We live in a digital age where virtually anything we want to know is a simple Google search away. When we notice something amiss with our health, many turn to the internet for answers, while others prefer to avoid the doom, gloom, and misinformation often found on medical information sites.
The majority of us, however, notice a change, watch it closely, and hope that the anomaly corrects itself on its own. Once the problem fails to subside, or it gets worse, it’s typically time to seek out a medical professional.
In January of 2016, 23-year-old Rachael Sawka of Winnipeg, Canada, saw her doctor at Seven Oaks Hospital about a small uncomfortable bump she’d noticed at the nape of her neck. Her doctor gave it a glance, told her the apparent cyst was nothing to worry about, and scheduled removal with a plastic surgeon for April.
In the three months before the planned removal, the bump grew alarmingly fast and bled regularly. This compelled Sawka to seek a second, third, and even fourth professional opinion during her repeated trips to the emergency department due to pain and profuse bleeding.
By April, the growth was alarmingly the size of a softball! Its mass exceeded the abilities of the plastic surgeon who stopped mid-procedure and announced that he couldn’t complete the procedure because the cyst was too large to get out.
A week later, the plastic surgeon, the fifth doctor, called Sawka with Earth-shattering news. “You have skin cancer,” he announced before quickly ending the call and leaving Sawka scared and alone.
As it turned out, even that doctor was wrong. Sawka has a rare and aggressive bone cancer called Ewing’s Sarcoma. She would need surgery to remove the tumor immediately. Her case was transferred to CancerCare of Manitoba.
Back in February, while being seen at Misericordia Health Center, practitioners there recommended that the assumed cyst have a needle biopsy performed on it. Biopsies are procedures where a sample from a questionable mass is taken and analyzed to tell practitioners what the mass is made of.
Such a biopsy would have taken place with Sawka’s primary care physician, but no such biopsy ever happened. Had it been, the cancer would have been caught and properly diagnosed months earlier saving Sawka pain, sleep deprivation, and extensive surgery.
Before surgery could be performed, radiation therapy was needed to shrink the tumor so that doctors could remove it. The painful treatments burned her skin, and the tumor bled so much she needed five transfusions.
In an 11-hour operation, the tumor was removed along with affected pieces of bone from the skull. Skin and muscle grafts were taken from her back and shoulders to replace skin on her head. The scar is large and Sawka will never be able to grow hair on the back of her head, again.
After the operation, Sawka started chemotherapy and is doing reasonably well. While they believe they got all of the affected tissue, practitioners admit that chance of recurrence is a high 50%.
While Sawka was frustrated that the inattention of doctors she trusted resulted in them overlooking a health risk as serious as cancer, Sawka has used her experience to encourage others to always advocate for their own health needs. If she had not been persistent about the growing bump doctors kept calling a cyst, the cancer may not have been caught before it could spread.
Sawka’s story has captured the attention of the national health board. Canada has socialized medicine, meaning every citizen has access to free basic healthcare, therefore accusations and complaints about quality of care are handled regionally, in this case by the Winnipeg Regional Health Authority. They opened an investigation to see if Sawka’s primary care team at Seven Oaks Hospital should have done anything different.
They call medicine a practice because it’s a field that is ever-changing, with outcomes based on individual circumstances and characteristics. While we trust doctors’ ability to evaluate and diagnose problems, no one is infallible.
What we do know, as Sawka points out, is our own bodies — specifically, when things don’t feel right. While we have gotten out of the practice, a second opinion on everything from medical diagnoses to treatment plans, is a wise and reasonable way to weight options and get clarity about your own health expectations and goals.