By Dr. Maria Simbra

PITTSBURGH (KDKA) – When cancer keeps coming back, sometimes doctors have to take drastic measures.

For the past 20 years, Noreen Kachonik of Penn Township has been dealing with breast cancer and recurrence after recurrence in her armpit.

She was treated with surgery, chemotherapy, radiation, but it kept coming back.

“It ached, and it hurt,” she said.

This time, she saw an orthopedic oncologist, a surgeon who specializes in tumors of the muscles, bones and connective tissue called sarcomas. While this was breast cancer and not a sarcoma, the tumor’s location was right up Dr. Lisa Ercolano’s alley. Ercolano is an orthopaedic surgeon with the Allegheny Health Network.

“I operate in areas such as the axilla,” Ercolano said. “And I think that is why she was sort of sent my way. Because it’s an area of the body I’m familiar with and that I work in frequently.”

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Because of all of Noreen’s previous treatments, another surgery was risky.

To try to keep the tumor from coming back, Dr. Ercolano wanted to do a wide resection, meaning taking all the cancerous tissue along with a rim of normal tissue. Nearby muscles, blood vessels and nerves that go to the arm could get injured.

“I couldn’t guarantee that her pain would be markedly better. I couldn’t guarantee that doing the surgery would be successful in the way that we were hoping. I couldn’t guarantee that it wouldn’t come back again,” Ercolano said.

“I was ready,” Noreen said. “I told her I wasn’t waiting.”

It has been eight months, and so far, the cancer seems to be wiped out.

“I still don’t have feeling in my fingers,” Noreen said. “There are some things I can’t do. I can’t lift my arm straight up in the air, which I don’t need to. I have my right arm. It’s nice to have help, so you ask for help.”

“She’s not someone out of a textbook, so I think every decision with her is sort of taking in all the variables at that moment,” Ercolano said. “At this point, she has no evidence of disease, and that’s a good place to be.”

Dr. Maria Simbra