Bone cancer

Sarah Garcia, Isaac's wife: Isaac is the kind of person who is so energetic, and he loves doing things with his children. And he loves being outdoors. And, just, he's very adventurous and exciting. And I think that's part of why I fell in love with him to begin with.

Isaac Garcia, cancer survivor/Mayo Clinic patient: My name is Isaac Garcia. I'm 38 years old and I live in Rio Rancho, New Mexico. I'm married to Sarah Garcia, and we've been married for 15 years. In late 2014, I started having a dull pain in my groin. And I was referred to a urologist by my local primary care doctor, which led to a misdiagnosis and an unneeded surgery. And it ended up delaying me finding out the real problem. So then I was referred to an orthopedic specialist here in Albuquerque. And the orthopedic specialist thought, since I rode dirt bikes a lot, that I probably damaged something in a crash and it was nothing big, it was tendonitis. Let's get an MRI and we'll see what's in there, and it's not going to be a big deal.

Sarah Garcia: So we went to see the doctor and he came in and said, "I have bad news for you. You look like what's going on is a malignant tumor in your bone. You need to see an orthopedic oncologist. My secretary will give you information." And he left the room.

Isaac Garcia: My wife and I were just floored. We cried a lot. It was not good news, you know. It was horrifying news, actually.

Sarah Garcia: I was very afraid that a diagnosis of a bone cancer meant he wouldn't be here. We drove all around that day trying to get in to see an orthopedic oncologist. The wait times were over six weeks or more to even speak to a doctor. So I called my boss because I wasn't in any position to go to work the next day. And he told me don't give up, there's other places. Go wherever you have to go. So I Googled "best bone cancer doctor" and Mayo hospital came up.

Isaac Garcia: So my wife contacted the Mayo Clinic in Phoenix, and they told us to fax my MRI report and some of my information to them and and they would get back to us. And that was on a Monday. And they called back the next day on that Tuesday and said be here Friday.

Christopher Beauchamp, M.D., Consultant, Orthopedic Surgery, Mayo Clinic in Arizona: After we completed all of the tests and investigations and performed a biopsy, the diagnosis was a chondrosarcoma. It's a malignant bone tumor involving a very challenging, difficult location, and that was his hip socket. A chondrosarcoma is a purely surgical problem. There's no medical or any other treatment options available for it. And the surgical treatment for this, for him, was to remove his entire hip joint, the ball and socket joint. Fortunately, we didn't have to remove any of the important muscles around his hip, but that presents a difficult problem to reconstruct for him.

Isaac Garcia: And there was basically three options, and one of them was just removal and you don't put anything back in. So they remove your hip socket and the top of your femur and they don't put anything back in. It's called a flail hip. And then the other one was to use the pelvic bone from a cadaver. And they, you know, make it fit and hope that it takes. Dr. Beauchamp really didn't like that idea either. He said that the best thing is a 3D printed titanium implant.

Dr. Beauchamp: The subsequent treatment of removing the hip joint has become almost the holy grail of orthopedic oncology. We can do it better than we've been doing before. To be able to do the resection, to print the model, to design an implant, and the technology is there.

Sarah Garcia: Yeah, Dr. Beauchamp came out to tell us "it was a home run," is the words he used to describe the surgery. He said, "I got all of it. It's clean margins. I got it all. The cancer is gone."

Isaac Garcia: Because of the Mayo Clinic, I'm back, you know, back to living a normal, good life. I just have a whole new appreciation for how the little things that you usually take for granted, they all mean a lot now. I have a whole new appreciation for life.

Sarah Garcia: I would like to tell Dr. Beauchamp, thank you so much. To make such a huge impact on my husband's life. And because of that, my life and my kids. By using this incredible technology that isn't everywhere else, he offered such a good outcome. He did such a good job. I would tell him thank you.

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Shanna Decker, Cancer survivor: My knee really just started to hurt a whole lot. And it went from no pain, to debilitating pain in three weeks. So much so, that as a seven-year-old, I asked my mom to take me to the doctor.

Vivien Williams: Experts at Mayo Clinic diagnosed a rare bone cancer called osteosarcoma.

Ms. Decker: But all I knew of cancer was that people died of cancer, basically. And so when they said cancer, immediately, even though I was seven, I knew this is a bad deal. Will I survive? Things like that.

Ms. Williams: That is a question no seven-year-old should have to ponder.

Carola Arndt, M.D., Pediatric Oncology, Mayo Clinic: So treatment for osteosarcoma involves surgery and chemotherapy.

Ms. Williams: Pediatric oncologist, Dr. Carola Arndt, and orthopedic surgeon, Dr. Franklin Sim, led the multi-disciplinary team that cared for Shanna.

Franklin Sim, M.D., Orthopedic Surgery, Mayo Clinic: The tumor was in the lower end of the thigh bone.

Ms. Williams: Shanna started chemotherapy and then had surgery, which in the past, would have meant amputating her left leg above the knee. Instead, she had what was then a new and groundbreaking procedure called rotationplasty. During the operation, Dr. Sim removed the section of the thigh, or femur bone, that involves the tumor as well as the knee and part of the shinbone, or tibia. Then, he rotates the lower leg and fuses it to the femur. The ankle now becomes the knee.

Ms. Decker: So on this leg, I take it off and then this is my foot, on backwards.

Ms. Williams: It may look a bit strange but the procedure and prosthesis have allowed Shanna to do just about anything. She says it was surprisingly easy to adjust to her new normal.

Ms. Decker: And as soon as my leg healed, I was walking with a prosthetic and it took me about 30 seconds to learn how to re-walk.

Ms. Williams: Shanna, who is now 24, has accomplished a lot in the years since her diagnosis and surgery.

Ms. Decker: So I'm 16 years out of cancer now, which seems so crazy, 16 years.

Dr. Sim: And we've seen her grow through her childhood and function as she's been able to do and remain active. And now at this stage, she's finished college and she's passing it on. She's giving back.

Ms. Decker: Right after my treatment, when I was eight years old, 1999, my family started mentoring kids with cancer.

Ms. Williams: Then, in 2007, with three other families, they started an organization called Brighter Tomorrows.

Ms. Decker: It supports families emotionally, spiritually, educationally, and a little bit financially, when they're diagnosed with cancer. And we have hundreds of people in our database now.

Dr. Arndt: It makes my day. If at the end of the day or during the course of the day, I see a long-term survivor like Shanna, it puts things in perspective and it reminds me this is why we do what we do.

Ms. Decker: Helping families with cancer. Being an advocate for childhood cancer. Helping every single family who walks through the journey, so they're not by themselves.

Ms. Williams: Giving back hope, love and healing.

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