Stories of progress, inspiration, and information in overcoming osteosarcoma.

An Opera Singer’s Cancer Story

Kathleen Watt was at the height of her career as a New York City opera singer when the diagnosis came: craniofacial osteosarcoma.

In Part I of this Q&A, Kathleen Watt, osteosarcoma survivor and author of REARRANGED: An Opera Singer’s Facial Cancer and Life Transposed, speaks of how she became an opera singer, and candidly about what it was like to receive a cancer diagnosis. In Part II, which will be featured in next month’s The Frontline, she reveals how she endured chemotherapy, how she became her own best advocate regarding treatment decisions, and life today in remission.

How did you become an opera singer, and what did that career mean to you?

My mother was a classical concert singer, so the sound of a classically trained voice was in my ear from early on.

I was hooked on grand opera. I loved the intellectual engagement of history and languages; I loved the psycho-emotional immersion in character development and drama; I loved the creative genius of costumers, lighting- and set-designers; I loved the camaraderie of theater colleagues, and above all, I loved the full-body athleticism of operatic singing.

Tell us about the process of being diagnosed with cancer?

My tumor was identified by my dentist, as often happens with head and neck cancers. He referred me to a root canal specialist the same afternoon, who immediately ordered a biopsy.

It’s not something you’re ever prepared for, even though you’ve seen it in others, even when you know it’s coming. Coincidentally, I went into surgery on the very day I was supposed to audition at the Metropolitan Opera to make my part-time chorus job permanent.

What did it mean to you to have to end your career because of your diagnosis?

As an opera singer the diagnosis of craniofacial osteosarcoma was cataclysmic, putting my career, my very instrument at risk. It happened in two acts. Act I was all about routing the cancer. In Act II they rebuilt whatever wreckage remained. So, a lot of surgery with some chemo in between. I fully expected to return to the Met in time for the next season. As soon as possible I cautiously resumed a vocal regimen. But my second act was full of setbacks; my facial reconstruction dragged on for years. Though I was spared the psychological concussion of losing everything at once, eventually any chance to return to career singing had passed.

How did your treatment proceed?

I had elected to be reconstructed with tissue grafts from my own body, in a high-stakes procedure which was new then, but brilliant, and to me, worth the risks. Ultimately the odds broke the wrong way for me, and my reconstruction flat-lined, leaving me with lots of wounds to heal, hopefully in time for meaningful chemotherapy.

Barely a week after I was discharged from the hospital the intraoperative biopsy came back positive for cancer. Moreover, this biopsy revealed a more aggressive pathology. Instead of medium-grade chondrosarcoma, the labs showed osteogenic sarcoma in a high-grade tumor. Doctors immediately readmitted me to carve deeper margins into my nasal wall and eye socket. Meanwhile the window to begin my chemo course was closing.

All remaining maxillary hardware was removed, with some bone grafts still attached. Within three months of my initial tumor resection, still prior to chemotherapy, I’d undergone nine surgeries. By mid-September, almost nothing remained of my state-of-the-art facial reconstruction. I would have to be fitted for an oral prosthesis.

When my chemotherapy finally began in October, I wanted assurance that chemo would not destroy any more of me than necessary. So, I followed a referral to a trusted outside consult, and discovered that one component of my protocol, cisplatin, could potentially damage my hearing. I was seized with a spasm of patient advocacy. As my return to professional singing steadily faded, it became less and less relevant as a rationale for treatment. But wasn’t I steward of what body parts I had left? I couldn’t let go of my hearing without a fight.

In the end, my oncologist was able, somehow, to rebalance my chemo cocktail to sharply limit my intake of cisplatin.


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