Wednesday, September 29, 2010

Rare But Serious

The patient and her parents were hardly focused on what we were saying.  Not surprising, since she was still recovering from the news that the pain in her leg was not from a sports injury, but from osteosarcoma.

Kameron was a high school athlete, and now, instead of anticipating a college scholarship to play hockey, she was anticipating a year's worth of chemotherapy and a major leg surgery.  She and her parents were in the office, listening (but probably not hearing) to the side effects she should expect from her upcoming chemotherapy.  At the end of the conference we discussed some of the "rare but serious" side effects, like fertility loss and heart failure.



Fertility loss is something that catches people's attention.  To some extent, so does heart failure.  But for adolescent patients, somehow infertility feels more "real."  So we talked about her possible future fertility problems much more than we talked about her heart.

Throughout her therapy, we monitored heart function with regular testing.  All of the tests were reassuring.  But one day, soon after her treatment was done, Kameron developed chest pain.  When treatment for reflux and then for infections didn't make things better, she came to the emergency room, and that is when we discovered she was in heart failure.

These side effects, the "rare but serious" ones, are some of the hardest for us to deal with.  Kameron's cancer prognosis is excellent.  I am optimistic she will become a survivor.  Unfortunately, she paid a huge cost to survive her cancer.  When she leaves the hospital, she will be on heart medicine for the foreseeable future.  She may even end up needing a heart transplant.  This is not a problem that is just going to go away, and for the rest of her life, Kameron will not only be a cancer survivor, but also a heart patient.

This is what drives us to work hard in the lab for treatments that won't come at such a high price to our patients. 

Related Posts:
Fishing, and the Kindness of Strangers
A Long Year for Mike
Cancer and Fertility:  How Can Treatment Impact Fertility? (Part 1)
Cancer Treatment and Fertility, Part 2:  What Can Be Done?

10 comments:

Stefanie said...

David,
Thank you for sharing Kameron's story. Have you considered setting up an online fundraiser to raise money for Kameron and her boyfriend to be able to go see a game? It could be administered either through a "cause" on facebook or directly on your site via paypal (or something similar).
I have found myself both surprised and inspired by the compassion shown by the internet blogging community. If you set something up, I'd be happy to post information about it on my site (pediatricsafety.net) as well. Thanks again for sharing!

Shadeh Rafi said...
This comment has been removed by the author.
Alexander said...

just found your blog and its so informative..thanks a ton doctor..

Carolina Mendez said...

It is very important that you have reflected on this short but rich history. One small problem many times to suffer and is defeated, but think of all those people who every day fight for his life no matter what the cost is in it. I would like to know your opinion on the matter.

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Mesothelioma Prognosis said...

kindly add more posts related to heart problems. Thanks in advance

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Diego Lillo Cuevas said...

Hello Dr. David:

I am a medical student of the University “Católica del Maule” from Chile. Your blog is very attractive and good, and this post in particular is very interesting. The sad Kameron’s history to moved me.

I knew that the Chemotherapy might to producer second effect, but didn’t know that one of this problem was the heart failure.

In the post tells that the probability of that the Chemotherapy may to producer infertility and heart failure, but: How low is the probability that these accidents occur? Are they isolated incidents or occur frequently?

Thanks for sharing this history.

Suhana Ansari said...

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Neural Tube Defect said...

Thanks for the great information Dr David!