title: Inadvertently boarding a pirate ship: disease progression in a paediatric patient with relapsed metastatic Ewing sarcoma receiving treatment at a centre for alternative therapy in Mexico.
abstract: Complementary and alternative medicine (CAM) therapies are commonly incorporated into the care of patients with paediatric cancer. Many modalities are safe and effective during cancer treatment and have proved beneficial for symptom relief and quality of life. However, situations where alternative therapy is provided without allopathic medical care supportive care resources can pose a safety risk to patients. This report describes the case of a 16-year-old Chinese girl with metastatic Ewing sarcoma who sought treatment with alternative treatment in Mexico. When her disease progressed with an ensuing significant loss of function, the centre personnel were unable to respond to her acute deterioration or provide necessary medical care. This resulted in her being stranded in a foreign country paralysed, isolated, and with large unanticipated financial expenditures.
authors.affiliation: School of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Cheng
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, California, USA.
authors.forename: Leslie Y
authors.initials: LY
authors.lastname: Chiang
authors.affiliation: Department of Pediatric Hematology-Oncology, University of California, San Diego, San Diego, California, USA.
authors.forename: Dennis John
authors.identifier: http://orcid.org/0000-0003-4154-0057
authors.initials: DJ
authors.lastname: Kuo
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000191:economics / Q000628:therapy*; D000529:Complementary Therapies / Q000009:adverse effects* / Q000191:economics; D017281:Cost of Illness; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D005598:Fractures, Spontaneous / Q000191:economics / Q000209:etiology; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000191:economics / Q000209:etiology; D012272:Ribs; D012512:Sarcoma, Ewing / Q000191:economics / Q000628:therapy*; D016103:Spinal Fractures / Q000191:economics / Q000209:etiology; D013125:Spinal Neoplasms / Q000556:secondary; D016896:Treatment Outcome