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Photo by Skip Brown
Jaiwen Hsu, a soccer player since kindergarten, had suffered his share of bruises and pulled muscles. So when his left knee started hurting a few weeks into soccer season, his parents didn’t think much of it. They figured their 11-year-old son had yet another sports injury that would heal if he stayed off the field for a week or two. But it didn’t.
The dull pain lingered on and off for weeks, causing an occasional limp. Jaiwen’s mother, Jeng, kept massaging his leg when it ached. Maybe he twisted the knee, she thought. Maybe he bumped it when he fell off his bike, or hurt it roughhousing with friends.
She’d never considered anything more alarming than that when she took Jaiwen to get an X-ray in October 2010. His knee felt fine that day. The newly minted sixth-grader at Thomas W. Pyle Middle School in Bethesda didn’t want to miss class, but his mom insisted he get checked. So they sat in an orthopedist’s office and waited for a doctor to examine the images in another room.
“Frankly, I was getting annoyed. We thought he had forgotten us,” Jeng says. “But as soon as he came back, I knew something was definitely wrong. His whole demeanor had changed. That’s when he told me, ‘We see something troubling.’ That’s when he said he thought it was a malignant tumor.” Mindful of Jaiwen’s presence, the conversation took place in hushed tones in a corner of the room. “I asked if malignant means cancerous, and he said yes.”
Jaiwen looked to his mother for an explanation, but she didn’t know what to say. “I was trying so hard not to break down,” Jeng says. The doctor pulled up side-by-side X-rays of Jaiwen’s legs. “I was numb. I couldn’t tell what he was looking at.”
The lesion that Dr. Christopher M. Farrell saw at the lower end of Jaiwen’s thighbone looked like a cloudy mass, Jeng says. He also spotted a small fracture near the knee. Farrell placed Jaiwen’s leg in a brace, gave him crutches and told him not to bear any weight on the left side. Doing so could further fracture the bone or break it, and possibly cause the cancer cells to spread.
Farrell then told Jeng to rush her son to Suburban Hospital for an MRI. It was a Friday, and the doctor had already scheduled an appointment for Jaiwen on Monday with specialists at Children’s National Health System in Washington, D.C. “My thought was: If we caught it early, we could save him,” Farrell says.
As Jeng watched Jaiwen hobble to the car, she could no longer hold back the tears. “He walked into that office a regular kid on his own two legs,” she says. “Everything had changed in that one hour.”
Once he settled into the back seat, he asked his mother one question: “Am I going to die?”
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Now a senior at Walt Whitman High School in Bethesda, Jaiwen likes to describe himself as “the luckiest unlucky person.” He’s lucky because he’s alive to tell his story. At 18, he’s class president for the third year in a row. He paints and writes fiction. A self-described foodie, he’s determined to find the world’s best burger, eat it and then make one that’s even better. He has a close-knit group of friends, a girlfriend named Annie, and a passion for raising money to support the hospital that he credits with saving his life.
He’s unlucky, of course, because of the tumor, a rare type of cancer called osteosarcoma. According to the American Cancer Society (ACS), roughly 1,000 people are diagnosed with osteosarcoma each year in the United States, and about 45 percent of them are under the age of 20. The disease accounts for less than one-tenth of a percent of the nation’s nearly 1.7 million new cancer cases annually.
For younger patients, osteosarcoma typically develops in bones around the knee. “The cells in growing bones are turning over rapidly, so they’re more susceptible to developing the genetic mutations that cause malignant bone tumors,” says Dr. Kevin Cullen, director of the University of Maryland’s Marlene and Stewart Greenebaum Comprehensive Cancer Center in Baltimore.
Forty years ago, osteosarcoma patients typically died in two years, says Dr. Robert Henshaw, the orthopedic oncologist who treated Jaiwen and still oversees his care. “These days, with the combination of effective chemotherapy and proper surgery, we’re able to cure probably close to two-thirds of the patients,” he says.
