After first noticing pain in her shoulder while climbing, 23-year-old Cat Holden thought it was a muscle injury. Her doctor also ordered “rest and ibuprofen.” The young woman suffers from a giant cell tumor.

When she felt a twinge in her shoulder, 23-year-old Brit Cat Holden assumed it was a simple sports injury – and her GP agreed. But there was much more to the pain than she could imagine at the time. She is now undergoing lengthy chemotherapy and has to have her shoulder joint and parts of the upper arm bone surgically removed. But why did the tumor remain undetected for so long?

Holden first noticed symptoms in March last year during a family adventure holiday in Great Yarmouth after her left shoulder began to hurt while climbing. She assumed it was just a muscle injury and in fact the pain initially disappeared.

However, five months later the shoulder pain recurred, this time while swimming. The pain became so severe that she was barely able to keep her head above water, reports the Daily Mail.

After this experience, she made an appointment with her family doctor for the first time. “The doctor said it looked really infected,” she recalls. But because nothing could be seen on the ultrasound, the doctor diagnosed tendonitis.

“I was told there was a simple solution – I just needed rest and ibuprofen,” Holden explains. She also did physio exercises via an app for six weeks.

After completing this physical therapy, she took the “trip of a lifetime” to Sydney, Australia. But after climbing the Sydney Bridge and skydiving, the pain in his shoulder returned again. This time more violent than ever. The throbbing, pulsating pain made it difficult for her to sleep at night. “I knew something was really wrong,” she remembers.

When she came home from Australia in mid-November, she didn’t notice any lumps or bumps on her shoulder. “But I couldn’t lift my left shoulder past a right angle.”

Earlier this year, Holden finally had an MRI done at a private clinic in hopes of finally finding the cause of the problem. She still didn’t expect that such a serious illness could be behind the pain.

But then the doctor said he found something really unusual in her shoulder – a tumor. Further tests eventually revealed that Holden had a malignant giant cell tumor – the size of an avocado.

Giant cell tumors are rare. In Germany there are around 1.8 new cases per 100,000 inhabitants. Men and women are affected equally often; most patients develop the disease between the ages of 20 and 40. Those affected often have joint pain for months – but usually to a mild to moderate extent, as well as restricted mobility. Since the disease shows these unspecific symptoms, especially at the beginning, misdiagnosis can occur. Especially since ultrasound or X-ray images often only show indirect signs of swelling. Magnetic resonance imaging (MRI) is therefore considered the most important diagnostic procedure.

Although giant cell tumors can be aggressive and grow quickly, damaging bone in the process, they are usually not cancerous. In Holden’s case, however, the tumor was found to be malignant and therefore had the potential to spread to other parts of the body.

Since then, she has been undergoing chemotherapy, which will last a total of six to nine months. Just two months after starting treatment, the 23-year-old lost her hair, eyebrows and eyelashes. She also developed tinnitus.  

“I don’t recognize myself in the mirror anymore – I used to have long, blonde hair and was a healthy girl,” she says. “There are days when I think I look like a leprechaun – I’m losing weight and I’m so pale.”

Chemotherapy feels like being hit by a bus. “I get nausea, diarrhea, fatigue and the worst mouth sores.”

Before she became ill, she underestimated the mental and psychological struggle that people with cancer have to go through. The day she was diagnosed with cancer was the “darkest day” of her life.

“Getting cancer was a really crucial point in my life because everything was fine before. And then I was faced with something that I never thought could happen,” she says.

In June, Holden will undergo surgery to have her entire shoulder and humerus bone removed and replaced with a metal prosthesis. She will probably never regain full mobility in her shoulder.

Although this prospect is discouraging, she is still looking forward to the future: “I will carry the trauma of it with me forever – but I will appreciate life afterward even more.”