No longer running from cancer

I knew as far back as December 2015 that something was wrong with me. I needed my friend to remind me of as much the other day, when we were talking on the phone. I had completely forgotten, or willed myself to forget, the conversation we had two winters ago outside our old middle school following a workout.

My best friend Christian was on a health bend. He had been a bit heavier in high school, far from fat, but his weight bothered him. With a steady diet and exercise, he had whipped himself into the best shape of his life. His wife had also dropped the baby weight after having their son, Nico. She worked as a nutrition’s aide so she knew how to help them eat healthy and stay trim. Christian would grill chicken and have a cheat day when he could eat anything.

On top of this, he went to the gym and ran laps around the track at James Monroe Middle School, our old stomping grounds. The school isn’t more than a mile and a half from my parents brown stucco adobe house in the middle of the golf course on the northwest side of Albuquerque.

Christian and his wife had settled into a fixer-upper home near Sierra Vista Elementary School, not far from our old school. It was a beautiful starter home for them and Christian and his father had remodeled parts of it, making it shine beyond its years. Christian installed a big-screen television in the front den, perfect for him to play video games or watch his Denver Broncos every weekend.

I had went with him that day to do wind sprints at James Monroe. He picked me up in his beat-up yellow-bus Chevrolet truck. We parked down the way from the track and hopped a fence to get to the track, a black oval encircling green grass. It was Christmastime in New Mexico but it was unseasonably warm that day. We set out to run 200 meter sprints. In between, we’d rest for a short distance then kick out another 200 meter sprint.

By the third one, I was completely gassed. It didn’t make sense to me.

Christian had caught up to me. I think I still willed him off my heels but I was in furious pain in doing so. The runs didn’t seem to affect him the same way they were impacting me, draining me of all my energy.

We had to stop. I broke down. I told Christian my back hurt. I remember crying that day and not knowing why. Christian tried to comfort me. I told him I felt something was wrong with me, this deep-seated worry that I couldn’t shake. It was just friendly wind sprints but I had treated it like something more grandiose.

Christian told me to shrug it off, thinking I was overreacting. Maybe it was the higher altitude, we thought. But I had been used to running in Albuquerque’s mile-high climate for years. There were no immediate signs that something was wrong except for the fatigue so we went about our day.

Something nagged at me, not enough to get me to go to the doctor but enough to stir me up.

Before I left Albuquerque, I had gotten into the habit of running 2–5 miles per day. My stamina had built up steadily. My mother used to hate when I opted to run at night, when I first started exercising, fearing I’d get hit by an oncoming car, and later, annoyed that one didn’t hit me after I’d spend the rest of the night keeping the family up by hacking up my lungs.

A year after the wind sprints with Christian, around the same time, I was diagnosed with stage III testicular cancer, two days before I was set to board a plane for Albuquerque. I had ignored little signs since that day I broke down crying on the track. I had blood in my urine, and felt lethargic more than normal.

The big red flag was the coughing up blood, which sealed it for me. Something was wrong, yet I still waited weeks, until I collapsed walking to a restaurant in Trenton, to get medical treatment.

I haven’t run since my diagnosis. The closest I’ve come is a couple of pick-up basketball games with my dad and my friends from Connecticut. The father-son game came on the last day of my final round of standard-dose chemotherapy. I somehow willed myself to victory, relying on my jump shot like a fading NBA star in his accelerated age. My legs were too rubbery to drive the lane and my coordination was off.

Plus, I expended so much energy getting into the lane, with my cancer-stricken lungs, that it wasn’t worth the risk. Settling for the jump shot is how I beat the old man. Last week I got back out on the court when my friends from Connecticut came to visit me. I wanted desperately to play, if only as a barometer to measure my progress physically from the last time I played my dad.

I felt better, stronger, but still off-kilter, like a fish out of water trying to dribble with slippery fins. The ball kept sliding off my palms. It didn’t help that my fingertips and feet felt numb, a side effect from this most recent rounds chemotherapy. I once again had to rely on my jump shot to get me through the day.

Cancer has robbed me of some coordination, my peace of mind, and it has robbed me of my ability to run. I miss the runner’s high of going out every day after working at the newspaper.

Before I started running, I hadn’t run vigorously since high school. I’d play basketball at Johnson Gym during my college years. But that was a different type of running, with a different level of stamina. Short, jagged bursts of speed rather than nomadic, paced jaunts. My lungs got stronger the more I ran, and eventually with time, the coughing completely ceased. I was in pretty good shape when I left New Mexico in fall 2013.

I stayed that way throughout my time in Connecticut and after coming to New Jersey. I remember I used to run through University City in Philadelphia. I was dating a woman at the time who was getting her pharmacology degree at the University of Sciences.

Her name was Leigh, a cute Jersey Shore girl with curly golden locks and a bright smile that made her look like she had pearls for teeth. She was shorter, about 5 feet 1 inches tall, and had short legs. We went running together. I’d start out with her and slowly speed up, to my normal pace of about six and a half minutes per mile.

I’d run past the students on the streets, patrons gathered on patio furniture outside the bars along that stretch of Philadelphia. I’d run all the way to University of Pennsylvania, down a corridor of dorms to the pyramid outside the glass doors of the Rhoads Center.

I didn’t know what the building was called until last week, when I was checking in at UPenn Hospital for my second round of chemotherapy, as part of a clinical study led by Drs. David Vaughn and Edward Stadtmauer, comparing the benefits of TIP and TICE regimen chemotherapies.

As I walked past that familiar pyramid, I couldn’t help but think of all the times I had run to it, healthy as can be. I could see my former self through the looking glass that was the Rhoads Center doors, and for a minute, I couldn’t fathom the thought of where I was now, on the other side of those double doors, fighting for my life.

The fight is still ongoing. In truth, I thought it would be over by now. When the doctors at Robert Wood Johnson in Hamilton told me I was going to die, I shrugged them off. I still had on this veneer of invincibility, unable to contemplate a scenario in which I’d die. I was very cavalier about my predicament with a reporter from the Daily Beast, who had written about the prior restraint fight I was involved in with the New Jersey Attorney General’s Office.

That fight has come to pass, with The Trentonian winning the case and publishing a series of articles questioning why the 5-year-old kindergartner wasn’t taken from his family sooner by child welfare workers after he was discovered with drugs twice in two months last year.

I was confident by the time my March 17 appointment arrived with Dr. Kevin Kelly at University of Jefferson Hospital, where I underwent an initial round of standard-dose chemotherapy, that my cancer would be cured.

I had imbued that date with so much meaning. It was my mother’s original due date when she was pregnant with me, and I thought, it would come to signify the re-birth of me, back from the wretches of this horrible disease.

But that wasn’t the case. I couldn’t stand the look on my father’s face when the doctor delivered the news. He looked crushed, but tried to feign strength.

I did the same, trying not to cry in the room when Dr. Kelly told me there was still some “residual cancer” left in my lungs, liver and abdomen. I was so confident that it would be gone, convinced by the fact that my tumor markers had come down significantly and the lesions in my brain had been resolved from chemotherapy, an unusual occurrence as those are normally eradicated with targeted radiation.

Hearing the news from Dr. Kelly, even as he put it in his eternal optimist way, took away for the first time my blinding, and binding, belief that I was going to be OK. That was the first day I truly felt like I could die from this disease. The thought of death haunts me regularly. I wonder what this world would be like without me in it. The trees would still be green; the birds would still chirp and the seasons would still come and go, each of them marking the years in my absence.

Life would go on, undoubtedly, but I don’t really want to fathom that thought because, moreso than anything, I know if cancer kills me it will also indirectly kill my mother. I know how she is. She would blame herself for her son’s downfall, for his stubbornness in not getting treatment sooner.

So I try not to get fixated on that thought and keep plugging down the road to recovery. I’m now in the midst of a second “salvage” chemotherapy that has shown to have a high success rate, even for people with aggressive metastic testicular cancer.

I’m part of what is considered the high-dose chemotherapy arm at UPenn, meaning I receive the treatment dubbed TICE. In laymen’s terms, it’s an acronym for the types of drugs that are filtered through my the body.

The doctors start by administering chemo drugs pacilitaxel and ifosfamide. In between the two rounds of the pacilitaxel and ifosfamide, given over three days in the hospital, I take daily shots of a drug called Neupogen, a cousin to Neulasta. It’s an immune booster that unleashes the production of white blood cells in order to cultivate for stem cell collection, a process known as apheresis.

They inserted a catheter in my neck and filtered blood out from one side, which was guided through a centrifuge that separated the stem cells from the rest of the blood, that is then re-filtered into the patient.

The machine, the nurses told me, circulated only about a soda can full of blood at a time. The goal for me was to collect roughly 8 million stem cells. After one round of apheresis, the doctors had collected 14 million, a positive sign that my bone marrow was “very healthy,” Dr. Stadtmauer told me. Usually, he said, patients hit the 6.6 to 8 million threshold after two or three cycles of apheresis.

The stem cells, in all their majesty to heal, looked like creamy tomato soup. It was crazy to think something so simple looking provides so much hope.

I’m hoping that soup-like substance paves the way for my successful recovery. I still live in fear of leaving everyone behind because that is the perspective cancer gives you. The perspective of knowing you have something inside you that can kill you, a cellular perversion that must consume life in order for it to live. It is, in some sense, the building blocks of our existence.

People with cancer deal with it differently. I met a man in the hospital, Steve, who was battling bladder cancer. We shared a room together at Penn. He named his cancer Uri. We joked that it sounded German. I haven’t named by cancer but I think about it a lot. I envision my cancer has a mind of its own and that we’re across from each other at a chess table in a park, sizing each other up and seeing what moves the other one will make.

Cancer, the “whispered-about” illness oncologist and author Siddhartha Mukherjee talks about in his biography on the disease, launched a methodical, prolonged attack on me while I was barely aware of it, the same way a chess player moves in stealth.

I’m a pretty aggressive chess player, so I’m not as surreptitious in my attack.

And there’s nothing to be coy about anymore. The doctors have laid everything on the table. This is my life. And I must confront the three-pronged perspective of ruminating about the early signs that something was wrong, living in the now, preparing for a future while also still worrying about my own passing.

I hope one day I can be like the great Mark Twain and say, “Rumors of my demise were greatly exaggerated.”