From MayoClinic.com
Special to CNN.com

The spring of her senior year in high school, Christina Martin arrived at her prom on the arm of a Harlem Globetrotter. Not long after, she was rubbing elbows and strutting her stuff with New York fashion models — in a photo shoot for Mode magazine. That summer, she donned a cap and gown and proudly graduated from high school — a school known to have a high dropout rate. What's most impressive, though, is that she did all this while undergoing treatment for cancer — treatment that followed a long and weary road of pain and misdiagnosis. br>
The 'not knowing' br>
When she was 16 years old, Christina started to feel a severe pain in her spine. It felt like someone was burning, punching and sticking her all at once. At first the pain lasted only a few days each month. Then it became stronger and more frequent.

By the next year, the pain had grown so intolerable that she was missing school and her grades were beginning to fall.

"One day, I remember I was walking to the kitchen, and it was like I lost control of my legs and I was about to fall," explains Christina. "The pain [was] so bad."

Although she went to several doctors and hospital emergency rooms, no one could explain the cause of her pain. Because many conditions can cause the type of pain that Christina was experiencing, determining the source was difficult. She was told at various times that it was due to muscle spasms, that it was because she was overweight and that she had gallstones — none of which proved to be true.

Frustrated, Christina knew it was something else and was determined to find out just what. "You know your body more than anyone, so just follow your heart," she says.

Finding out

In September 1999, 2 years after the pain started, Christina's doctor discovered its true source — bone cancer. Christina then saw a pediatric oncologist, a specialist in treating bone cancer in children and teenagers.

To find more specific information about her cancer, Christina's doctor conducted a number of tests. Typical tests for bone cancer include biopsy along with one or more of the following:

X-rays. X-rays are taken to look for bone tumors. If a tumor is found, a CT scan of your chest and a chest X-ray are typically done because bone cancers often spread to the lungs. CT (computerized tomography) scan. This procedure uses an X-ray-sensing unit, which rotates around your body, and a large computer to create cross-sectional images (like slices) of the inside of your body. To help visualize the area or areas of interest, a dye (contrast medium) is almost always used. The dye often is injected into a vein in your arm. When the images are combined, tumors can be clearly seen, accurately measured and then later biopsied if necessary. CT scanning is the best way to evaluate your lungs for evidence of tumor spread.

MRI (magnetic resonance imaging). An MRI also views the inside of your body in slices, but it uses an extremely strong magnet instead of X-rays. The magnet manipulates water molecules in your body so that they tumble and produce a very faint signal. A very sensitive receiver — like a radio antenna — then picks up those signals. A computer used to generate the pictures manipulates the resulting signal. In some instances, a contrast medium is injected into a vein to enhance the images.

Radionuclide bone scans. A small amount of radioactive material is injected into your blood. All of your bones absorb some of this material. Tumors absorb more of it, however, and appear as a black area. A special camera passes over your body to scan for these areas. Christina's tests included an MRI, a bone scan, a chest CT scan and biopsies of her tumor and bone marrow. From these tests, Christina's doctor determined that she had a type of bone cancer called Ewing's sarcoma (ES). It had started in the soft tissue next to the upper part (thoracic area) of her spine and spread within her spinal column.

ES is the second-most common type of childhood bone cancer, although it accounts for less than 5 percent of all childhood bone tumors. The most common type of childhood bone cancer is osteosarcoma. ES usually originates in the bones of the legs, hips, pelvis, ribs or arms.

While Christina Martin's tumor was found in her spine, Ewing's sarcoma usually originates in the bone marrow of the legs, hips, ribs or arms. This X-ray, taken of another patient shows the presence ...

In addition, more than 80 percent of those with ES are white, and the disease is slightly more common in boys than in girls. So for Christina, an African-American female, it was even more rare. Most people who develop ES are between the ages of 10 and 20.

Signs of ES include several of the symptoms that Christina experienced — persistent bone pain, fatigue and some weakness. Other symptoms include fever, weight loss, swelling or a lump at the site of the tumor, and impairment of nerve function. But the most common symptom is bone pain.

If you ask Christina what the worst part of her whole experience was, she'll tell you it was the 2 years of pain before the diagnosis was made.

"Once I was [diagnosed], my pain was under control, so things got a little easier," she says. "But that period when I was in so much pain, I did not know what to do — I seriously did not know what to do."

While ES of the spine often can be mistaken for a herniated disk, the pain of ES, unlike the pain of a herniated disk, won't go away with bed rest.

Approximately 150 children and adolescents in the United States are diagnosed with a Ewing's tumor each year. Two-thirds of those will survive for more than 5 years. This is partly because of the use of chemotherapy. Childhood cancers usually respond well to chemotherapy because their cells grow quickly, and most types of chemotherapy specifically affect rapidly growing cells.

Because of the rarity of ES — and because cancer in children is relatively rare — it's recommended that children with ES seek treatment at centers that specialize in childhood cancer treatment.

You've been diagnosed with cancer, now what? An interview with a Mayo Clinic specialist

Undergoing treatment

At the end of September 1999, when she finally knew what she had, Christina quickly started treatment — chemotherapy coupled with radiation therapy. She was expected to continue this treatment through fall 2000, nearly 1 year after she began.

Depending on the size and location of a Ewing's tumor, as well as how far it has spread, treatment can include any or a combination of the following:

Surgery. Surgical treatment involves removing as much of the tumor as possible while trying to minimize damage to the function of the body part. This can be difficult if the tumors are in the arms or legs.

Chemotherapy. Drugs taken by mouth or intravenously can help kill cancer cells. Side effects include nausea, vomiting, loss of appetite and temporary hair loss. Children appear to have less severe side effects.

Radiation therapy. Radiation is often used to treat ES, but it can interfere with bone growth in children. By carefully aiming and regulating the dose, high-energy radiation can be used to destroy cancer cells.

According to Christina, her first course of chemotherapy treatment was the only difficult one. "I lost 20 pounds after that first round because I wasn't eating, and I just couldn't keep anything down," she says. "But after that treatment, everything has been fine, and I haven't gone through that again."

Things weren't always easy for Christina, though. "I try to stay positive, but sometimes it's hard," she says. "But I just try to look at it as there being a reason for everything, and while I might not understand it right now, I eventually will."

Christina also explains that helping others helped her, too. "To a certain extent, I'm kind of happy I went through it," she says. "Because I now know that it [life] is not all about me. I feel for other people, and I feel that it's necessary for me to help other people."

Patti Rankin, director of the Ronald McDonald House, where Christina lived for much of 2000 with her mother, echoes this sentiment. "I definitely see it [helping others] as a way of healing," she says. "We've been very blessed having Christina and her mother here. And they've been especially wonderful with our international families, drawing them out a little bit, encouraging them to share their cultural things, like meals."

Debunking cancer myths: An interview with a Mayo Clinic specialist

Life amid it all

In many ways, Christina is like any other young woman her age — happy about having gone to the prom and graduating, looking forward to going to college and planning for how she'll make her mark in the world.

Since she was a little girl, Christina had dreamed of being famous. "Some people say that that's something you kind of get over, but I haven't gotten over it yet. So I think it's meant to be," she says with a laugh.

What Christina really wanted to do was design clothing for full-figured women. And thanks to the Make-A-Wish Foundation, she got a chance to dabble with fame and the full-figured garments industry. They set her up on a modeling shoot with Mode, a women's magazine that features full-figured models. Christina's picture was published in Mode's August 2000 issue.

Throughout her treatment it was very important to Christina to keep striving to achieve her goals and to graduate from high school. And she did just that, while looking forward to attending college in Washington, D.C.

"Even though I went through this, I still made the effort to graduate," Christina says. "That was something I felt good about." She suggests trying to succeed at whatever you do — no matter what you're going through.

Those around Christina say they are struck by her positive and optimistic attitude. And though she'll admit it wasn't always easy, she kept a good attitude by living as she might have without cancer — she kept dreaming, kept setting goals and kept aiming to succeed at whatever she did — all the while still learning from her experiences with cancer.

Christina and her family will not forget what they've learned most from this experience — that time, life and what you do with them are extremely valuable. "It's really helped my family," she says. "They look at things differently and say, you know, life isn't just all about them. You can go at any time, so when you leave — what have you done?"

July 30, 2002

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