Mumbai doctors go out on a limb to help girl walk again

Dr Manish Agarwal, director, Surgical Oncology (Orthopaedic), Nanavati Max Super Speciality Hospital with Bangladeshi national, Ramisa Uddin

A nine-year-old Bangladeshi girl, suffering from bone cancer and advised amputation, recently underwent a complicated limb-saving surgery at a city hospital. Now back on her feet, Ramisa Uddin wants to study medicine and become a doctor.

"Though rare, bone cancer commonly affects young adults between 10 and 25 years, and thus, has a huge societal impact. Moreover, many patients such as Ramisa either undergo amputation or the cosmetically disfiguring rotationplasty. If a standard adult prosthesis is used for paediatric patients, the bone growth is often restricted and the patient's one leg permanently remains shorter," said Dr Manish Agarwal, director, Surgical Oncology (Orthopaedic), Nanavati Max Super Speciality Hospital, Mumbai, while discussing the major complications of paediatric bone cancer management.

To ensure that Ramisa maintained her current bone length, a special, made-in-India "expandable prosthesis" was used to replace the tumour-ridden section of her left leg. The replacement, doctors said, will also ensure a natural limb growth. "The key advantage of the prosthesis is that it can be extended with a simple keyhole surgery every six months using a scientific formula, which predicts a patient's limb growth. This prosthesis is also affordable and can substantially reduce the impact of increasing limb disfigurement or amputation due to cancer," said Dr Agarwal.

Ramisa underwent a successful surgery in the last week of October, followed by chemotherapy under Dr Muzammil Shaikh, director, Medical Oncology, to ensure complete eradication of the cancerous cells. She was first diagnosed with osteosarcoma, a fast growing bone cancer in April this year. "In December 2020, while playing with her brother, Ramisa complained of pain in her left leg. We immediately sought advice of an orthopaedic specialist. He dismissed any serious causes, termed it as growth-related pain and prescribed painkillers," said Riaz Uddin, Ramisa's father. Due to a number of domestic hurdles, the family couldn't visit doctors for a follow-up visit.

"When the pain became more intense and her leg started swelling, we met another senior oncologist, who based on MRI and X-ray findings, diagnosed Ramisa with osteosarcoma," her father added. Doctors in Bangladesh suggested a treatment plan of three chemotherapy sessions, followed by a surgery. But in order to avail quality medical care, the family travelled to Mumbai for Ramisa's treatment. A top cancer hospital in Mumbai had advised amputation, but after consulting other surgeons, they were able to find the best option for her. The family will now return for a follow-up and limb extension after six months. "Ramisa's experience with bone cancer and contribution of doctors to her future has encouraged her to take up medicine," her father added.