It happened so quickly. One day I was working out and noticed a bulge in my left shoulder but I didn’t think much of it, in fact, I thought maybe my muscles were growing! But my concern grew as the lump got larger. I made a random visit to the chiropractor and during the visit he moved my right arm across my body. When he went to move my left arm across my body, it was impossible; motion of my left arm was completely restricted. The chiropractor knew something was not right and referred me to a primary care physician for an X-ray. I was scared and didn’t want to face reality that this inability to move my arm could be something serious. I wasn’t in pain – the ball on my shoulder wasn’t bothering me or affecting my life – but it was critical that I figure out what it was.
On September 5, 2013, the news was broken to me that I had a tumor in my left shoulder. It was on that day that I was diagnosed with Osteosarcoma, the most common type of bone cancer. This cancer begins in the bone compared to other cancers that begin somewhere else in the body and spread to bone. Immediately my parents started making calls, knocking on neighbors’ doors and doing research in hopes of finding the best doctor and treatment in the area for my diagnosis. My parents were told that an oncology surgeon, Dr. David Monson at Emory Orthopedics & Spine Center in Atlanta, GA, was the best in the business. That’s when I knew I was going to be in good hands. Dr. Monson’s exceptional reputation was my definition of a rock star surgeon!
The first step in this treatment journey was to make an appointment for an MRI, CT scan and biopsy. Before the tests, my medical oncology team prepped me that chemotherapy and radiation would mostly likely be needed for the next 6 months of my life. Thankfully, the MRI and CT scan showed the cancer had not spread to anywhere else in my body. Then the biopsy results came in and revealed that the bulge was a low grade tumor, which meant no chemotherapy or radiation was needed, rather surgery and physical therapy.
I was informed that the surgery would be to remove six inches of bone from my arm and replace it with a cadaver. I was relieved and extremely grateful that this treatment option wouldn’t turn my whole life upside down, but there were still concerns. I didn’t know if I would ever get back full motion in my arm or be able to get my arm over my head again. I didn’t know if I would look the same after surgery with this “new” arm.
Less than twenty days from the date of my diagnosis, on September 23, 2013, I had surgery. I remained hospitalized for three days following the surgery and then began my healing journey. I couldn’t return to work for four weeks and went through six months of physical therapy. The team at Emory made my journey to recovery seamless. I especially loved my physical therapist. Her excitement every session made me excited! She looked at my circumstances as a challenge, but together we pushed through. In fact, because my recovery went so well – something she had never seen with my type of surgery before – she ended up using it as a case study.
Today, my life is mostly back to normal. I have full motion in my left arm again, but my arm is still restricted when it comes to putting weight on it. It is going to take some time for the new bone to fully fuse with my natural bone, so right now I cannot hold more than five pounds with my left hand. I am aware and mindful of the activity and stress I place on my new arm, but I do not want to do anything that could potentially damage it, but thankfully I am able to work out regularly and both my work and social life are as normal as they can be!
A Note From Dr. Monson
Ms. Peterson was fortunate in that her osteosarcoma was low grade and required surgery alone for resection and reconstruction. There was no need for chemotherapy as there is in high grade osteosarcomas. There are only about 50 of these tumor types diagnosed a year in the entire United States. Our goal was to provide Ms. Peterson with as functional a reconstruction as possible and thus we chose to do so with a cadaver bone transplant of the proximal humerus where we could perform a direct rotator cuff repair. Repair of the shaft of the cadaver to the patient’s own remaining humerus bone distally was performed with plates and screws, much like that performed in fracture repair surgery. Reconstruction with an artificial prosthesis is actually an easier procedure technically; however the inability to reestablish reliable rotator cuff function often leads to lesser function of the shoulder. Although no reconstruction option can be declared a permanent solution, the use of the cadaver transplant burns no bridges and keeps options open for Ms. Peterson should she require more surgery in the future. She has excelled with her physical therapy and her full restoration of motion reflects strongly on her will and determination.
About Dr. Monson
David Monson, MD, and his partners at Emory Orthopaedics & Spine Center have the ONLY multidisciplinary musculoskeletal oncology service in Georgia that serves both children and adults. His focus is on rare tumors, sarcomas of the bone (2,500 cases a year in the U.S.) and soft tissue (10,000 cases a year in the U.S.) as well as other uncommon benign bone and soft tissue tumors. He also treats metastatic disease to the bone from other primary malignancies and often performs complex reconstructive procedures for these disorders not available in the community. The efforts of his practice also extend to complex skeletal reconstructions that may arise from failed orthopaedic procedures performed elsewhere.
He is only one of two fellowship-trained orthopaedic oncologists in the state of Georgia (the other is his partner, Dr. Shervin Oskouei) that concentrates his practice within his subspecialty. He also performs total hip and total knee replacements, specifically more difficult primary replacements or revisions that may require the skills developed within his practice of musculoskeletal oncology.