Nicole Upchurch is once again an active high school student, playing for her Somerset, Ky., varsity soccer team and planning for college. More than a year ago she was hit with troubling symptoms and went from doctor to doctor to find a diagnosis. Hear her story of being the first UK HealthCare patient to receive specialized treatment for a rare giant-cell tumor (5:39). Watch video in new window) »
A troubling swelling on Nicole's finger stumped her doctors.
Nicole Upchurch is an active high school student, playing for her varsity soccer team in Somerset, Ky. But last year she suddenly felt ill and tired and began losing weight. When her mom started making frequent trips to pick Nicole up early from school or soccer practice, they knew something was wrong.
Nicole’s left index finger became swollen, so in September of 2012 she went to an urgent care center near her home, where providers diagnosed it as a spider bite. The urgent care center prescribed steroids to reduce the swelling. But Nicole’s other symptoms didn’t go away, and the swelling reappeared over her Christmas break.
She scheduled an appointment with a local orthopaedic surgeon in Somerset who referred her to a hand specialist in Lexington. Doctors thought Nicole might have a cancerous tumor on her finger. They removed the tumor and performed a bone graft where the tumor had worn away part of her bone. But in April, the tumor was back again.
After treatment, Nicole is back to playing soccer.
This time, her doctors sent her to Patrick W. O’Donnell, MD, an orthopaedic oncologist recently recruited by UK HealthCare. Dr. O’Donnell is the only orthopaedic oncologist on staff at any hospital in Central and Eastern Kentucky. He specializes in treating patients with bone tumors.
As an academic medical center, UK HealthCare is often the best choice for patients who have rare or complicated conditions that are difficult to diagnose and treat. UK HealthCare is home to 116 doctors on the 2013 list of Best Doctors in America®, an honor received by only 5 percent of practicing physicians in the United States. Our doctors are able to provide the multidisciplinary, highly specialized care patients need.
Dr. O’Donnell diagnosed Nicole with a giant-cell tumor. Giant-cell tumors are rare and aggressive but non-cancerous. According to the American Academy of Orthopaedic Surgeons, giant-cell tumors occur in about one person per million each year. And it is even more rare to find a giant-cell tumor in a patient younger than 20.
“I think that’s why everyone was like, ‘This is crazy,’” Nicole said. “It just doesn’t happen very often.”
Because of the aggressive nature of the tumor, Dr. O’Donnell removed Nicole’s finger. He also performed a chest scan and found spots on Nicole’s lung. Dr. O’Donnell referred her to Joseph A. Iocono, MD, chief of pediatric surgery at Kentucky Children's Hospital, who sees pediatric-tumor patients.
Dr. Iocono was able to remove some of the tumors. But they caused part of her lungs to collapse, and she required a chest tube and a three-week hospital stay to help her lungs stay inflated.
Eventually, Nicole’s lungs filled with enough air so she could remove the tube and return to school. She even started practicing with her soccer team again. By her team’s senior night, Dr. Iocono told Nicole she could finally play for more than 10 minutes without having to sit out 10 minutes to rest.
“So from now on hopefully I can play just as much as I would have,” Nicole said. “They said I can play as long as I’m feeling good.”
Like any caring mother, Nicole’s mom, Tammy, was concerned for her daughter’s health.
“Thinking your child might have cancer, it scares you half to death,” Tammy said. “So when we got the answers at UK, even though it was still a little scary, it was almost a relief. You hate for your baby to lose a part of them, but we were glad to know they could get rid of the tumor and stop it from spreading.”
Even though giant-cell tumors are not cancer, they are treated in much the same way. Nicole receives chemotherapy shots under the care of Lars M. Wagner, MD, a pediatric oncologist at Kentucky Children's Hospital. The giant-cell tumors on her chest are shrinking, and Nicole will continue her follow-up appointments with her doctors at UK HealthCare every month.
“I have never questioned anything they told me,” Nicole said of her team at UK HealthCare and Kentucky Children's Hospital. “I wholeheartedly believed they knew what they were doing. And they obviously did because it’s working.”
Tammy said nurses and staff from different departments who have seen Nicole often come by during her follow-up visits to see how she’s doing. “We have had awesome doctors and nurses,” Tammy said. “It’s like they’re family now. That’s how we think of them.”
The experience has led to a new career goal for Nicole. She hasn’t decided where to attend college – she is still pursuing an opportunity to play soccer – but she is thinking about majoring in psychology.
“When I get older, I would like to be able to counsel kids who are going through something like this too,” Nicole said. “I feel like I have learned enough that I could help them.”
For more information about treatment options at UK HealthCare, call 800-333-8874.
• UK HealthCare named ‘Rising Star’ hospital by University HealthSystem Consortium, October 18, 2013• UK HealthCare named a Top Performer by The Joint Commission> • UK Stroke program receives quality achievement award, May 22, 2013• Markey Cancer Center • UK Markey Cancer Center: Our pursuit of an NCI designation • What is patient centeredness?
• Markey announces high survival rates for many cancers • A patient's guide to MRIs • Cancer nutrition advice: Markey Menu blog • Advances & Insights publication: cancer topics
A giant-cell tumor is made of benign, or non-cancerous, cells. It is an aggressive tumor that usually forms near the end of a bone or near a joint. Learn more »
Nicole’s team of providers at UK HealthCare included:
• Getting a good second opinion • Should you choose a multispecialty group practice for your care? • Should you participate in a clinical research study? • What to do if you have multiple medical problems
Expert perspectives from UK physicians on the latest medical breakthroughs. Read online or subscribe via mail to one of these areas:• Cancer • General health • Heart health • Neurosciences • Pediatrics • Women's health
Visit That's Why We're Here or read more patient stories.
• Use our online Health Content Library to research conditions, tests, treatments, medications, etc.• Subscribe to HealthMatters, a free e-mail alert service provides medical news and UK HealthCare event notices in your area of interest.• Follow us on Facebook and Twitter.• Ask for UK House Calls to be delivered to your home monthly.• Search the UK HealthCare YouTube channel.• Visit the Don & Cathy Jacobs Health Education Center, UK Chandler Hospital.• Call UK Health Connection for health information, physician referrals or to schedule an appointment: 800-333-8874.
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