Rucker’s Timeline of Events
- In late March, Rucker went to the ER at Children's after a few days of limping and complaining about pain in his left leg. An X-ray followed up by an MRI showed a small lesion in his fibula. The doctors were concerned so they ordered a biopsy the following week. The results of the biopsy appeared to be negative for malignancy, although the pathologist noted some findings of inflammation and giant cells (which are benign). Due to the lesion's potential to ultimately cause a fracture in his bone, our orthopedic surgeon recommended that the mass be surgically removed.
- Fast forward to late June, when Rucker was supposed to have the surgery to remove the mass in his left fibula. Before Rucker could go in for the outpatient procedure, he fell in the driveway and injured his right leg. We took another trip to the ER, where imaging showed a broken femur above the knee - and another lesion, similar to the one already seen in his left leg. This is when the doctors realized there was a bigger problem. Full body x-rays were ordered to determine whether other lesions could be seen in his bones. Although the x-rays did not reveal other bone lesions, the interpreting radiologist notified our attending physician that there appeared to be a large mass in Rucker's belly.
- On June 26th, a CT scan showed a large tumor on Rucker’s kidney, and the doctors believe that is the primary source of the cancer. They also found some nodules in his lungs and at least one additional lesion near his shoulder bone. He was immediately admitted and placed in the cancer wing (8th floor) at Children’s. An open biopsy on his kidney was scheduled for the following day.
- On June 27th, Rucker went into surgery. In addition to performing the biopsy, the surgeons installed a chest port for IV meds (and later, for chemotherapy). And while he was still under, an orthopedic surgeon put a cast on his leg for the broken femur. Unfortunately, the cast also wraps around his abdomen, which means Rucker won’t be able to walk (or go to the bathroom by himself...) for at least 8 weeks.
- A couple of tough days followed. Over that weekend, Rucker’s pain from the surgery began to subside. Because the doctors were still waiting on pathology results and weren’t ready to start chemo without a formal diagnosis, they decided to send us home on July 3rd, just in time to be able to watch the fireworks.
- The past week has been a waiting game. Pathology had ruled out some of the more common tumors (e.g. Wilms), and had developed a working theory that it was clear cell sarcoma of the kidney (CCSK). However, to be sure, the head of pathology at Children’s consulted with Dr. Elizabeth Perlman, the top pediatric kidney tumor pathologist in the country. After reviewing Rucker’s pathology, she agreed that it is most consistent with CCSK, but she ordered additional stains and testing in order to confirm that theory. We are still waiting on the results of that additional testing. However, our team decided that we should go ahead and begin chemotherapy since the additional testing may not come back for another week or two.
- On July 12th (today), Rucker went in for his first round of chemotherapy. To be absolutely certain of the CCSK diagnosis, the kidney tumor specialist wants to rule out an incredibly rare type of blood cancer that presents in the kidneys (she has only seen 1 case of this), so a bone marrow biopsy was also performed. Rucker was a trooper and all went well for day one (of many to come). We get to go home tomorrow and will return to the oncology clinic on Wednesday for more chemo (no overnight stay). That's where we are today....we'll keep you posted as our treatment continues.