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Osteosarcoma survivor carves a new path forward

Cancer stole her knee; OHSU patient with cancer Rebecca Johnston wouldn’t let it steal her heart
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Rebecca Johnston in snow gear atop a snowy mountain, preparing to snowboard. After recovering from osteosarcoma, Rebecca Johnston made the decision to amputate her left leg above the knee. Since then, she has become a World Cup parasnowboarder who has competed around the world for Team USA. She’s now training for the 2026 Winter Paralympics in Milan, Italy. (Photo courtesy of Rebecca Johnston)
After recovering from osteosarcoma, Rebecca Johnston made the decision to amputate her left leg above the knee. Since then, she has become a World Cup parasnowboarder who has competed around the world for Team USA. She’s now training for the 2026 Winter Paralympics in Milan, Italy. (Photo courtesy of Rebecca Johnston)

Rebecca Johnston took her position at the gate and looked down the mountain. Far below, the floodlights marked out the course she would ride. In winter, there are only three hours of daylight in this part of Finland, north of the Arctic Circle. She checked her helmet one more time. She had the slowest qualifying time for this event, which meant she had the last choice of gate.

She closed her eyes and pictured herself shredding through the course. She tried to remember all the advice from her coaches and teammates. Slow your breath. Focus on the horizon.

The contestants lined up at the gate. “Riders, ready!” the official shouted.

She angled forward, ready for launch. Her heart was pounding. The gate dropped and she hauled herself forward with a mighty heave. The race was on. Four snowboarders plunging down the mountain on a course full of twists, turns and jumps.

She was last out of the starting section, but she was catching up. The first turn went fine. On the second turn, she took the high line, which gave her a little extra acceleration — almost enough to overtake the next rider. Then she came to a jump. She hit it OK, but she felt flustered — the other rider was too close. When her board landed, she couldn’t find her balance.

She fell.

For a moment, it felt like all her dreams crashed along with her, pulverized in the Arctic snow.

A bump in the knee

A little pain and swelling in her left knee. That’s how it started. Johnston was a high school volleyball athlete from Hood River, Oregon, heading off to freshman year at Whitman College in Walla Walla, Washington, in the summer of 2017. She figured the bump was just the result of overuse. After she showed up for pre-season training at Whitman, it got bigger. And the pain got worse. She blamed it on intense volleyball workouts.

Rebecca Johnston by the lake on a sunny day. “Cancer is a terrible thing to have,” Rebecca Johnston says. “But you’ve got to move forward. You’ve got to lean into it. I kept a positive outlook. It helped my body heal. You take it one day at a time. Sometimes you take it one hour at a time.” She went on a camping trip in Canada in 2022. (Photo courtesy of Rebecca Johnston)
“Cancer is a terrible thing to have,” Rebecca Johnston says. “But you’ve got to move forward. You’ve got to lean into it. I kept a positive outlook. It helped my body heal. You take it one day at a time. Sometimes you take it one hour at a time.” She went on a camping trip in Canada in 2022. (Photo courtesy of Rebecca Johnston)

But in the first week of the semester, she woke up in her dorm room to go to English class and couldn’t straighten her leg.

She talked to her trainers. Saw a sports doctor in Walla Walla. The X-ray showed a sinister mass in her femur (the long bone in your thigh). Her doctor referred her to OHSU Knight Cancer Institute for a biopsy to confirm the diagnosis. It was sobering: osteosarcoma — a type of bone cancer.

Osteosarcoma is rare. About 1,000 cases are diagnosed in the U.S. every year, mostly in children, teenagers and young adults. It forms when, somewhere in the body, a bone cell goes haywire and starts to multiply out of control. Before long, the bad cells clump together and form a tumor. The tumor grows inside the bone, forming a painful lump. Left unchecked, the tumor will destroy the bone and spread through the body.

“A cancer diagnosis at any age is terrifying,” says her oncologist, Lara Davis, M.D., assistant professor of medicine at the Oregon Health & Science University School of Medicine and director of the sarcoma program at OHSU. “But in someone Rebecca’s age, the stakes are extra high. Even when caught early, osteosarcoma requires nearly a year of intense treatment — time spent in the hospital instead of off at college.”

Johnston took a medical leave from Whitman and moved back in with her family. Davis, her oncologist, started her on a tough regime of chemotherapy designed to stop the cancer from growing and spreading. She suffered from nausea, weakness, brain fog and exhaustion. She lost some hair and shaved her head. After several months, she was ready for the next phase: surgery.

The tumor had penetrated deep into Johnston’s femur, just above the knee. Her surgeon, James Hayden, M.D., Ph.D., associate professor of orthopedics and rehabilitation in the OHSU School of Medicine, would have to remove the lower third of it. However, the team could replace the missing bone with a length of titanium that would connect to her knee, a procedure known as limb-salvage surgery.

Johnston could hardly wait. “I really liked my team,” she says. “Dr. Davis is one of the smartest and most capable doctors I’ve ever met. She’s an amazing person. We got to know each other so well. Same with Dr. Hayden. I got the best treatment possible. They were great at supporting me. I was ready to get this tumor out and get on with my life.”

But it wouldn’t be so simple.

A big step

Recovery from the surgery was long and difficult. Her leg couldn’t bear any weight at all for six weeks. She used a walker, then crutches. And she was still doing chemo. She binge-watched The Office, then Breaking Bad, then The Office again. But the pain never really went away. “I really struggled,” she remembers. Six months after the surgery, she still couldn’t bend her knee.

Rebecca Johnston competed in the FIS Parasnowboard World Championship winter games in La Molina, Spain, in 2023, where she placed fourth in snowboardcross and fourth in dual-banked slalom. She also represented Team USA in the team version of those events. (Photo courtesy of Rebecca Johnston)
Rebecca Johnston competed in the FIS Parasnowboard World Championship winter games in La Molina, Spain, in 2023, where she placed fourth in snowboardcross and fourth in dual-banked slalom. She also represented Team USA in the team version of those events. (Photo courtesy of Rebecca Johnston)

After a year, she had a procedure known as revision surgery to remove scar tissue that had crept into the joint. Still, it came back three months later.

In 2018, after she finished chemo, she connected with the Sam Day Foundation, a Portland nonprofit dedicated to helping young people with cancer and physical challenges. The foundation paid for her to visit a sports center in San Diego, California, to meet other volleyball players with physical challenges and play sitting volleyball with the Challenged Athletes Foundation.

She went back to college at Whitman and got a summer job at a lodge in the Grand Tetons in Wyoming as a concierge at the activities desk, helping guests organize horseback rides and whitewater rafting trips. The job should have been an outdoorswoman’s dream. But she wasn’t living it. “I felt so limited by my knee,” she says. “I wanted so much to be strong, but I couldn’t do it.”

That summer she also went to training camps with the USA Sitting Volleyball Team. Talking with other players, she began to think about a step she had never considered: amputation.

Johnston asked her surgeon, Hayden, about her choices. He told her that they could try removing the scar tissue again, but there was no guarantee it would help. Amputation was definitely an option, he said, if she wanted to pursue it.

Johnston didn’t hurry the decision. She did her own research and talked to other people about their physical challenges. She tried to understand the capabilities and limitations of a prosthetic leg. She continued to do physical therapy and rehabilitation. But something became increasingly clear: “I was never going to run on that knee,” she says. “I was never going to jump on it.”

Amputation would free her from the limitations of her knee. But it would also mean losing everything below it: the calf, the shin, the ankle and the foot — forever.

In May 2020, she decided it was time to take the plunge. There was no going back. Hayden performed the surgery, leaving her with a residual limb composed of the top two-thirds of her femur. That summer, she got fitted for a socket and tried out her first prosthetic leg.

‘Dude, you can do this.’

The basic type of prosthetic leg features a “door hinge,” or mechanical knee. There’s no resistance in the joint. Johnston could use it for flat surfaces, but not for stairs or steep paths. That fall, she got a temp job at an urgent care clinic in Walla Walla doing COVID-19 testing. With effort, she learned how to walk from the curb to the clinic.

Six months later, she got an upgrade: a microprocessor knee. This type of knee detects an abnormal step and stiffens the joint to prevent a fall, a technology known as stumble recovery. The knee came with a hydraulic ankle that helps steady her gait. “If I’m wearing jeans, people don’t even know I have it,” she says.

Upstairs, downstairs, indoors and out, the new leg was much better suited for her everyday activities as a biology major at Whitman. But she wanted to get back to sports. Thanks to the Move For Jenn Foundation, she was able to get a prosthetic knee specially designed for athletes. “That was an amazing gift,” she says.

That spring, she took snowboarding lessons at Timberline Lodge on Mount Hood. “I had a blast,” she says. “It was strange and weird to trust my leg.” She posted a photo of herself on Instagram, standing on a snowboard with her prosthetic leg.

To her surprise, a few days later she got a call from Noah Elliott, a snowboarder who also lost a leg to osteosarcoma and who now competes with the U.S. Paralympic team.

“Dude, you can do this,” he told her.

That summer she did an internship at a cancer research lab at the Mayo Clinic in Rochester, Minnesota. The research fascinated her, but she found her thoughts returning to Elliott’s call.

In the fall, she met up with Elliott and the U.S. team at Mount Hood for a reality check. Could she really compete as a para snowboarder? “I was getting better every day,” she says. “I really wanted to be part of this. But I knew I had a long way to go.”

All through her senior year at Whitman, in between biology lab and chemistry tests, she went snowboarding whenever she could snatch a spare moment. After graduation, she moved back to live with her parents in Hood River and worked at a winery, saving up for training and airfare. She trained in Utah. She raced in Canada. She trained in Utah again. The next step: competing in the Europa Cup in Pyha, Finland. If that went well, she might qualify for the World Cup.

Down, but not out

At the moment, it wasn’t going well. Johnston was lying spreadeagled in the snow. But she remembered something her coach once said: “There’s a lot of race left to go. So much can happen in 90 seconds.”

Rebecca Johnston earned two bronze medals for Team USA in the team events at the FIS Parasnowboard World Championship winter games in La Molina, Spain, in 2023. (Photo courtesy of Rebecca Johnston)
Rebecca Johnston earned two bronze medals for Team USA in the team events at the FIS Parasnowboard World Championship winter games in La Molina, Spain, in 2023. (Photo courtesy of Rebecca Johnston)

She popped back on her feet and got on the board. She was dead last — but she was still in the race. “I was determined to keep going,” she says.

Building up speed, flying down the course, she could see the other riders in front of her. This course gave athletes a choice: a small jump or a big jump.

The other riders made a conservative choice and took the small jump: it was safer but slower. Johnston knew in a split-second what she would do. “I gotta go big,” she thought.

Now was the time. Time for redemption. Time for adventure. Time to go all in.

She accelerated down the slope and hit the jump straight on. She soared into space through the long, aching seconds of flight, the moments stretching out like wisps of smoke borne aloft. Then the mountain rose to meet her like a solid wall of snow.

She flexed her knees and nailed the landing.

The big jump gave her so much momentum that she blew past two other riders to finish second overall.

“Finland was the turning point,” she says. “That’s when I knew I could do this.”

Her race in Finland helped Johnston qualify for the FIS Parasnowboard World Championship winter games in La Molina, Spain, in March 2023. Competing with world-class para-athletes and gold-medalists, she placed fourth in snowboardcross and fourth in dual-banked slalom. She also represented Team USA in the team version of those events, winning two bronze medals.

“I’m so inspired by Rebecca,” says Davis, her oncologist. “Even not considering the challenges she’s faced from this bleeping cancer, she’s done awesome things. And she’s always with a smile!”

Since then, Johnston has raced all over the world. She lives in Salt Lake City and works for Pit Viper, a sunglasses and apparel company. She’s training for the 2026 Winter Paralympics in Milan, Italy. She’s also planning to go to medical school.

“Cancer is a terrible thing to have,” she says. “It sucks. But you’ve got to move forward. You’ve got to lean into it. I kept a positive outlook. It helped my body heal. You take it one day at a time. Sometimes you take it one hour at a time.”

What insights would she offer to other young people with cancer?

“When you’re young, a week feels like forever,” she says. “You want to get on with your life. But you have to accept that right now, your job is to get better. Not to be in school, not to work, but to heal. Cancer will always be a part of you. But one day you will look back on this and be grateful you kept on fighting.”

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