|Becky Greenway, Marysville, Washington|
It is her outward sign of the strong, self-assured woman she became during the fight with sarcoma that began when she was only 17, says her mother, Jackie Fuller. "She seems to have nothing but positive thoughts," Fuller says. "She looks to the future and she doesn't look back."
These days, Becky has a lot to smile about: More than 15 years after she was first diagnosed with sarcoma as a high-school senior, her cancer is gone and she is considered cured.
"After 10 years [without a recurrence], my chance of getting cancer again is the same as anyone's," she says.
Becky has a knack for accentuating the positive, and she was optimistic and cheerful throughout a protracted battle with bone cancer that included an initial misdiagnosis, more than a dozen surgeries, and an artificial joint to replace her left knee.
Raised in a small town north of Seattle, Becky now enjoys the life of a stay-at-home mom. She and her husband Doug, an electrical contractor, have two daughters, Madisen and Kylar.
More than growing pains
Becky's left leg began to hurt during her junior year of high school. Sarcomas can be difficult to diagnose, and she remembers that one doctor told her mother it was growing pains. She was given an anti-inflammatory drug, walked with crutches, and even had X-rays taken of her leg, but the doctors who read them never saw the tumor growing below her left knee.
Finally, after six months, her mother says she "grabbed the X-rays" and took them to an orthopedic surgeon in Everett, who saw the tumor immediately and referred Becky to Seattle Children's (then called Children's Hospital & Regional Medical Center), an SCCA parent organization.
There, Becky saw Dr. Ernest U. Conrad, III -- known as "Chappie" to his patients and their families -- director of SCCA's Sarcoma Service. "If my doctor had been anyone except Chappie," Becky says, "my leg would have been amputated immediately."
Her cancer was a combination of Ewing's sarcoma and small-cell osteosarcoma in the tibia below her left knee. "It's unusual to have a mixed type," says Dr. Conrad.
Until fairly recently, everyone with bone cancer had the limb amputated, but SCCA and its parent organizations offer limb-sparing procedures that replace diseased bone with either an artificial joint or bone from donors.
Dr. Conrad treated Becky with a procedure that was experimental at the time. She had months of chemotherapy as an inpatient at Children's before surgery to remove the tumor and replace her damaged bone with a donated bone.
Because of problems with this first implant, a year or so later Dr. Conrad replaced the entire knee with an artificial joint.
Greenway was fortunate that she had finished growing by the time of her cancer treatment. "Making a leg grow after you've taken out the growth plate is very difficult," Dr. Conrad says.
Making friends with chemo
Becky doesn't recall much about those early days.
"I don't remember the first three months," she says. "I know I didn't think it was that big of a deal. I didn't worry about my survival. I didn't realize the severity of it; it was just a blur."
Becky says she does remember that the chemotherapy was "tough." "I'd vomit for an hour every day, but after the first five months, I changed my way of thinking. I started thinking of my chemo as my friend, as something that was helping me to survive."
Fuller remembers that her daughter was extremely sick with the chemotherapy. "It was pretty tough at times," she says. Becky was in and out of the hospital for chemotherapy and surgery for a period of 14 months.
Fuller says Dr. Conrad and his staff helped the whole family, which includes three other children, and her husband Rick, get through Becky's treatment.
"He's the best, we just absolutely love him," she says of Dr. Conrad. "They were so uplifting and so wonderful to Becky and to the whole family. Dr. Conrad just led the way.
"As awful a time as we had with all of that, they made it very bearable. They were kind, they made us laugh, they treated us like we were special, like they were looking forward to our visits."
A lesson in appreciation
Most of the treatment Becky received was through clinical trials. "Most kids are treated on trials, unlike adults," Dr. Conrad says.
Fuller says she recognized the necessity for Becky to be treated in a clinical trial, but that initially it was hard to accept. "You want more reassurance," she says. "You want something more substantial than a 65 percent recovery rate," which is what she was told were Becky's chances of beating the cancer.
Dr. Conrad has cared for Becky for more than 15 years now, first at Children's, then later at University of Washington Medical Center and SCCA.
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Becky is a veteran when it comes to surgery: she had a total of 13 surgeries at Seattle Children's and three at UW Medical Center, with Dr. Conrad as her surgeon each time. Some of these surgeries were minor procedures done to tinker with the artificial joint, Dr. Conrad says.
Her most recent surgery, in December 2003, was to replace the cement holding the implant, which had come loose. "I have almost no pain, and I'm very excited about it," Becky says.
She says her left knee "feels different" from the other leg, "and it's not as strong." She's not encouraged to hike or walk long distances, because too much use will wear out the joint faster. Generally, though, Becky says the leg takes her where she wants to go. "I don’t want to miss out on anything [with my family], so I do what I want to do," she says, which includes swimming with her older daughter at the pool or the beach.
Having cancer, Becky says, "teaches you to appreciate everything that you have."
Becky's mother gets the last word: "I cannot describe how proud we are of how she handled this whole thing. Whenever there's a problem, Becky just says, ‘Dr. Conrad will fix it.'"