The Diagnosis

If someone would have told me as a teenager or in my 20s that I would be walking into a place like Columbia Basin Hematology and Oncology as a patient for the first time at age 34 I would have laughed in their face.  How is that even possible?  Only old people get cancer, right?!?!  But no, here was the harsh reality striking me in the face, I walked into CBHO in Kennewick on Wednesday morning, May 30, 2012 as a cancer patient for the first time.  My test results were in and after approximately 16-18 different special stains on my tissue samples revealing practically nothing, they finally achieved a diagnosis using something called a FISH assay at a specialty pathology lab in Seattle.  This test detected a very particular cell mutation called a translocation between chromosomes 22 and 11 which fuses the EWS gene to the FLI1 gene, causing those cells to start growing out of control and suddenly we have a very aggressive tumor on our hands called Ewing's Sarcoma.  I was about as atypical of a signalment for a Ewing's patient as you could get.   This is a cancer found most commonly in children, usually pre-teens and teens, and males are more commonly diagnosed than females.  It is also typically a primary bone tumor, with primary soft tissue tumors only found in about 20-30% of cases depending on which source you read.   So not only is it extremely rare to have someone diagnosed with this cancer over the age of 30, it is also rare for it to be found only in the soft tissues and no bone involvement.  And here I was, a 34 year old PREGNANT female with a primary soft tissue tumor diagnosed as a Ewing's Sarcoma.  I have no doubt that I was likely the ONLY person in the USA diagnosed that year with that signalment.  I was only the 4th Ewing's patient Dr. Rado had ever treated in his 4 decades of experience in oncology, and the only one who had ever been pregnant at diagnosis.