Fighting osteosarcoma: Grace's story

Grace's diagnosis

Grace Abraham is a 19-year-old survivor of osteosarcoma, a malignant bone cancer. All cancer journeys are unique, but her story is unlikely to be duplicated. Two years ago, Grace had the opportunity to visit the University of Nebraska on an exchange program from her home in Botswana. What started as the adventure of a lifetime took a dire turn.

In her own words:

What had been a nice day immediately turned sour upon hearing these words, ''The Chief Radiologist in the area has viewed the images we took this morning; he suspects you might have osteosarcoma or Ewing sarcoma.” Upon hearing this I cried so hard, I wished it could be the end of the day immediately. My worries were: how are my parents going to handle these huge bills? Am I going to die? Am I going to lose my leg? How am I going to live … would my life be different? 

I was depressed. I managed to talk to a few people and they helped me feel better. Everything happened so fast. In three days I learned I had osteosarcoma. We mapped the treatment with the pediatric oncologist in Omaha and, in the meantime, we were seeking options back home. Luckily, we found Dr. Slone! I have to say this was the greatest discovery ever! I flew back home to Botswana and the next day my mom and I met with Dr. Slone to discuss my treatment plan. He made sure I understood every tiny detail, even illustrated some things by drawing on a piece of paper. I told him I wanted to begin treatment the next day.

When I get emails from the U.S. Department of State, it is typically in the form of some update or alert regarding a foreign country I am living in or visiting. I was quite surprised to be referred a patient by a representative of the State Department. Due to logistical and personal issues, having Grace treated for osteosarcoma in Nebraska was not feasible. In many places throughout the world, treatment for pediatric cancer is not even possible. Through a unique partnership Texas Children’s Hospital has with the Botswana government and several other key partners, we have been developing a pediatric cancer and blood disorder program in Botswana since 2007. While we face many hurdles in treating pediatric cancer in a resource-challenged area like Botswana, I knew we would be able to offer Grace a treatment protocol modified to fit our resources. I vividly remember meeting Grace and her mother in an exam room at the Botswana-Baylor Children’s Clinical Centre of Excellence. Grace is a dynamic young lady and she was determined to overcome the enormous challenge that faced her. She was eager to get started as soon as possible!

 

Grace's osteosarcoma in her left knee

Grace’s treatment

Grace faced many challenges throughout her treatment and even became a Motswana pioneer, being the first pediatric osteosarcoma patient treated in our program who had a limb-salvage surgery (her tumor was removed but her leg was spared). I have one very enduring memory of her treatment. The chemotherapy she received is one of the most notorious nausea- and vomit-inducing chemotherapy agents. On the day of discharge after her first cycle, she was not feeling well, yet she wanted to get home. I was at her bedside trying to convince her to stay for another day of supportive care. She reached beside her bed, grabbed a bucket, quickly expelled whatever was left in her stomach, put the bucket down, then got up and went home. I knew she was going to be fine. So much of cancer treatment is the mental aspect to take the highs and the lows in stride and continue to push forward.

Grace’s description of her treatment:

The first dose of chemotherapy was OK. I knew I would lose hair at some point in time, but, three weeks later, it was just too soon! The thought of being bald and walking with crutches depressed me. I always made sure I covered my head every time I left the house. Chemotherapy started being a hellhole, a rollercoaster ride would have been way better. Dr. Slone was always cheerful and made sure I had all the necessary treatments. I threw up for almost two weeks of every month; this was my new life. I always told people I had two weeks of normal life and two weeks of hell. I lost weight instantly. The changes were overwhelming. In May of the same year, I had surgery. Upon arrival in Johannesburg I did a few restaging images. From the images, I learned my tumor had grown larger and had now encased my popliteal artery. I was afraid my leg would be amputated. After 11 long hours of surgery, I woke up to the exciting news that the surgery was successful! Half way through my treatment, after surgery, everything started getting better; I became resistant to the side effects of chemotherapy and my life became totally normal again! I now had the task to learn how to work with my new cool leg! 

As I was celebrating my huge victory, my doctor had to leave. I was so sad. I could not even make it to his farewell party. But hey! We got another cool doctor, Dr. Anderson--we got along quickly. All that was left was for me to get to the finish line. There were a couple of times when my blood counts were too low and I had to get blood transfusions, but I braved through. I could not let a mere cold, nor low blood counts, get me down. I watched a few videos on YouTube of kids battling cancer and came across this quote: ''Chemotherapy sucks, but if it sucks the cancer out of me, then Yay! Chemo!'' I became a lot more determined. In February 2016, I had my last cycle of chemotherapy and was free from all the needle pokes, drugs and hospital beds! I was too happy. Though happy, I was too afraid to complete treatment. This is the fear I have even to date, recurrence.

Grace is a year-and-a-half out from finishing her treatment. She is doing quite well but remains at risk of recurrence and undergoes routine testing to make sure the cancer is not coming back. She has become a pediatric cancer advocate in Botswana. Recently, at a landmark event announcing the Global HOPE initiative, which plans to build pediatric hematology-oncology centers of excellence in Botswana, Malawi and Uganda, Grace shared the stage with Botswana’s President, His Excellency the President Lieutenant General Dr Seretse Khama Ian Khama.