In the fall of 2007, David Paul Koury noticed his knee was sore, but since he was a teenager, it could have been nothing more than a pulled muscle. When it started to swell days later, however, he had it checked by a doctor.
It turned out to be a suspicious bone tumor, said his mother Kristi Koury.
On Oct. 18 of the same year, David was diagnosed with a metastatic osteosarcoma, an incurable form of cancer. He has since undergone a year of chemotherapy and 10 surgeries to treat the disease, Koury said.
"He had his femur and knee replaced, and for a few months, it was clear," she said. "But it's back now, in his lungs. It's very aggressive. They removed 10 nodules, but they had told us if it came back, it was not survivable, so it's been really hard on us."
Koury said they found two more spots in David's lungs in October and January, but that they are stable for the time being.
David, 15, the youngest of Koury's four children, is having trouble coping with his prognosis.
"He's been very depressed and withdrawn. He doesn't like to talk about it or be reminded of it, but he knows it's there," she said.
"We've lost friends and family members," who found it too hard to cope with their situation, Koury said. "It's really sad."
Aside from the emotional and physical trauma, the Koury family is nearing the end of David's insurance coverage, and to date, it has cost $1.5 million for treatments and surgeries.
Travel has also taken its toll on the family finances, since they must go to Oakland Children's Hospital every three months, and to the University of California, San Francisco four times a year.
"He was not supposed to live beyond last summer. They didn't expect him to live that long, and the fact that he made it past there is a miracle," said David's father, Bryon Koury. "We just take it one day at a time, and rely on the strength of God."