January 2, 2020

Rare Disease, Rare Specialist: Peggy Burns Finds Help Close to Home for Her Sarcoma

Peggy Burns Sarcoma PatientBy Deanna Thompson

Peggy Burns had a nagging pain above her right knee that gradually got worse. She saw doctors and tried physical therapy, but nothing brought lasting relief.

“It got so bad I could not lift my kids,” the former special education teacher said, referring to her students. “It was hard even to walk around the hallways without the area above my knee hurting “

In 2015, after the pain forced her retirement at age 61, Burns finally found a specialist who pinpointed her problem — Donald Gajewski, MD, at Mission Musculoskeletal Oncology. The shocking answer: sarcoma, a rare type of cancer.

“I had never even heard of sarcoma,” Burns said.

The Right Place

Sarcoma is cancer of the bone or soft tissues, such as muscles, nerves, joints and blood vessels. It makes up just 1 percent of adult cancers and 15-20 percent of pediatric cancers. Because it can appear virtually anywhere in the body and has few symptoms, it can be hard for doctors to detect.

Burns was fortunate to land at the right place at the right time to get a proper diagnosis. Dr. Gajewski is a specialist in cancers of the bone and connective tissues. Dr. Gajewski had just joined Mission when Burns, who lives in Johnson City, Tennessee, sought help from another doctor in the practice, T. Marcus Barnett, MD, a graduate of the high school where she had taught. Dr. Barnett referred her to the practice’s new specialist.

“The day I met Dr. Gajewski, I knew instantly he was the one who was going to take care of me,” Burns said. “He is brilliant, humble, caring and gives his heart and soul to every patient he touches.”

One in a Million

His first step was to order an MRI of Burns’ leg, which showed a 6-centimeter mass above the knee. “Dr. Gajewski told me that 99 percent of these things are benign, but the 1 percent — we were not taking any shortcuts,” Burns said. His next step, a needle biopsy, found advanced synovial sarcoma, an especially rare type of sarcoma that is diagnosed in just 1 to 3 of every million people.

Sarcoma: Don’t Ignore That Bump
The first sign of this type of cancer is often a lump or swelling. Don Gajewski, MD, advises patients not to ignore a lump or bump that is unusual, painful or getting bigger or an injury that doesn’t get better. “If it doesn’t get better, it’s worth a work-up,” he said.

Dr. Gajewski performed surgery to remove the mass. That was followed by radiation and a series of surgeries to close the wound. Because sarcoma often recurs or spreads, Burns will continue follow-up appointments and imaging studies for 10 years. In 2018, an MRI showed a small recurrent sarcoma in her leg, and Dr. Gajewski operated to remove it.

“We caught her recurrence very early and were able to take her to the operating room to completely remove it,” he said. “That’s why surveillance is so important. You want to identify any recurrence early.”

Specialty Care Close to Home

The only musculoskeletal oncologist in western North Carolina, Dr. Gajewski relocated to Asheville after 21 years in the Army, where he worked primarily with amputees. His goal was to practice musculoskeletal oncology in a setting where he could help people who otherwise would have to travel hours to see a specialist. Because sarcomas are so rare, most specialists are in university medical centers.

“I’ve already met two or three people who would never have gone to a big center,” Dr. Gajewski said. “Just coming to Asheville was a chore for them. Now we can offer them a service they don’t have to travel for. They can come here and get the same level of care they would get at a university center.”

Burns is thankful to have found a specialist with Dr. Gajewski’s level of expertise — and happy to be free of pain. “This was a time when God came down and put a puzzle piece together for me to meet him,” she said. “I don’t think anybody would have ever figured out my leg if it was not for him.”


Donald Gajewski, MD, is a board-certified surgeon at Mission Musculoskeletal Oncology.

Mission Cancer provides cancer prevention, diagnosis, treatment, supportive care and survivorship with an emphasis on convenience for our patients and their families with a team approach to cancer care. To learn more about our services, visit missionhealth.org/cancer.