Family's crisis an inspiration to others

By Jessica Howard Ennis

Photo by Kats Barry

The Stevens brothers, who were born just 15 months apart, share more than an unbreakable family bond — they also share the same life-threatening disease, Joshua, 13, and Christopher Corey, 15, were both diagnosed with osteosarcoma and are being treated at the Vanderbilt Childhood Cancer Program at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

Osteosarcoma, although rare, is the most common kind of bone cancer in children, striking approximately 400 to 500 pediatric patients each year. The bones most frequently involved are the large bones of the upper arm (humerus) and the leg (femur and tibia). While there is a probable genetic link with this kind of cancer, the occurrence in siblings is extremely rare. There are only a few families described in medical literature in which multiple members have developed osteosarcoma.

The boys' mother, Teresa, received a shocking diagnosis while her two sons were battling cancer. She too had cancer, but hers was a recurrence of breast cancer. She was diagnosed the first time while pregnant with Joshua. Teresa recently had surgery to remove the tumors, and hopes she won't require further treatment.

She wonders if her service in the Air Force flying on an AWACS plane for four years, which is a radar platform that uses radiation, could have contributed to the cancers.

Although their situation may seem too overwhelming for many others to even think about what life would be like in their shoes, Teresa and the boys maintain an unwavering positive attitude. Laughter — not sadness or self-pity — is a huge part of their daily lives which comes from their spiritual beliefs and "remembering to place everything in God's hands," Teresa said.

"We just take it day by day and try to get through it the best we can," Teresa said. "We try to laugh as much as possible."

Both boys are home-schooled by their mother and are both completing eighth-grade level coursework. They are avid

Photo by Kats Barry

computer users, and love to play video games. Joshua says his favorite thing to do with his brother is beat him at video games.

"I laugh when I beat people," Joshua said with a mischievous grin.

Christopher received a computer from the Make-A-Wish Foundation in 2004 and set up a chat room, which he paid for with his own money at www.chatwithuskids.com so other patients, no matter where they are hospitalized, can talk to him and each other.

"I created it because people [in the hospital] couldn't come out of their rooms, so now people can make friends without having to leave their rooms," Christopher said.

He's already made a few friends and it has been a helpful part of his recuperation, providing other patients a place to go, day or night, to talk if they feel alone.

Sue Alisanski, M.D., a clinical fellow in pediatric Hematology/Oncology, has been treating both boys.

"The way this family has juggled everything amazes me, Teresa is very resourceful," Alisanski said. "They are an extremely upbeat and positive family. When patients go in with that kind of attitude, in the long run, it helps."

Christopher developed the disease first in the summer
of 2004. The Stevens family lived in Baltimore until they moved to Thompson Station, Tenn., in the spring of 2005. The family was in Tennessee visiting relatives when Christopher began having severe pains in his arm after being hit by a basketball.

Doctors contributed the pain to muscle being pulled away from the bone. A month later, Christopher was punched in the arm while roughhousing with his cousin, which again caused him pain. They later discovered Christopher had bone cancer in his humerus, and an orthopaedic surgeon suggested Christopher's arm be amputated.

The boys' parents, Teresa and Leon, wanted to exhaust other options before considering amputation, and Christopher began chemotherapy treatments. The osteosarcoma cancer cells also spread (metastasized) to Christopher's lungs. He had nearly half of each lung surgically removed when the nodules were extracted, while the family still lived in Maryland.

When the family decided to move to Tennessee and were waiting for their new home to be built, Christopher and his parents traveled to Nashville twice to meet with doctors at Children's Hospital. They determined the course of his therapy when the move to Nashville was complete in March 2005.

"Not once was amputation brought up as an option," Teresa said.

Christopher continued his chemotherapy treatments and also had surgery to remove his left humerus, which was replaced with a cadaver bone.

Herbert S. Schwartz, M.D., professor of Orthopaedics and Rehabilitation and director of Musculoskeletal Oncology, performed the very difficult surgery.

As the family was settling into their new Tennessee home and while Christopher was midway through his cancer treatments, Joshua was experiencing a rapid, and painful, growth spurt.

"He grew four inches in a few months," Teresa said, of her almost 6-foot-tall son.

At first, no one really thought Joshua was experiencing anything other than growing pains, but because of Christopher's diagnosis, Joshua's pediatrician Monica Nania, M.D., took X-rays, which came back fine. When Joshua came back for a follow-up a month later, more tests revealed that he too had bone cancer in his left femur.

Joshua began chemotherapy and endured a painful surgery to replace his femur with cadaver bone in August 2004.

"I just thought it was weird that he had it right after me, and the same cancer," Christopher said.

The hardest part of having cancer for the boys is that it keeps them from being active, because both love sports.

"The boys have their purple belt in karate and played all kinds of sports," Teresa said. "They went from that to not being able to do anything. Joshua loves to ride his bike and hasn't been able to since before last summer."

Joshua is currently undergoing chemotherapy and must keep weight off of his leg by using crutches until around April. Christopher was just recently allowed to use his left arm again.

"The first thing I did was learn how to type and write with that hand again," said Christopher, who is left-handed.

"Both had very complex limb salvage procedures to remove their cancers," said Schwartz, who performed both surgeries. "Christopher's function is 80 percent normal. Joshua barely limps."

Added Schwartz, "Not only are they optimistic but supportive, friendly, intelligent, hopeful, respectful, strong and compliant. They are an incredible family unit."

In December, the family got a much-needed break. Joshua received a cruise from the Make-A-Wish Foundation, and the whole family was able to enjoy several days of fun and sun on a cruise to the Caribbean. The highlight for Joshua was a stop in Tortuga, the pirate city depicted in one of his favorite movies, Pirates of the Caribbean.

"The cruise was great, and we all had so much fun and were able to relax for a while," Teresa said.

While the boys recuperate, they are working on writing and illustrating a book - with the help of their mother - for other pediatric patients with cancer.

"We've learned a lot over the last year and a half, so we're writing a book - easy read, big pictures - for kids who require long stays in the hospital, focusing on things we've found that help during chemo and how we keep our spirits up. We hope it will help and bring peace to others," Teresa said.

Alisanski said she has been positively impacted by the family, and other patients at Children's Hospital have too.

"I truly feel blessed with having them as part of the patients I care for," Alisanski said. "They are already providing remarkable support for other families and uplifting others."

For more information about Joshua and Christopher, visit www.makingpeacewithdestiny.com and click on the link "Joshua and Christopher."