When Leonard Wexler, a pediatric oncologist at Memorial Sloan-Kettering Cancer Center, first met him, Yehuda was in a great deal of pain and in desperate need of a diagnosis.
"Yehuda was very sick when he arrived here on a Friday in early May 2005, less than one week after the onset of his symptoms," Dr. Wexler remembers. On the day before his transfer to Memorial Sloan-Kettering, a CT had been done that demonstrated an aggressive-looking tumor of his upper sacrum. "When he got here, he had excruciating nerve pain in his leg and foot that prevented him from straightening his leg and that was so painful he could not tolerate even having his foot looked at closely, let alone touched," Dr. Wexler says. Thankfully, the studies that were done showed no evidence of visible spread of his cancer to other parts of his body. "Fortunately," he adds, "after aggressively treating his pain to try to make it more tolerable, we were able to perform a biopsy of the tumor a few days after his admission and quickly to obtain molecular confirmation from the pathology report that his tumor contained a less common variant of the genetic abnormality that is present in virtually every case of Ewing's sarcoma."
Excellent Response to Chemotherapy Followed by "Tour de Force" Surgery
One week to the day following Yehuda's transfer, Dr. Wexler and his team began an intensive chemotherapy treatment regimen, the hope being that it would produce a good enough response to eventually render the tumor surgically resectable. While Yehuda's prognosis for a successful outcome from his cancer was quite good, it was unclear what the degree of neurological recovery, including the use of his leg, would be. Fortunately, Yehuda had an excellent response to chemotherapy.
On August 22, 2005, after extensive preoperative testing and intensive discussion, surgeon Patrick Boland performed what Dr. Wexler refers to as a tour-de-force daylong operation, in which the tumor was successfully removed in its entirety. "To our delight," Dr. Wexler says, "one week later we received the pathology report indicating that the tumor had been completely destroyed by the four cycles of preoperative chemotherapy (and removed with clean margins by Dr. Boland during surgery) -- an achievement that made it unnecessary for Yehuda to receive postoperative radiation, which we very much hoped to avoid given his young age and skeletal immaturity."
Four-Year "Cancer-versary" and a Doctor's Many Privileges
Yehuda completed the third of his three postoperative cycles of chemotherapy in November, approximately six months after treatment started, and has remained well for more than three years since then. As Yehuda approaches his four-year "cancer-versary," his prognosis for cure is excellent, Dr. Wexler notes with great satisfaction.
"Equally gratifying," he goes on to say, "he has made an extraordinary and near-total neurologic recovery. I was privileged to see him take his first steps after being immobilized for more than six months. I was privileged to see him running down to first base during a Little League baseball game. I was privileged to see him running around camp with his mischievous smile, being just a 'regular' kid, less than two years after his surgery. And, God willing, I will be privileged to dance with him and his family at his bar mitzvah and his wedding. I recognize how fortunate I am to have gotten to not only care for Yehuda, but to have become personally close with him and his wonderful family."
