The ball leaps off the metal bat with an unmistakable “ping” that denotes good contact. Miles Goldberg runs to first base, from which the 13-year-old will soon contemplate – and safely execute – a steal of second.
His treatment included a wide resection of his right proximal tibia in June 2015 that resulted in the loss of most of his right leg bones and part of his thigh bone. Miles is able to move more freely on a prosthetic thanks to an innovative surgery called rotationplasty, which is an option for some Dana-Farber/Boston Children’s patients with osteosarcoma whose cancers require very wide surgical resections.
In the procedure, Miles’ lower right leg and foot were rotated and attached to his thigh bone, so his ankle now functions as a new knee joint. The prosthetic leg is modified to slip over his reattached foot, and makes up for the difference in height with his left leg.
“There were several amputation options, but after I watched some videos about how much mobility you have with rotationplasty, and met some people who had it done, I knew it was for me,” says Miles. “I even met a kid who played varsity high school football and baseball after the same surgery.” …
More than 50 feet above ground, a wire rope extends from one tree to another. High in the trees, seven-year-old Carter Mock fearlessly steps off a platform and places first one foot, then the other, onto the wire. Holding tight to hanging ropes for balance, he navigates across the wire to the next tree.
It’s an impressive feat for anyone, but for Carter it’s extra special. Just weeks earlier, he completed treatment for osteosarcoma (a bone cancer), and he now has a prosthetic bottom left leg and foot.
Carter says navigating the wire rope is tricky, because he can’t feel the pressure of the rope below his prosthetic leg as distinctly as he can with his other leg. But that doesn’t deter him. On this warm August day, he expertly completes all four levels of an aerial rope course at Mount Sunapee in New Hampshire with remarkable speed and agility.
Two weeks after school had started in fall 2015, Carter started to complain of a strange knee pain, and he developed a slight limp. After a whirlwind of subsequent doctor visits — and an X-ray, MRI and then biopsy — his family received his diagnosis: osteosarcoma.
Carter would need months of treatment, which would include chemotherapy, radiation and surgery. He had two options for surgery. One was rotationplasty, an unusual procedure that preserves the lower leg, attaches it to the thighbone, then uses the ankle as a knee joint. After surgery, he’d be fitted with a prosthetic lower leg. Once healed, he could resume all types of physical activity again, even high-impact sports. Another option was limb-sparing surgery, which would maintain the normal appearance of the leg. But the leg would never have the strength it had before, and Carter wouldn’t be able to ski, skate or run again.
It was an easy choice for Carter. He had no plans to give up skiing, skating, baseball or activities like the aerial course challenge — so he chose rotationplasty. After interviewing many surgeons at many cancer centers, Carter’s parents chose Dana-Farber/Boston Children’s. They were impressed by surgeon Dr. Mark Gephardt’s experience — and even more convinced when a rotationplasty surgeon at another high-profile center told them outright: If it were my child, I’d go to Dr. Gephardt.
Carter received his first of many ongoing chemotherapy infusions in October 2015. His surgery was in January, and physical therapy started just days later. In April, he received his prosthesis. In June, he had his final chemotherapy infusion, and his doctors cleared him to resume medium-impact activities, including the aerial rope course. He hopes to get full clearance for all sports — including skiing and hockey in January.
Sometimes, Carter notices people stare at his prosthetic leg, and when he still was in treatment some people gazed at his bald head. But here’s what Carter really wants people to see in him: He is active and athletic. He can complete the aerial course at Mount Sunapee without fear or difficulty. And soon, he will ski and play hockey again.
September is Childhood Cancer Awareness Month — and this month, Carter and other children at Dana-Farber/Boston Children’s are sharing this message: We are more than you see. Don’t focus on the side effects of our treatment — see who we really are.
College student Caitlynne McGaff bounces from one adventure to the next. One weekend, she might be on stage, performing in the Complete Works of Willliam Shakespeare, (abridged) a rapid-fire tromp through the bard’s best works. The next she could be scaling mountains in Maine or jumping into the icy waters of the Atlantic. In December, she spent three weeks in South Africa on a service trip, teaching life skills to disadvantaged high school students.
She’s leading the life she and her parents envisioned in 2001, when Caitlynne, then 8, underwent a rotationplasty. After she was diagnosed with osteosarcoma at age 6, Caitlynne was treated with chemotherapy, but eventually it became clear her best chance would be for orthopedic surgeon Dr. Mark Gebhardt to remove her knee.
The McGaffs weighed the pros and cons of two options: replacing the knee with a metal plate or rotationplasty. During rotationplasty the surgeon removes the knee and attaches the shin bone to the thigh, rotating the ankle into place as a new knee. The procedure provides children with a longer leg, making it easier to use a prosthesis and allow patients to play sports and lead active lives.
And Caitlynne has done just that since her surgery. She switched from gymnastics in elementary school to softball in middle school, before finding her niche in theater and show choir in high school.
Now a junior at Boston University, Caitlynne walks the mile-long campus several times a day and is a regular at the campus gym. “I never have any problems with my leg. I’m much too stubborn for that,” she says. “I’d make the same choice [rotationplasty] again.”
Mahra Saeed is at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center for her last checkup before heading home to the United Arab Emirates (UAE). The spunky 8-year-old sports a new dress and cowboy boots, and carries a large stack of thank you cards. She hands them out to oncologist Dr. Carlos Rodriguez-Galindo, nurse practitioner Annette Werger and other staff members, who try to contain their emotion as they read, “Thanks for helping me to fight cancer.”