Early in 2016, Gerald Barlow, then 79, started to experience puzzling symptoms, notably a lack of appetite, night sweats, and some minor discomfort in his right thigh. But he had bigger things to worry about at the time—his wife was suffering from severe back pain and needed his help. In the fall, 30 pounds lighter, he finally sought medical advice. After visiting several doctors, the retired aeronautics engineer had an MRI in December.
The results clearly showed a mass in his right thigh.
Fortunately for Gerald, he was referred to Brock Adams, MD, an orthopaedic oncologist at the Washington Cancer Institute at MedStar Washington Hospital Center. The orthopaedic oncology team—medical oncologist, radiation oncologist, surgical oncologist, pathologist, and radiologist—diagnosed liposarcoma, a cancer that starts in the body’s fat cells, often in the thigh.
“Liposarcoma is rare, especially in adults, and only accounts for ¼ of a percent of cancer cases,” Dr. Adams says. “The first tumor started out as a low-grade tumor, and then became high-grade.” The team decided the best course of action was radiation to reduce the size of the five-inch tumor, followed by surgery to remove the remaining tumor.
After two months of radiation, surgery was scheduled for April 2017. The surgery went well, and Gerald left the hospital five days later. After intensive physical therapy in a rehabilitation facility and later at home in Aspen Hill, Md., he was able to walk again with the help of a cane.
“It took Gerald extra time to get back on his feet because he developed some unrelated neurological issues that made walking difficult,” Dr. Adams says. “But he stuck with it, and it paid off.”
Gerald continued to visit Dr. Adams every three months to monitor his progress. In November 2019, Dr. Adams found evidence of the cancer’s return. This time it was in his left hip and had penetrated into nearby bone. But there also was some good news: a PET scan showed that the cancer had not spread to other parts of his body.
“It was somewhat unusual for it to metastasize only to the opposite leg,” Dr. Adams says. “It had elements of both a low-grade and high-grade tumor, which also was unusual.”
Dr. Adams removed the diseased part of the bone, performing a hip replacement. “I removed a little more than what I would for a conventional hip replacement. I needed to reconstruct the hip joint with an oversized prosthesis,” he says.
Again, Gerald spent five nights in the hospital and had intensive rehabilitation after he was discharged. As had happened after his first surgery, he experienced some weakness in both legs but stuck to his exercise regimen and gradually improved.
Now, at 84, Gerald manages with a cane and a souped-up walker. The cane, incidentally, is one he’s had since his college days at Catholic University, when he was injured running cross country. He’s an advocate for Dr. Adams and his nurse Carolyn as well as for physical therapy, which he credits for keeping him walking despite the cancer and the surgeries. “From the very beginning,” he says, “Dr. Adams and his nurse looked me straight in the eye and told me I was going to be okay. Obviously, I was in good hands.
I couldn’t ask for better care. I count my blessings—I’ve still got both legs.”
“Liposarcoma is rare, especially in adults, and only accounts for ¼ of a percent of cancer cases. The first tumor started out as a low-grade tumor, and then became high-grade...It was somewhat unusual for it [the second tumor] to metastasize only to the opposite leg. It had elements of both a low-grade and high-grade tumor, which also was unusual.”
- Brock Adams, MD