171: Hope Nightingale survived osteosarcoma | neoadjuvant chemotherapy | cisplatin | doxorubicin

At age four, Hope Nightingale complained of severe pain in her legs.  At first, her parents thought she was just being a hypochondriac.  That changed when she fell off her scooter and broke the distal femur in her left leg.  The following year, 2011, this led to a diagnosis of Stage II osteosarcoma, a type of bone cancer.  After a regimen of neoadjuvant chemotherapy featuring cisplatin and doxorubicin, Hope underwent a surgical procedure, a vascularized fibula transplant.  Her left femur was removed, and her right fibula was inserted in its place.  Confined to a wheelchair and then crutches at such a young age, Hope underwent extensive physiotherapy rehabilitation so that she could relearn how to walk despite her left leg being 2cm shorter than her right leg.  Hope has survived and is training to compete in a half marathon!   Hope says as a four-year-old she was often accused of overreacting to just about everything.  So, when she complained of pain in her legs, her parents did not take the complaints seriously.  That changed when she fell off her scooter, couldn't get up and her parents discovered she had broken her left leg.  She had her distal femur x-rayed.  That led to a biopsy, and, at age five, a diagnosis of Stage II osteosarcoma, a form of bone cancer.   Treatment was to begin with neoadjuvant chemotherapy aimed at shrinking the tumor.  Hope said unlike many people, outside of hair loss, she suffered few nasty side effects.   Next was a vascularized fibula transplant.  The cancerous left distal femur was removed and was replaced by her right fibula.  A result of this surgery was the loss of both her quadricep muscles.   Hope returned to school, but in a wheelchair with casts on both legs.  This did not go unnoticed by her classmates, most of whom wanted to know what happened.  Hope says her diagnosis was not a blessing, but she felt blessed that her diagnosis took place at such a young age, when she was unable to process it in full.  She said physically, it was tough being in a wheelchair, but emotionally it was tougher because at recess, she wanted to join her friends, running around and playing.  Hope said it was amazing that sometimes her chums would halt their activities and gather around her to include her in their fun.    Hope eventually got out of the wheelchair and was on crutches, but that, too, was frustrating because she wanted to be ambulatory, like her friends.   At this time, Hope Nightingale had to relearn how to walk, which involved extensive physiotherapy rehabilitation.  As if that were not tough enough, the surgery left her left leg 2cm shorter than her right leg.  She went to a specialist who gave her a wedge to put in her left shoe, removing the discrepancy in the length of her legs.   These days, Hope leads an active lifestyle.  She enjoys going to the beach near her hometown of Cape Town and to the mountains and vineyards outside of town.  Not only is she walking, but Hope is training to run a half marathon.   Additional Resources:   Support Group:   Cancer Association of South Africa  https://www.cansa.org.za