On Thanksgiving Day 2011, Court Simmons threw
on a pair of shorts and jogged toward the hospice
center where her mother, Crystal, was a patient.
The energetic 16-year-old loved to cook and had
just finished making turkey dinner for her favorite
person—her little brother, Reginald, who was 14.
As Court (short for Courtney) ran down the street
toward the hospice center, a few blocks away from
her Philadelphia home, a throbbing ache beneath
her left kneecap forced her to slow her pace to a
walk. “I was dealing with a lot, so I ignored the
pain. It seemed like the right thing to do at the time,”
Since Court was 9 years old, she had watched
her mom, a single parent, deal with a soft tissue
sarcoma, a type of cancer that develops in tissue
such as muscle or fat. The experience forced Court
to grow up fast. When she was 12, her older sister,
Christina, who was 17 at the time, died of a brain
tumor. And Court was just 16 when her mother died
on Christmas Day 2011, at the age of 41.
After her mother’s funeral in January 2012, Court
couldn’t wait to get back to school. She and Reginald
were staying temporarily with her mother’s friend
because they had no legal guardian at the time. School
was a refuge—she enjoyed class time, loved reading
and longed to laugh with her friends.
On her first day back, Court chased her best
friend down the hallway near their lockers. A terrible pain shot up her left leg, similar to what had
happened when she ran to her mother’s hospice
center on Thanksgiving Day. She sat down on the
floor as her leg throbbed, rolled up her pants leg
and saw the skin had turned purple. “I thought
maybe I had torn a muscle,” she says.
A few days later, she found herself sitting in a dark
room at Children’s Hospital of Philadelphia (CHOP)
staring in disbelief at an MRI image of an orange-sized mass protruding from the top of her left shin.
A biopsy confirmed that she had osteosarcoma, a
form of bone cancer. “The universe wouldn’t do this,”
she thought to herself.
A Family History
To say cancer runs in Simmons’ family is an understatement. Court, her mother and her sister all
were diagnosed with a condition called Li-Fraumeni
syndrome, a rare genetic disorder that predisposes
children and adults to several kinds of cancer. (Reginald
does not have Li-Fraumeni.) “People with Li-Fraumeni
syndrome are born with a mutation in a tumor-suppressing gene or oncogene that predisposes them
to certain types of cancer,” says pediatric oncologist
Abby Green of CHOP, who treated Court. Cancer
striking two young people in one family is a major red
flag suggesting Li-Fraumeni syndrome, Green says.
In the Simmons family, cancer had hit three family
members when they were young: Court’s mom was
diagnosed with breast cancer at age 18, while pregnant with Christina, and with soft tissue sarcoma in
Court is one of about 1,000 people in the United
States who are diagnosed each year with osteosarcoma, a type of cancer associated with Li-Fraumeni
syndrome. Close to half of those diagnosed with
osteosarcoma are children and young adults. The
disease tends to develop in the rapidly growing long
bones of the legs and arms, especially in teens hitting
their growth spurt.
In Court’s case, the cancer had not yet spread
beyond her leg bone, and the tumor was in a good
location for removal. Her prognosis was favorable,
says Green, “but we knew it wouldn’t be easy for
her.” She would require 30 weeks of chemotherapy,
reconstructive surgery on her leg and rehabilitation
to strengthen her leg muscles.
In the Simmons family,
cancer had hit three
family members when
they were young.