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As a former high school athlete and college baseball player, 25-year-old Alex Foell has weathered plenty of minor injuries.
After one particular health club workout in the spring of 2007, however, the upper part of Foell's left arm felt "different"—like a pulled muscle but with no pain.
"By late summer my upper left arm seemed to be swelling and it was hard to the touch," he says. "It hurt if I bumped it."
Alex decided to go to Central Iowa Orthopaedics in Des Moines, where his mother works. An X-ray by William Boulden, MD, showed that an aggressive mass was growing on his left humerus, the long bone of his upper arm.
"It was shocking," Alex says. "We had never experienced cancer in our family. Dr. Boulden told us we could go to a number of places but he suggested University of Iowa Hospitals and Clinics. He said Dr. Joseph Buckwalter was a highly respected orthopaedic surgeon and that they had been college classmates. We were grateful for his advice."
During an initial appointment, Buckwalter concurred with Dr. Boulden's diagnosis and ordered further tests—an X-ray, an MRI, and a biopsy.
The biopsy tested positive for osteosarcoma, or bone cancer.
Buckwalter conferred with several colleagues, including Mohammed Milhem, MD, a UI oncologist who specializes in sarcoma and melanoma. Together with other specialists on a sarcoma tumor board, they developed a treatment plan that called for chemotherapy before and after surgery.
The UI team also suggested that Alex partner with oncologist Mark Westberg, MD, at the John Stoddard Cancer Center in Des Moines.
"Since we lived in the Des Moines area, this was a good idea to take care of in emergencies between treatments," Alex says. "We used them a number of times for blood work, a couple of times for infections, and additional blood."
The UI team's goal was to save Alex's arm but that would depend entirely on the condition of the tumor and Alex's humerus.
After four rounds of chemotherapy, Alex underwent surgery on Dec. 13, 2007. Buckwalter replaced the upper two-thirds of his left humerus with a steel artificial humerus and removed his deltoid muscle.
"Amazingly, they were able to save the nerve in my upper arm, which allows me to move and control my hand and fingers," Alex says.
Alex then went home to recover for a few weeks and then resume chemotherapy, which ended in April 2008. After a great summer, he has returned to teaching school.
"I feel great," he says. "I can't do some of the physical things I used to do because I have some limitations in my left arm. But I am learning to do new things that I hadn't taken the time to do before."
Alex says he and his family are grateful for the care he received.
"This is a tough situation and they were there for us, answering all our questions and concerns," he says. "Dr. Buckwalter and his clinic staff, especially Chrissy, Dr. Milhem and his nurse, Wendee Beranek, the nurses on 4 John Pappajohn East, and all the staff were so very helpful. They were very professional, caring people with amazing medical abilities."
For questions or more information about sarcoma, patients and family members should contact Mohammed Milhem at 319-356-2324 or e-mail mohammed-milhem@uiowa.edu.
For consultation or referral, physicians should call UI Consult at 319-384-8008 or 800-322-8442.
—Michael Sondergard
"Dr. Milhem was so good at giving us the time we needed to ask all the questions we had, what the treatments would be like, and what we had to look for during my treatment. My parents, my sister and I knew nothing about cancer before. We know a lot now! "
—Alex Foell, cancer patient
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