Team Approach Helps Courageous Young Man Win Long Battle Over Two Sarcomas

What did it take for Kyle Harvey to survive two serious cancers stretching over ten years of his life? Just ask the care team who treated him for rhabdomyosarcoma when he was five years old and for osteosarcoma when he was fifteen.

Kyle Harvey

"Kyle is a remarkable person," says orthopaedic surgeon Rex Haydon, MD, PhD, assistant professor of surgery, who performed Kyle's orthopaedic surgery during his treatment for osteosarcoma. "It would have been so easy to become very discouraged, but he kept marching through all of his care. He had a good attitude and resilience, and that made a big difference."

In 1994, Valerie Harvey took her son, Kyle, to the emergency room after he got sick while in kindergarten. What looked like appendicitis turned out to be a ruptured tumor in his abdomen. A biopsy revealed the tumor was rhabdomyosarcoma, a cancerous growth that originates in the soft tissues of the body.

Kyle was treated with eight months of chemotherapy and several months of radiation followed by six months of hyperalimentation, a nutritional treatment he received twelve hours a day. He attended kindergarten as often as possible, where his classmates were very protective of him and thought his central line was "really great." Kyle doesn't remember much of that illness. According to his mother, he mostly recalls getting lots of attention and gifts.

The young boy was fine for years after his treatment for rhadomyosarcoma. But then, while playing on the tennis team during his freshman year of high school in 2004, he felt pain in his right knee.

"We went back to the University of Chicago expecting to hear that Kyle had a sports injury," says Valerie. Instead, an X-ray showed that Kyle had a malignant tumor in the proximal tibia of his right knee. A biopsy performed by Dr. Haydon revealed the tumor was osteosarcoma.

It is not known if Kyle's second tumor was related to his first cancer or its treatment. Although rare, osteosarcoma occurs most commonly in teenagers at the peak of their growth period. Doctors in the U.S. see between 600 and 800 cases a year. Twenty-five years ago, amputation was the first line of treatment in many cases. In the 1980s, pioneering clinical research by orthopaedic surgeon, Michael Simon, MD, professor of surgery at the University of Chicago, helped to demonstrate that local control rates were equivalent between limb salvage surgery and amputation in osteosarcoma of the distal femur.

Due to advances in chemotherapy treatment in recent years and to limb salvage surgery, it can be said that both "life and limb" are now saved in most patients with osteosarcoma.

Kyle's physicians worked as a team to direct his treatment for osteosarcoma. In addition to six rounds of chemotherapy, Kyle underwent limb salvage and reconstruction surgery. Dr. Haydon replaced his knee and part of his tibia. Throughout his treatment, Kyle was part of all the decision-making.

"Kyle was concerned about his height. We decided together to lengthen the affected leg with the goal of giving him optimal height and of having both legs the same length when he stopped growing," says Dr. Haydon.

The toughest time for Kyle came after his knee surgery when he suffered from regional pain syndrome in his leg. "The pain was awful at first and then lingered for years," says Ms. Harvey. "It was a long struggle for him to get over that. Throughout the ordeal, Dr. Nachman (Kyle's oncologist) always kept us 'up' and Dr. Haydon was always calming."

"Kyle has been with us for a long time," says Dr. Haydon. "He was consistently a positive person. He made an impact on all the people who treated him."

Kyle Harvey is now at college, attending Alabama A & M in Huntsville. He is concentrating on political science and is considering a career in law.

"It is great for him to be away," says his mother. "He was so used to being pampered, but now he loves his freedom."