Speedy Sarcoma Treatment Gets Single Dad Back to Raising Son

When Curtiss Woodruff, III, was diagnosed with an aggressive form of sarcoma two years ago, his thoughts immediately turned to his 12-year-old son, Matthew, a straight-A honor roll student who will be starting seventh grade next month.

“I instantly thought about what would happen to Matthew if something were to happen to me,” says Mr. Woodruff, a 54-year-old marine contractor and single father who has lived in Martin County for nearly 50 years. Fearing the worst, he started writing a diary to his son.

Juan Pretell, M.D. orthopedic oncologist surgeon and chief of musculoskeletal oncology surgery at Baptist Health Miami Cancer Institute

That was in 2022. Today, thanks to orthopedic oncologist surgeon Juan Pretell, M.D. chief of musculoskeletal oncology surgery at Baptist Health Miami Cancer Institute, Mr. Woodruff is cancer-free, his diary is on hold, and both father and son are planning their annual summer adventure to celebrate Matthew’s continued academic achievements.

A bump on the arm turns out to be something more

Mr. Woodruff remembers how it all began in April 2022. He was doing some work on a house he had bought with the intention of fixing up and selling at a profit a couple of years later. “I hurt my left elbow – something pulled on the inside – and it hurt for about a month,” he recalls. “Then, suddenly, a small quarter-sized bump appeared. My friends and I decided it must be a torn bicep due to the pain in my elbow, so I decided to have it checked out.”

The orthopedist he saw had no idea what the bump was and referred him to Nicola Lekic, M.D., an orthopedic surgeon in Stuart. “At that point, the mass had grown to the size of a racquetball,” Mr. Woodruff recalls. “The moment Dr. Lekic saw it, he pretty much knew what it was.” The doctor referred him to Dr. Pretell, whom he had trained under years earlier.

“Mr. Woodruff was referred to me in December 2022,” Dr. Pretell recalls. “He had a soft tissue mass on the biceps muscle of his left arm and it was growing into the tissue under the skin. It had appeared several months prior without cause or any known trauma. Although it wasn’t affecting his quality of life or his work at that point, it was growing and starting to cause some pain.” Further tests revealed that the lump on Mr. Woodruff’s arm was a grade 3 aggressive myxofibrosarcoma.

What is a myxofibrosarcoma?

According to the National Cancer Institute (NCI), myxofibrosarcomas are a rare type of soft tissue sarcoma that forms in the fibrous connective tissue that supports and surrounds the body’s organs, bones and muscles. The NCI says myxofibrosarcomas are usually found in or just under the skin of the arms and legs. While they may occur in children, they are most common in adults 50 and older. Because myxofibrosarcomas also tend to recur, patients with this type of cancer must be followed closely for their first five years after treatment.

An aggressive treatment plan for myxofibrosarcoma

In consultation with other specialists at Miami Cancer Institute – medical oncologist Nicole Eiseler, M.D., and radiation oncologist Ana Botero, M.D. – Dr. Pretell recommended an aggressive treatment plan for Mr. Woodruff that included chemotherapy, radiation and surgery.

Nicole Eiseler, M.D., medical oncologist with Baptist Health Miami Cancer Institute

Ana Botero, M.D., radiation oncologist with Baptist Health Miami Cancer Institute

“Because these cancers tend to be aggressive and can spread to surrounding tissue, they require neoadjuvant treatment prior to surgery, starting with chemotherapy and followed by radiation therapy. Then we wait four to six weeks to do the surgery,” Dr. Pretell says.

Mr. Woodruff was completely on board with Dr. Pretell’s treatment recommendations. “He explained to me that the reason we had to be aggressive is because mine was a high-grade cancer and sarcomas are dangerous enough as it is,” he says.

Mr. Woodruff started his chemotherapy just six weeks after his diagnosis. “It was not very kind on my body but all of the nurses were wonderful. After the second cycle, however, they told me that the chemotherapy wasn’t working so they immediately stopped my treatment.”

Instead, Mr. Woodruff started 25 treatments of radiation therapy, which he says was “completely painless.” “I didn’t think it was working, as there were no visible effects during my treatment,” he says. “But two weeks after my last treatment and just before my first surgery, I noticed the bump was shrinking a little bit and getting pretty ‘toasty' – it looked like a third-degree burn.”

Surgically removing the myxofibrosarcoma

Dr. Pretell had prepared his patient for the possibility of several possible surgeries to completely remove the tumor and reconstruct the damaged portion of his arm. However, due to the tumor’s radiation-induced shrinkage, it required only two surgeries. The first surgery was difficult but successful, he says.

“We had to remove the skin covering the tumor and go deep into the muscle to get to negative margins,” Dr. Pretell says. Negative margins refers to when doctors surgically remove a tumor. They aim to get all of the tumor and just a little extra “margin,” or healthy surrounding tissue, to ensure there are no remaining cancer cells. The second surgery was a skin graft from Mr. Woodruff’s thigh to his bicep and that, too, was a “complete success.”

Dr. Pretell says that a year after his surgery, Mr. Woodruff is cancer-free. “He has had no local recurrence or distant disease and is doing pretty well. His function in his left arm is preserved, he has a full range of motion and no limitations on his work or daily living.”

Aside from a minor side effect that persisted for a few months following his surgery, Mr. Woodruff says his recovery has gone well. “I'm pretty healthy again. I had a pressure problem in my neck and head that made me feel like I was under water. The worse it got, the deeper underwater I felt.” As a result, he just returned to work a few months ago, where he says he’s making up for lost time by working 68-hour weeks on a canal-building project.

Spotting a sarcoma: what to look for

Dr. Pretell says sarcoma is an aggressive cancer with a “very high” mortality rate, and adds that it’s a tricky disease, too. “It doesn’t give you the sense of feeling sick. Soft tissue sarcomas most often appear as a non-painful bump, he says; in up to 60 percent patients associate them with a history of trauma of some sort to the area.

According to Dr. Pretell, the most common symptoms of sarcoma include:

·      A painless “bump” that appears for no apparent reason

·      Any lump or mass that grows

Dr. Pretell says that even other physician specialties aren’t aware of sarcomas, something Mr. Woodruff discovered when even an experienced orthopedic specialist was stumped by the bump on his arm. “That is why they need to seek care at a center like Miami Cancer Institute that specializes in sarcoma treatment,” he says.

“I wouldn’t have gone anywhere else”

Mr. Woodruff says his sister was there by his side at Miami Cancer Institute for all of his initial visits and both of them were “very impressed” with the professionalism of the physicians, nurses and staff, as well as the speed at which things moved along.

“I’m just so thankful to Miami Cancer Institute and Baptist Health, my doctors, and their amazing staff,” says Mr. Woodruff. “Even the phone operators there are amazing – they’re very knowledgeable and they relayed all of my questions or wishes on every call. Even though I had to drive two hours each way for my treatments, I wouldn’t have gone anywhere else.”

Dr. Pretell calls Mr. Woodruff “the kind of patient every doctor wants to have.” “He was all in and open to going to wherever he had to for his treatment. He was optimistic and had a positive attitude, and that’s very important for anyone fighting a cancer diagnosis.”

Mr. Woodruff says he can never thank Dr. Pretell enough for saving his life. “Thanks to his knowledge and quick reaction time, he immediately took the proper course of action the moment he knew for certain it was serious. I can only imagine if I had gone to somebody else who wasn’t as experienced as he is. I’m sure I would have had a different outcome. Thanks to Miami Cancer Institute, I’m still here to raise my son and watch him grow and play sports.”