Rebecca Lilly (center) and her family take a brief trip to Disney World after her surgery. James A. Parcell—The Washington Post

F

ive days later, she was home. The seizures and double vision abated, and she gradually gained strength. "Remarkable," Packer said when he saw her 12 days after surgery.

But they were hurtling toward another critical decision.

"This thing grew very quickly," Packer warned. "It's not going to slow down just because we did a good surgery." At best, the operation had bought them a month or two in which to try one more attack.

He outlined two possibilities: one drastic, the other less so.

The more drastic option, high-dose chemotherapy, was the only one with any hope of stopping the tumor -- but that hope was slim and carried a risk of fearsome side effects. It would start with heavy rounds of the proven anti-cancer drug Cytoxan. If that significantly shrank the tumor, Becca would receive an extraordinarily high dose of a newer drug. The "blast," as Packer called it, would lower her blood counts, temporarily weakening her immune system and making her vulnerable even to minor infections. It would be akin to a bone marrow transplant, and almost as risky. Not only hair loss, Packer said, but "more toxicity than she has ever seen."

"Your heart tells you what to do," said Kathleen Bula. "It's a parent looking at their own flesh and blood and not knowing what to do. It's horrible."

The data weren't much help. In one unfinished study of inoperable brain tumor patients, the high-dose chemo kept a small number alive for at least two years. Other studies were less encouraging.

The other option, a promising but unproven drug called SU-101, had fewer known side effects, but at best would merely slow the tumor's growth. Becca would be the youngest patient ever to try it.

Packer told the Lillys he would "absolutely" support either decision they made. He himself was torn. But he felt a responsibility to tell them which treatment he probably would choose: the high-dose chemo. For all its toxicity, it offered a long-shot chance of gaining her a few more years.

There wasn't time to hedge their bets and try both approaches. If they were going to try the high-dose chemo, it was now or never.

It was, Maureen Lilly said, the most difficult decision she had ever made.

She and Joe pondered it for days. They went back and forth -- between and within themselves -- before finally settling on the less toxic treatment. Quality-of-life concern tipped the balance.

"Our problem is that if [high-dose chemo] doesn't work, she'll spend the last weeks of her life in miserable shape," Joe Lilly said.

If anyone knew what the Lillys were going through it was their friends Kathleen and Jim Bula, of Derwood, who faced a similarly agonizing choice for their 8-year-old daughter, Kelley, last year. Kelley died of brain cancer in January.

"You do what your heart tells you to do," said Kathleen Bula. "It's a parent looking at their own flesh and blood and not knowing what to do. It's horrible."

I

n early April, Becca's parents drove her to New York to visit an unorthodox health clinic headed by a 100-year-old Romanian doctor.

Emanuel Revici first came to the Lillys' attention because of a recent limited-edition book, "The Man Who Cures Cancer," which touts Revici's methods and describes him as "perhaps the greatest medical scientist this world has ever known." Among its many anecdotes, the book cites several cases of brain tumor patients allegedly helped by Revici.

Revici still shows up most days at the clinic on the 12th floor of a midtown Manhattan office building. His approach to health is based on the belief that cancer and other diseases are caused by a biological imbalance which may be corrected by administering certain nontoxic substances.

The Lillys spent about two hours at the clinic, mainly with Kenneth Korins, a 32-year-old physician who has taken over Revici's practice. He examined Becca and prescribed for her a "protocol" consisting of several medicines produced at the clinic, supplemented by a meatless diet emphasizing vegetable juices, herbal tea and vitamin and enzyme supplements. The charge for the visit was $300.

Becca is in tears because of pain she's experiencing while waiting to see Dr. Packer. Her parents sit with her. James A. Parcell—The Washington Post

Revici entered Korins's office, steadied by an aide, and sat down on Becca's left. Maureen Lilly went over to him, took his hand and introduced herself.

"Brain tumor responds better to our treatment," the old man said. "She has a good chance of survival. ...With brain tumors, we are in general more optimistic."

"That's kind of the opposite of what we hear from most other doctors," Maureen Lilly replied.

"With our treatment, brain tumors have one of the best results," Revici said.

"My age is very interesting," Revici continued. "Do you know how old I am?"

"100," Maureen Lilly said.

"Over 100," he said, and got up to leave.

Korins continued discussing his recommended treatment, including the diet and every-other-day injections of "Revici compounds" -- labeled LU, SECOL and TTó -- which he said were a nontoxic combination of selenium, sulphur, magnesium and other minerals.

Suddenly, they realized that Becca had left the room and not returned. Maureen Lilly found her in the hallway, crying. "We should have known she would bolt from the room as soon as he said the S-word [shots]," her mother said.

"She's probably also picking up on the fact that we don't have a whole lot of hope for what we're trying right now," Joe Lilly said.

"She's probably also picking up on the fact that we don't have a whole lot of hope for what we're trying right now," Joe Lilly said.

They left the clinic with several small bottles of "Revici compounds" -- still unsure whether they would ever use them.

If they decided to adopt the Revici method, Joe Lilly announced, maybe the whole family should join Becca on the natural food diet.

"Everybody gets a shot too," Becca said without missing a beat.

Revici's methods have come under sharp criticism. In 1985, the New York State Board for Professional Medical Conduct recommended that his license be revoked, stating that there was "no persuasive evidence that Revici's method of treating cancer is effective" and that he was "grossly incompetent and grossly negligent" for failing to recognize that. State authorities briefly suspended his license in 1983, put him on five years' probation in 1988 and required that he refer all cancer patients to a board-certified oncologist.

The American Cancer Society last year urged patients with cancer "not to seek treatment with the Revici method."

"It's so far outside what we've been doing," Maureen Lilly said. As she tried to explain to people what they were considering, she realized "how little I know about what it actually involves."

And would it complement -- or conflict with -- Becca's other treatment?

Neurologist Packer saw no problem with nutritional supplements "as long as they're not doing any harm," but he could not approve use of the Revici compounds without knowing exactly what was in them.

In the end, the Lillys decided against pursuing the Revici alternative. Becca hated the idea of shots -- not to mention the vegetarian diet. Especially as her symptoms mounted, Joe Lilly said, "it just didn't seem to make sense."