This is a case of how a young patient's medical travel to India gave her a new lease of life.
On 26th of July, 2012 the reports of a young patient was sent in to us, and from the reports it was established that it was a case of metastatic osteosarcoma of femur.
Metastatic osteosarcoma refers to the osteosarcoma that has spread from the bone at which it initially started to one or more other parts of the body. It commonly spreads or metastasizes to the lungs.
The treating doctor suggested that treatment for this patient was still possible as the lung lesions were small and it was resectable. The treating doctor also established the fact that the survival rate of this patient was as low as 20 to 30 percent.
The treatment plan that the doctor put forward was that the patient requires neoadjuvant chemotherapy. As part of this process the radiation therapy that was planned out was a total of 25 fractions at the rate of 5 per week. The chemotherapy that was planned out was to be administered on the first 5 days of the radiation therapy and also on the last five days of the the radiation therapy. The patient need not be admitted in the hospital for the chemotherapy sessions and could visit the hospital for the treatment on a day care basis, and so it would involve 10 day care sessions.
Limb salvage surgery – The treating doctor had decided for a megaprosthetic replacement for her affected bone together with lung metastatectomy.
Upon receipt of our analysis, the patient immediately started out with the doctor's suggestions of neoadjuvant chemotherapy at a cancer hospital in the patient's native country. The neoadjuvant chemotherapy treatment almost went on for a month and a half. The effects of the treatment forced the young patient to shave off her hair; the chemotherapy and radiation therapy sessions usually have a toll on the patient's hair.
Our hospital forwarded the medical visa invite to the patient on the 27th of August to enable the patient to travel to India for the treatment. The patient arrived at India on the 14th of September, 2012. The patient was accompanied by her parents. The patient was advised to carry all her previous medical reports along. Once the patient arrived at the hospital, we briefly explained to her and to her parents the next treatment that had been planned out for her.
The patient underwent a thorough evaluation PET Ct scan, x- rays , MRI and blood tests on the 15th and 16th and the PET CT reports revealed that the patient did not have any metastasis in her lungs, which meant that it was cured by the chemo and radio therapy sessions. Also, the lesion in the thigh had shrunken.
We counseled the patient and explained to her family that the success rate of the procedure that we were about to undertake was only about 30 percent. Post the procedure and with the passing of some six months, the patients will need to undergo another evaluation to determine if there is any recurrence of the metastasis. If any metastasis is noticed during this evaluation then it would turn out to be a very unfortunate situation and the patient may survive for only a few more months. In such a situation, numerous surgeries will be required and those surgeries will be quite traumatic on the patient, and no clear benefit would emerge from it.
The patient's family was further advised that during the surgery the young patient's leg's growth center may require removal since it was noticed that the lesion was in the very vicinity of the growth center. It was advised that the young patient will need to wear shoes that suitably compensated for the growth of her other leg. It was also advised that a leg lengthening surgery could be undertaken once the patient attained an age of 18 years to correct the height mismatch of her legs.
The surgery was posted for on the 17th of September, 2012. The surgery was a success and the patient had to remain in the hospital for 10 days post the surgery. She was able to walk on the third day after surgery. Once discharged from the hospital, the patient had to stay outside the hospital for a period of another ten days after which the fit-to-fly certificate was issued to her.
Thus, the patient flew out of India healthier and with a new lease of life.
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