Harvard Bound and Determined

Teen Athlete Wins Big After Double Diagnosis

Tyler Neville was just starting ninth grade in the fall of 2016 when he learned he had Hodgkin lymphoma. His parents, Tara and Tom, will never forget his reaction. “We talked with Tyler about his diagnosis and the months of chemotherapy he would need, then waited for all his questions,” says Tom. “But, there was just one: ‘Can I still go to basketball practice tonight?’ “

As surprising as his reaction was, the path to his cancer diagnosis was just as unique.

Tyler, a talented multi-sport athlete from Williamsburg, was already on a medical journey that started a year before with a single symptom: shortness of breath while exercising. The Neville family consulted ear, nose, and throat surgeon, Dr. Eric Dobratz, who noticed a sunken area in the center of Tyler’s chest – a telltale sign of a condition called pectus excavatum. He referred Tyler to Dr. Robert Kelly, an international expert on chest wall deformities and chief of pediatric surgery at Children’s Hospital of The King’s Daughters in Norfolk.

“There are two main concerns when a patient, especially an athlete, has pectus excavatum,” Dr. Kelly says. “Because the chest wall is curved in towards the spine, severe cases like Tyler’s can impair normal breathing. The heart can also be crowded. When competing, Tyler may need to pump 10 times more blood than when he is at rest. His sternum was pressing in so profoundly it was limiting his lung capacity and his heart’s ability to pump those large volumes of blood. That’s why he was so easily winded.”

In August of 2015, Dr. Kelly performed the Nuss Procedure on Tyler to correct the shape of his chest wall. This minimally invasive surgical technique, the treatment of choice for pectus excavatum worldwide, was developed at CHKD by now-retired surgeon Dr. Donald Nuss. “The Nuss Procedure is a two-part treatment,” says Dr. Kelly. “In the first operation, we place a metal bar under the sternum and rib cage to push the chest out. The bar remains in place for about two years while the chest wall hardens into the new shape. In a second surgery, we remove the bar.”

When a patient has a Nuss bar in place, contact sports like football are off the table for safety reasons. So Tyler spent his freshman season sitting on the sidelines of his favorite sport, football. Dr. Kelly agreed to allow him to play basketball, but only if Tyler wore a protective vest.

“The vest was kind of like the chest protector a catcher wears in baseball,” says Tyler. “It conformed to my chest and protected the area around the bar.”

The bar had been in about a year when Tyler began to feel discomfort deep in his chest. Dr. Kelly ordered an X-ray to make sure the bar was still in its proper position. When CHKD radiologist Dr. Susanne Grasso reviewed Tyler’s images, she found no issues with the bar, but noticed a small spot on one of his lungs.

“It could either be an infection, like a mild pneumonia, or a lesion,” Dr. Grasso says. “We gave it a few weeks to resolve, then repeated the X-ray. It was still there.”

Dr. Kelly performed a biopsy on an enlarged lymph node in Tyler’s neck, and the family learned that Tyler had Hodgkin lymphoma, a cancer of the immune system.

“Tyler was fortunate that we found his cancer early, while looking at something else,” says Dr. Eric Lowe, a pediatric oncologist at CHKD who specializes in lymphoma. “For most kids, a swollen lymph node is the first sign of Hodgkin. But Tyler is a big, athletically built kid. The muscle mass of his neck made any swelling of lymph nodes hard to detect.”

“We ordered the X-ray to look at his bar and found something entirely unrelated,” Dr. Kelly says. “Dr. Grasso is the hero in this scenario, no question about it.”

Tyler was another kind of hero, showing tremendous bravery and perseverance. From November to early March, he would complete four rounds of chemotherapy while playing on Lafayette High School’s varsity basketball team, a rarity for a ninth grader. He didn’t miss a single practice.

“I wasn’t going to stop him from playing,” Dr. Lowe says. “Our goal is always to help our patients maintain as much of their normal life as possible.”

One morning, Tyler awoke to find clumps of hair on his pillow – a side effect of his treatment. “I decided then that I would be the one to determine when I went bald,” he says.

So, he shaved his head. And, as a show of support, his dad and four brothers did the same.

As his sophomore year of high school began, Tyler would spend another football season on the sidelines. Chemotherapy had slowed the healing process, and Dr. Kelly felt the 13-inch bar needed to remain in his chest a little longer. By the start of basketball season, his cancer was in remission. And, despite playing a second season with his protective vest in place, Tyler made the starting lineup.

By spring of that year, Tyler, already 5 feet, 11 inches and 160 pounds when his Nuss Procedure was done, had grown so much that the bar was now too small for his ribcage. It was time for it to come out.

With the bar removed, Tyler was finally cleared to play football. His junior year was that of a superstar. Playing both tight end and outside linebacker, Tyler had 18 catches for 404 yards and five touchdowns on offense, along with 36 tackles – 19 of them solo – on defense. In basketball, he averaged 19 points and 15 rebounds a game.

When Tyler, now 6 feet, 4 inches and 230 pounds, hit the football camp circuit this past spring, an avalanche of college offers followed, 27 in all. With only one season of high school football under his belt, Tyler chose an offer from Harvard University, which, in addition to being one of the world’s most respected academic institutions, is known for producing NFL-caliber tight ends.

Playing football at Harvard will be far removed from where Tyler began his challenging medical journey four years ago – a place he says he will never forget.

“CHKD means everything to me in so many ways,” he says. “Everyone there has one purpose, to help you get better. Even the patients are there for each other.”

“One day during chemotherapy, another patient offered me her Girl Scout cookies. She had my two favorites: Thin Mints and Samoas. I just can’t imagine that would have happened at an adult hospital. It’s so many little things that make CHKD a really special place.”

This story appeared in the Fall 2019 edition of Kidstuff magazine, a quarterly publication from CHKD that features inspiring stories about patients, families, physicians and friends of CHKD.