My main goal is to be able to graduate with my class.

Not a lofty dream for most high school seniors. But one young woman with a pirate’s crooked smile is thrilled to know that this goal is finally attainable.

Devastating diagnosis

Breanna Rose Pflaumer learned that she had a brain tumor almost three years ago. She was 14 years old and a freshman at Moorpark High School. Doctors told Breanna and her family to get her affairs in order; she was given from three weeks to three months to live. They said the tumor was inoperable. Doctors also presented an impossible scenario. They told the family that Breanna had a mixed astrocytoma ependymoma. Translation: There is no effective treatment for this type of cancer.

Can there be any grimmer news for a youngster or her parents? Unfortunately, yes. The family was insured by Kaiser Permanente, and the HMO refused to pay for treatment outside of its own facilities, where clinical trials offered the only hope of meaningful treatment.

Early on, the attitude of Kaiser doctors had been disconcerting to Tom Pflaumer, Breanna’s father. He was getting angry at what seemed to be a health organization which was not paying attention to the red flags.

Tom gives the example of Breanna’s diminutive size, which was off the charts by the time she was seeing a specialist at Kaiser. She now tips the scales at 65 pounds, which is a significant improvement from her weight at the time her symptoms became impossible to ignore. The specialist who saw Breanna for nine months before the tumor was diagnosed had suggested that her underweight condition could be due to an eating disorder.

That was the last straw for Tom. The family researched outside clinical trials that were accepting patients. They settled on a trial being conducted in Houston, and the entire family traveled to Texas. There they learned about the treatment and how to administer the drugs at home. After approximately three months of receiving this treatment, no improvement was evident, only disturbing side effects. They discontinued Breanna’s participation in the trial.

Even worse, a new MRI indicated that there had been significant growth in the tumor. Desperate for any hope of treatment, Tom contacted the University of California, Los Angeles. That was when Breanna’s world began to tilt upright once again, although her road of treatment has been more difficult than many adults could bear.

One tough cookie

Cancer could not have encountered a more formidable opponent than Breanna. She is described by many who know her as one tough cookie. Breanna seemed to have been born with the determination to stake out her ground and hold it as long as needed.

Terrie Pflaumer, her mother, says Breanna was always a tomboy. She liked to wear boy’s clothes and really liked to compete with them at their games. Better yet, Breanna was good at sports. Once, when Breanna was about 7 years old, she beat a bigger boy at a game.

“He didn’t think I played fair so he could say why he lost,” Breanna said. “He pushed me from behind, and I fell to the ground. It caught me off guard.”

Breanna did not cry. Instead, she picked herself back up.

“And socked him right in the face,” Breanna said. “That was the happiest day.”

“We have taught our children not to instigate, but if somebody threatened or pushed you around, stick up for yourself. It’s OK,” Terrie said. “So when the organization called me (about the dust-up), I told them I’m not going to punish her because she didn’t do anything wrong, she was just defending herself.”

“That was awesome,” Breanna chimed.

Apparently, that lesson stuck with Breanna and has been an invisible weapon against an illness which had been labeled by doctors as terminal. She has proven them wrong.

Breanna’s former soccer coach has known her since she was 4 years old. Joe Priebe has become a close family friend and admires Breanna’s determination.

“Breanna possesses many qualities that were helpful when she played sports and battling cancer,” Priebe said. “She always gave 100 percent when she played a sport and never quit. She is a great example of a positive attitude.”

Juvenile brain tumors

According to the National Cancer Institute, cancer in children is rare. However, brain tumors are the most common type of childhood cancer other than leukemia and lymphoma. These tumors can occur in both adults and children although the treatment may differ. The cause of most childhood brain tumors is unknown.

Tom Pflaumer learned that less than 5 percent of Breanna’s tumor had been removed for the initial biopsy at Kaiser. That was generally considered to be inadequate for an accurate diagnosis. Tom took his daughter to UCLA for a second opinion. There, Dr. Jorge Lazareff, the Geri and Richard Brawerman Chair in Pediatric Surgery, showed an interest in the case. Lazareff had a reputation as one of the most skilled pediatric neurosurgeons in the world, He offered to try to remove a large part of the tumor surgically, which would also provide a superior speciman for biopsy.

In an update from June 2005, Tom bitterly recalled his feelings of having been mislead by the HMO doctors.

“Kaiser stumbled when they did not see the signs of a tumor in March 2004,” Tom wrote. “Their lack of concern and effort through a botched biopsy resulted in an insufficient specimen to properly diagnose the tumor.”

Once Dr. Lazareff determined that it would be possible, in fact, to surgically remove the bulk of the tumor, Kaiser altered its position.

“Kaiser back peddled and declared their surgeon could do the same surgery that (the Kaiser doctor) had previously stated as inoperable,” Tom wrote in 2005. “After careful review, Kaiser ‘determined that appropriate care, including tumor resection, is available within the Kaiser Care Program,’ and as a result I will be financially responsible for any expenses incurred.”

The surgery by Dr. Lazareff was successful, although he was unable to remove all of it. The pathology report following the surgery indicated that the tumor was a Pilocytic Astrocytoma.

According to the UCLA Neuro-Oncology Web site, the Pilocytic Astrocytoma is a tumor of children and young adults, with the peak age of 10 years old. It accounts for one-third of all pediatric brain tumors and is the second most common brain tumor in children.

For the first time, Breanna and her family knew what they were dealing with and the prognosis was far better than originally believed. Finally, they had reason to hope. This type of cancer was highly treatable.

“When we went to Dr. Lazareff and Breanna asked if she was going to die, he said, ‘You are not going to die,’ Tom said. ‘I want to be at your wedding.’”

Breanna added, “When Dr. Lazareff said they were going to do everything to prevent my dying, I felt like I trusted him.”

Kaiser’s refusal to underwrite the UCLA surgery presented an enormous financial burden to the Pflaumers.

“When we took that leap of faith to UCLA, I had to pay the bills for the first surgery,” Tom said. “I had to walk in there with $60,000.”

But friends and other supporters were there for the family. Tom works as a mortgage broker at American Family Funding.

“When the time came that this happened, they said, ‘Don’t show your face in the office. Take care of your family.’” Tom said. “I still received salary. My wife works for a very good company that did the same thing. We are blessed in that respect.”

A number of local fundraisers soon followed.

After exploring his legal options, Tom worked out an informal agreement with Kaiser for cooperation and reimbursement.

“The lawyer for Kaiser now says that they have compassion for our needs,” Tom said. “I will never forget that phrase.”

And so the crushing financial burden was lifted, and all involved could focus on Breanna’s health.

Unforgettable Breanna

Many people wanted to comment on the extraordinary person Breanna had been even as a child, long before the cancer nearly defined her.

Deonna Armijo was a middle school P.E. teacher and knew Breanna for three years.

“She was very tiny but had a lot of spunk and personality,” Armijo said. “She was one of those unforgettable kids with a heart of gold.”

Armijo said Breanna demonstrated her unusual sensitivity at a middle school track meet.

“After Breanna had finished the mile run she noticed a girl from the other school, who she had never met, still had a whole other lap to run,” Armijo said. “So she ran over to the girl and helped her finish the race by encouraging her and running the last lap with her.”

Armijo added that the gesture was typical of Breanna’s selflessness and natural tendency to befriend those who are in need.

Armijo has continued to support the family as a friend.

“She showed us how valuable life is and if you believe and keep fighting, even cancer can be beaten,” Armijo said. “Her family persevered through things that would make others give up and throw in the towel.”

Dr. Lazareff was asked what in particular about Breanna stands out.

“The depth of her wisdom,” he said. “I always maintain that we treat patients and not diseases. Although ‘brain tumor’ sounds grim, it is not necessarily so.”

Breanna’s excellent adventures

As Breanna was swept along in the dark wave of events and procedures, she also had the opportunity to do some traveling for fun.

First, Make-A-Wish Foundation answered a request and sent Breanna and her family to the Bahamas where she would get the chance to swim with dolphins.

Breanna said it was a lot more fun than even she had expected. She said the dolphins instinctively knew how to behave.

“The dolphins can tell when someone is sick. They sense it,” she said. “They could tell that I was ill. They surrounded me and protected me.”

Not long after Breanna returned home from her therapy in Houston, a family friend arranged for her to meet the singer/dancer Usher. When asked who her favorite singer now is, Breanna quickly said, “Usher.”

Then there is the family cabin in Idaho, which they visit every other year. Aside from boating, tubing and fishing, it is usually a quiet place.

“We have a cabin right on the lake,” Breanna enthused. “One year, when the thunderstorms came, the power went out and we got stuck up there for an extra day. Not that we were complaining.”

The trip to New York last summer was full of surprises for Breanna. She had wanted to visit New York ever since 9/11 in order to pay her respects. Once there, she did the tourist thing, including taking in a Broadway show. When she went to see a Yankees game, she was treated like a VIP, complete with a locker room pass.

“Meeting the Yankees was amazing,” Breanna said. “They gave me a ball, and I got it signed by the team.”

Although Breanna is not able to attend school, she is not one to miss the big events.

“I went to Moorpark High’s homecoming dance,” Breanna said. “A bunch of my other girlfriends got together and we rented a limo, went out to dinner and then to the dance.”

Friends, after all, are what make life so delicious.

“My friends are really nice,” Breanna said. “One of them stuck with me the whole night and was always checking up on me. ‘Breanna, are you alright? Breanna, are you getting tired? Do you need to call your mom?’ I had a good time just being with my friends again.”

Family fallout

Cancer affects everyone in the family, and this family has not been spared the fear, anxiety, exhaustion and the loss of the sense of self. When Breanna was careening from crisis to crisis, everything and everyone else was secondary.

Breanna has not only had at least four major brain surgeries, but she also has endured several other procedures along the way, as well as enduring numerous seizures. After receiving chemotherapy, she suffered two strokes. Her left side was completely paralyzed and she spent nearly two months in the hospital.

Breanna is recovering from the strokes, although her left arm is still not functional. She can walk up and down stairs slowly, and can get around pretty well with a cane. She enjoys physical therapy only when it involves digging into her boxful of puzzles.

Shannon is Breanna’s big sister. She is tall, tanned, blonde and fashionably thin. During her senior year in high school, she was faced with some difficult choices.

“It was tough,” Shannon said. “I had wanted to go away. Teenage rebellion years, I wanted my space. My plan was to go to San Diego State University.

“It had come down to the point where Breanna was given three months to live,” Shannon said. “Family comes first, and you can do classes anywhere for the first two years.”

Shannon spent the bulk of those years attending Moorpark Community College. Now, she is attending UCLA and is living on campus. Looking back, Shannon believes she did the right thing despite initial resistance to attending a community college.

“I think it was one of the best decisions,” Shannon said. “It prepared me for UCLA.”

Terrie has been Breanna’s constant companion in all things non-medical. She is in charge of arranging home study and is the liaison to Moorpark High.

Tom has been the public face for the family. Just as Terrie is responsible for the home front, Tom has submerged himself in medical and financial issues.

Terrie admits she has passed that baton to her husband.

“Tom is very educated on the medical things,” she said. “I can’t look at it. It is depressing so I remove myself from that.”

Tom summed up the emotional toll on the entire family.

“Being in and out of hospitals, it’s a traumatic experience for the patient and equally traumatic for those that support the patient,” Tom said.

Breanna’s uncertain future

Breanna’s condition has been basically unchanged for several months.

“Breanna has a large cerebral tumor that cannot be resected and more likely will remain stable for the rest of her life,” Dr. Lazareff said. “She knows that and that fact has not dwindled her will to live and her certainty that she will also fulfill the dream of everyone that treats children; that the patients bury their doctors.”

Tom looks at the future of his daughter without blinking.

“It has been over a year since Breanna has had any treatment,” he said. “The tumor was stable but now it is showing signs of growing again.”

Breanna is also fully informed about her options.

“I want to try chemo again, but at a lower dose,” she said. “I’m feeling good now. I’m working on my school. I’m doing independent studies to catch up with my class so that I can graduate with my class.”

Breanna’s goals reach beyond graduation. She wants her experiences to help others.

“I think I’ve got other people interested in finding a cure for cancer a little bit more,” she said. “I’ve kind of bumped it along. My goal is to one day defeat this. Me, myself. And then I want to find a cure for all the other people out there that have it.”

Tom is a proud parent.

“Breanna is definitely a success. She has tread new water,” he said. “She has gone down this road where they’ve almost cured this cancer.”

Tom then broke the solemnity of the moment, explaining Breanna’s current challenges.

“She has had a couple of falls,” he teased. “I tell her to land on her pride.”