to have the radiofrequency ablation procedure because it was the current standard of treatment.

Ghanouni lobbied insurance company doctors on the Stokes’ behalf for months. In the meantime, the family considered getting the procedure done in Italy, by a physician who pioneered the method in treating osteoid osteoma. Dianne Stokes said she and her husband, Jeff, also looked into paying out of pocket for Ghanouni to perform the procedure.

“No. 1, you’re scared,” Dianne Stokes said. “Could it be something else? I know they say the characteristics are benign but you want it out completely.”

Eventually, Ghanouni persuaded the insurance company to pay for it.

The procedure, on July 18, took nine hours. It left no scars, and except for stiffness, Payton Stokes said he was able to return to action Aug. 3 without issue.

“I just tried to stay positive the whole time,” Stokes said. “Just the hope to play. That was my main reason to get better.”

He said he confided in only a few close friends about the seriousness of the situation because he didn’t want his teammates to worry about him while they trained for the season.

Before the treatment, Stokes missed the baseball season, too, after playing on the Saratoga varsity team as a freshman and sophomore. He said he plans to play again next spring.

He would like to continue playing football in college, but he is not quite 6-feet-tall and is lean at 170 pounds. College recruiters have shown no interest so far because he is considered too short to play quarterback.

Because of his medical condition, Stokes could not attend college summer camps where recruiters often get a better sense of a player’s overall worth.

Lugo is trying to get college coaches’ attention this fall. He talks about how Stokes has mastered the Falcons’ spread offense, similar to that used by the USC and UC Berkeley teams. He talks about the player’s 3.75 grade-point average and the way he unites teammates.

“If I can get a college coach to spend 10 minutes with him, they’d want him,” Lugo said.












Source: mercurynews
Thanks to a novel treatment, this Bay Area high school QB beat a tumor and led his team to the playoffs