Rare But Not Alone: A “Little Warrior’s” Strength in Facing Astroblastoma

When Jessica Speidel named her daughter after the brave character from The NeverEnding Story, she had no idea how fitting the name would one day become. Atreyu, meaning “little warrior,” has lived up to her name in ways her family could never have imagined.

Atreyu, an outgoing, vibrant teen, had been experiencing migraines for years. Just after her 14th birthday she had a migraine that was so severe Jessica took her to the emergency room. Jessica, who had faced a brain tumor in the past, insisted on a brain MRI scan with contrast. The results revealed what appeared to be a brain calcification — a buildup of calcium deposits in areas of the brain where they don’t normally belong.

Atreyu was referred to OU Health University of Oklahoma Medical Center for further imaging, and then to pediatric hematologist-oncologist, Dr. Rene Y. McNall-Knapp, M.D., FAAP, director of neuro-oncology and professor in the Department of Pediatric Hematology-Oncology at the University of Oklahoma College of Medicine. Dr. McNall-Knapp told Jessica and Atreyu that the imaging confirmed it was a brain tumor, not a calcification.

A Rare Diagnosis

It was unknown exactly what type of tumor Atreyu had, and whether it was cancerous. The decision was made to carefully monitor it. Within three months, imaging revealed that the tumor was growing.

“In young patients, any visible growth within a few months is considered rapid,” said pediatric neurosurgeon Dr. Karl Balsara, M.D., assistant professor in the Department of Neurosurgery at the OU College of Medicine who performed Atreyu’s surgery in June 25, 2024. “That was the turning point — this wasn’t something we could just watch.”

Dr. Balsara explained that the tumor was on the surface of the brain, which made it more accessible.

“We were able to achieve a complete resection, confirmed by post-operative MRI.”

The pathology report identified it as astroblastoma — one of the rarest pediatric brain tumors. Dr. Balsara had seen only one other case in his career.

Astroblastomas are so rare that fewer than 1,000 cases are documented in the United States. They can behave unpredictably, sometimes returning even after complete removal.

“I've been doing neuro-oncology for 25 years,” said Dr. McNall-Knapp, “and Atreyu’s tumor was the first astroblastoma case I had seen. It is extremely rare.”

Facing the Unthinkable — Twice

Atreyu recovered quickly from her first surgery and returned home within days. Initially, doctors chose not to pursue radiation or chemotherapy in hopes that the tumor would not return. But within the year, MRI scans showed signs of recurrence, a sign of more aggressive behavior.

In May 2025, just before her 15th birthday, Atreyu underwent another surgery with Dr. Balsara to remove the tumor. Surgery was followed by radiation therapy at Oklahoma Children's Jimmy Everest Center with radiation oncologist Dr. Jerry Jaboin, M.D., Ph.D., MBA, FACRO, FASTRO, professor in the Department of Radiation Oncology at OU College of Medicine.

Atreyu received a highly specialized type of radiation called proton beam therapy. To put it simply, radiation uses invisible energy beams to kill tumor cells. OU Health uses the most advanced form of this therapy, called pencil-beam scanning proton beam radiotherapy, which “paints” the radiation directly onto the tumor area. This level of precision treats the tumor effectively while protecting the healthy brain tissue around it.

“The proton therapy at OU Health Stephenson Cancer Center is not widely available, but it’s ideal for children,” said Dr. McNall-Knapp. “By precisely targeting the tumor it protects healthy tissue, which is critical for a developing brain.”

The treatment itself is painless — Atreyu would lie still on a treatment table while the machine delivered the therapy in just a few minutes each day. However, Atreyu grew weak and lost much of her hair. For Jessica, watching her daughter’s hair fall out was one of the hardest moments.

“I stayed strong through everything — the surgeries, the radiation,” Jessica recalled. “But when they cut her hair, the tears just fell. It broke my heart because I knew how much her hair meant to her.”

Support came in unexpected ways. Thanks to partners like Proton Pals and Hair We Share, Atreyu received wigs that helped restore her confidence.

Despite the effects of the treatment, Atreyu never lost her sense of humor and vibrant personality. The care team at the Jimmy Everest Center became like family, even earning nicknames from Atreyu.

“During her treatment, we met at least once weekly, mostly for her to tease me while I reviewed her progress and changes over the week,” shared Dr. Jaboin. “In particular, Atreyu was fond of interfering with my handshakes in a variety of ways over the course of our six plus weeks together.”

Atreyu’s spirit touched her doctors and nurses so deeply that they organized a surprise. Rumble, the Oklahoma City Thunder’s mascot, was there to celebrate her final radiation treatment and bell-ringing ceremony.

Looking Ahead with Hope

Just nine days after finishing radiation, Atreyu returned to school. Though still regaining strength, she is determined to live life fully.

Jessica and her husband, Keith, and Atreyu’s brother, Benjamin, continue to stand by her side.

“She’s a survivor,” Jessica said proudly. “She lives up to her name — that girl’s a warrior. The team at Jimmy Everest Center treated us so well. They cared for Atreyu like she was their own.”

Atreyu is now cancer free. She and her family remain closely followed by her OU Health team. Because astroblastomas can behave unpredictably, she will require lifelong monitoring. OU Health has recently launched a transitional neuro-oncology clinic to ensure children like Atreyu are supported not just through childhood, but into adulthood.

“This new model is one of the reasons families should come to OU Health,” Dr. Balsara said. “It’s not just about the surgery — it’s about long-term support and continuity of care for life.”

“We have a team of people who are focused exclusively on brain tumors in children from oncology to neurosurgery,” said Dr. McNall-Knapp. “We follow the kids very closely — short and long term — as well as the most up-to-date radiation. Added to this, all the research throughout the country is available here.”

Dr. Jaboin said that because OU Health is the only center in Oklahoma offering pencil-beam scanning proton therapy, families don’t need to travel out of state for the most precise form of radiation available for children. Another distinction is that pediatric radiation oncologists are quite rare, and OU Health’s program has two — Dr. Jaboin and Dr. Michael Confer, M.D. who are deeply committed to kids with brain and other tumors. Dr. Confer is also an assistant professor in the Department of Radiation Oncology at the OU College of Medicine.

“Atreyu’s care also reflects the strength of our larger team,” said Dr. Jaboin. “Behind the scenes are nearly 150 people — nurses, radiation therapists, dosimetrists, physicists, and others — who work together to design, verify, and deliver treatment safely every day. That kind of depth and teamwork is what makes OU Health a special place for families”.

Jimmy Everest Center’s 30^th Anniversary

Celebrating 30 years of hope and healing, the Jimmy Everest Center stands at the forefront of pediatric cancer care in Oklahoma. Your support does more than treat illness; it fuels groundbreaking research, provides comfort to families, and ensures every child receives the most advanced, compassionate care possible. Every gift brings us closer to a future where no child faces cancer alone.

By supporting the Jimmy Everest Center, you help extend our reach, advance lifesaving treatments, and inspire hope in children and families across Oklahoma and beyond. Join us in shaping a brighter tomorrow for pediatric cancer care.