Saving life and limb

A young woman wins fight against cancer

Lori Armstrong has always been active and in good health. The 32-year-old mother of three had gone back to school and, after a physical education class, noticed pain in her right knee.

“I was diagnosed with arthritis,” Armstrong said. “For some reason, that just didn’t sit with me. So my primary care doctor X-rayed it.”

Even though Armstrong knew something wasn’t right, she wasn’t prepared for the X-ray results that showed a tumor and small crack in her femur. A biopsy confirmed it was high-grade bone sarcoma, the most aggressive form of this type of bone cancer.

Armstrong’s doctor referred her to an oncologist, who saw her the same day. Because this type of cancer cannot be treated with chemotherapy alone, she was sent to an orthopaedic oncologist, who specializes in surgical removal of tumors.

Armstrong was immediately started on four high-dose, aggressive, inpatient chemotherapy treatments over three months before undergoing surgery to remove the tumor and replace her knee and part of her femur with a prosthesis.

“I didn’t take time to ‘react’ to the diagnosis – I remember going home and counting down the days on the calendar until everything would be over,” Armstrong said. “I knew what had to be done, so I just did it. I kind of went through the motions without thinking about it.”

Typically, bone sarcomas occur in young people and are fairly rare. “It’s not uncommon to be misdiagnosed because symptoms are similar to other conditions, like arthritis or injury,” said Peter Buecker, M.D., orthopaedic oncology.

“The most common sites are around the knee – at the end of the femur or tibia – or in the upper arm near the shoulder. Lori’s tumor was at the end of the femur.”

What distinguishes symptoms of sarcoma from arthritis or injury is deep-seated aching that doesn’t go away with rest or medication. Over time, the pain worsens or wakes a person from sleep.

Armstrong now appears to be cancer-free and is back to her active routine. She has a CT scan every three months until she reaches two years post-surgery, then scans will gradually decrease to once a year for the rest of her life.

“When these types of cancers spread, they typically spread to the lungs or another bone,” Dr. Buecker said. “The CT scans check these sites.”

Awareness is key to detection

With bone sarcoma, a person doesn’t feel “sick.” There may be a bump or pain that’s easy to dismiss or put off getting checked out. Even though bone sarcoma is rare – making up less than 1 percent of new cancer diagnoses – it’s important to know it’s a possibility if someone is experiencing unexplainable pain in an arm or leg.

“If the pain is only when using the limb or goes away with medication, it usually is not sarcoma,” Dr. Buecker said. “If it hurts even while resting and especially if it wakes you from sleep, it’s important to seek medical attention, especially if your family has a history of cancer.

–Jennifer Stewart

Want to know more?

Norton Cancer Institute’s medical staff includes Kentucky’s only orthopaedic oncologists, as well as doctors and nurses specializing in many forms of cancer.
Visit NortonCancerInstitute.comfor resources on screening, risk assessments and treatment.

Multidisciplinary approach to care

Lori Armstrong’s road to recovery took a team of specialists working together. Called a multidisciplinary approach, this type of care provides patients with treatment decisions made by consensus rather than by a standard “formula.” Patients take comfort in knowing several specialists are in communication with one another and have input in their care. Patients have convenient access to imaging, pathology, oncology and all other medical needs as well as support services, like individual and family coping strategies, community resources and other personalized services. Find out more about Norton Cancer Institute’s services at NortonCancerInstitute.com or call (502) 629-HOPE.