Surgeons, robots, movie and sports stars key to saving Freyja

Freyja Christiansen is the only child to have robotic surgery to remove a tumour from her neck. Five years on, she is back in Melbourne to celebrate a Christmas and living her best life.

From movie stars to MotoGP champions, there have been many people in Freyja Christiansen’s corner in her fight against a rare and aggressive cancer.

In the end it came down to robots and the unique skill of a Melbourne surgeon to save her. That, and the unshakeable determination of her single mum who search worldwide for answers when “no” was not one she would accept.

Five years ago Freyja, now 12, became the first child ever to have a tumour removed from her neck using robotic surgery. The surgery at Epworth Richmond made global headlines.

In time for Christmas, Freyja and her mum Lizzie Christiansen Young will soon return to Melbourne from their Canberra home to celebrate that milestone and also that she is in remission.

Nurses at the Epworth with Freyja Christiansen before surgery in 2018. Image: Supplied.

Ms Christiansen Young said 37 surgeons refused to remove her daughter’s tumour, called a clear-cell sarcoma, as it was dangerously close to Freyja’s carotid arteries. These are the major blood vessels that provide blood supply to the brain.

She persisted, never giving up, after discovering a lump in her youngest daughter’s neck in 2016.

Italian champion rider Valentino Rossi sent a handwritten note that helped to raise $40,000 for #acureforfreyj. Picture: AFP

Thinking the family would have to travel to the US or Europe for treatment, Ms Christiansen Young said she did what she could to raise a dollar to help pay for the anticipated costs.

Her ‘#acureforfreyja campaign’ so touched MotoGP world champion Valentino Rossi that he sent a handwritten note to be auctioned. It raised $40,000.

Learning Freyja was a Wonder Woman fan, the star of the Hollywood blockbuster movie Gal Gadot sent a message on Facebook to wish Freyja, “health, luck and love and may you always be happy”.

Ironically, the answer for Freyja was closer to home.

Dr Ben Dixon with Freyja Christiansen, then six, and her mother Liz Christiansen Young at the Epworth Hospital before surgery. Picture: David Geraghty

An oncologist who was treating Freyja in Sydney referred the family to Epworth Richmond’s head and neck surgeon Dr Ben Dixon, one of only a handful worldwide using robotic surgery to treat adult patients with similar sarcomas.

“Lots of surgeons said no, he said yes,” Ms Christiansen Young said.

It still took some juggling: the family that includes Freyja’s sisters Brynn, now 16, and Inge, 14, moved temporarily to Melbourne in 2018 expecting it would be for a couple of weeks. It turned into almost a year.

Freyja’s medical care also required meticulous planning. It was a combined effort by a skilled multidisciplinary team across major hospitals in both Melbourne and Sydney that was many months in the making before her world-first surgery took place.

It had started a year earlier with immunotherapy in Sydney and then followed the intricate surgery at the Epworth.

Five years ago Freyja Christiansen became the first child in the world to have robotic surgery to remove tumours from her neck at the Epworth in Melbourne. Picture: David Caird

The multidisciplinary team who had helped to plan the surgery also included the Royal Children’s Hospital led by pediatric oncologist Dr Lisa Orme and the Peter MacCallum Cancer Centre where Professor Grant McArthur and pediatric radiation oncologist Dr Greg Wheeler oversaw the delivery of her radiotherapy.

Five years on Ms Christiansen Young says Freyja is living her best life.

“I am very grateful to Melbourne and the community and how they run their health system. In my opinion they are a flagship for the rest of the country. Melbourne has got it right,” Ms Christiansen Young said.

Dr Dixon said Freyja’s tumour was a difficult one because of its location, but also because it was a one-off case.

“This type of pharyngeal surgery had never been done before or after in a pediatric patient,” he said.

“I do robotic surgery in the throat and tumours multiple times a month at Epworth, but always in adults. We rarely see a sarcoma requiring such surgery in pediatric patients.”

Robotic surgery at the Epworth came of age for this unique moment.

It was 20 years ago this month that the hospital did its first robotic surgery.

A year before that urologist Tony Costello had returned from a visit to the US where he saw the beginnings of a surgical revolution; robots being used to assist surgeons perform operations.

Professor Costello said he was blown away by the technology that allowed a robot to digitise a surgeon’s hand movements inside a body, through small ports.

Epworth agreed to invest $3 million in a surgical robot, the first in the Asia-Pacific region.

Professor Costello said it saw Australia become a global leader and that reputation helped to attract more than 1400 surgeons globally to Melbourne in July for a major robotic surgery conference.

Professor Costello has just written the world’s first text book on this type of surgery, with a chapter by Dr Dixon.

Professor Costello says Australia needs to invest more in robotic surgery equipment to ensure it is available for both public and private patients.

“We also don’t have a fit for purpose training program to train surgeons in Australia in this type of surgery; that must be a priority.”

If anyone needs convincing it is the way of the future they need only to look at patients like Freyja; a determined environmental warrior who says she doesn’t want her cancer to be the main thing about her.

“I try my best to live a regular life,” Freyja said, “and I am going to change the world one day, saving our oceans!”

Visit the Epworth Medical Foundation: www.emf.org.au