Whether you have been diagnosed with cancer, are a caregiver for a patient with cancer, or know someone living with cancer, you know that a cancer diagnosis is one of the most life-altering moments a person can experience.
Many patients will tell you that the day they learn they have this dreaded disease becomes a seminal moment that rocks their world, while also directing them to a potentially different and often richer life. Indeed, cancer gave me an appreciation for the life I was living, and a new opportunity to add to my list of accomplishments as a competitive triathlete.
The Thrill of the Race
My introduction to competitive triathlon was on TV, with the dramatic finish of the Hawaiian Ironman in 1979. That experience and physical challenge stirred something inside me, although it took me a while to translate that excitement into active participation.
Five years later, I observed a local triathlon in my hometown. I will never forget watching a female competitor cross the finish line after 7 grueling hours of biking, swimming, and running. She still looked amazing, and when she got off the bike after completing the final event, she kissed her kids and her husband and asked, “Do they have anything to eat?”
I was awestruck. I had run 3 marathons in 1984 and was proud of my accomplishments, but that was nothing compared with that woman’s fitness, which was absolutely amazing. It was then that a triathlete was born.
In January 1985, I started swimming in addition to running and bike training, and completed my first triathlon in May that year. Shortly after, I completed my first half Ironman in Boston, and my first official Ironman distance in Cape Cod in 1987.
By then, I was already an avid runner, so it took little coaxing to add swimming and cycling to my training. After competing in my first triathlon, I was immediately hooked on the unexpected friendships that I made with fellow race mates, in addition to the athletic and health benefits.
Mingling, Family, and Mt. Kilimanjaro
Each race had hundreds or thousands of people who, like me, relished the chance to mingle with other triathletes and share stories of personal bests, training regimens, injuries, favorite and worst races, and ponder the question everyone was thinking: “Why the heck do we do this, really?” Our standard answer was, “We get a T-shirt!”
What also appealed to me was how I could combine training, competing, and family time. I operated my own CPA firm and was a committed husband and father. I tried to train in the mornings before work and ran at noon, so as not to interfere with family commitments later in the day. I always did my best to be home for dinner with my wife and 3 kids.
In a short time I competed in several triathlons. My involvement took me in 2005 to the Nationals in Kansas City, where I qualified the first time for the International Triathlon Union Worlds competition in Honolulu as a member of TEAM USA. Competing in these events became my avocation and passion. In 2012, I achieved my goal of completing a triathlon in all 50 states. But not to be defined by only one thing, in 2015 I managed to squeeze in a hike up Mt. Kilimanjaro.
It was challenging to juggle my many involvements of work, family, and triathlons, but somehow I made it work. Until it didn’t.
Bumps in the Road
In November 2018, I had a partial knee replacement, which sidelined me from triathlon competition for a while. I was making steady progress from surgery and continued to train, until I began to slow down, and my running times dropped significantly.
Naturally, I figured that my 67-year-old body was aging. My 9.5-minute miles slowed to 11 minutes and then 13, for no apparent reason. Nonetheless, I still felt okay and was looking forward to completing a personal milestone of 300 triathlons on April 30, 2022, at a race that I had founded 25 years earlier.
During a July training run, my running partner was concerned when she noticed I was stumbling over my words. After running 4.5 miles together, she alerted my son, who called my wife. We went to the ER that afternoon.
CT scans identified a tumor located on the left side of my brain, which the doctor said was affecting my speech. I had surgery, which successfully removed the tumor. I was told that this type of brain tumor called meningioma is normally benign, so I was hopeful for a full recovery, despite the hole in my skull that would stop me from swim training for 3 months, because of the risk of infection.
A Harsh Prognosis
Even more serious was what I learned from the pathology report on August 5. The CT scans showed that the brain tumor was in fact metastatic renal-cell carcinoma (or kidney cancer) that spread to the brain. According to my oncologist, because it was stage IV (or metastatic) kidney cancer, my prognosis was grim.
“I cannot cure you,” my oncologist told me. “You will die from it.” In these initial conversations, I learned a lot about my disease and my prognosis. I also learned that metastatic cancer does not come with a rulebook or any guidance about what you are supposed to do, or how to act.
Some may take a breather from the challenges of life and enjoy their remaining time with family and friends. I am not cut from that cloth, and I figured that the life I was living before my diagnosis could continue.
I had achieved a certain amount of professional success, had a family that I love and that loves me, and combined an activity outside of these commitments with triathlons that I truly enjoyed. Why change, just because I have cancer?
So, I made a pact with my wife and children. If I could continue doing the things I did before the diagnosis, my mortality was not to be a part of the conversation.
When you have cancer, your mortality, to a large extent, can be dependent on the level and type of medical treatment you receive. At the time (in 2021), I was receiving oral targeted therapy in combination with immunotherapy, and the tumor’s initial response was quite favorable, although my oncologists still had lingering questions about my long-term survival.
During a trip to Florida in November 2021, where I hoped to notch race 294 and 295 in a matter of 6 days, I met a patient with glioblastoma while waiting at a bike shop to pick up my race packet. He told me that he was cured of this usually incurable brain cancer after receiving treatment at the Moffitt Cancer Center in Tampa, Florida.
A brief online search led me to this cancer center’s new patient registration page. After completing the patient information, I got an appointment (the cancer was only in 1 of the kidneys) for 2 weeks later. My new team of oncologists at the Moffitt Cancer Center initially recommended to remove the diseased kidney, and referred me to a surgeon, Logan Zemp, MD.
Initially, Dr. Zemp said he would not remove that kidney, so I continued to take the medicines, despite the minor side effects.
Side Effects and Onward
The side effects of cancer treatments are often harder to live with than the disease itself. Yes, my side effects were uncomfortable at times, but despite some minor physical inconveniences, I was still able to finish 300 triathlons. The treatment was doing its job, and I began to see progress in my scans.
In fact, in February 2022, my doctors reduced my oral medicine by half (but I was still taking the immunotherapy as well). I remember telling my oncologist after taking the lower dose, “I feel too damn good,” but they did not restore the higher dose.
Despite the initial improvement, at the end of May 2022, my new scans revealed that although the tumor had continued to shrink, it was shrinking much slower than before. I then decided to have the affected kidney removed.
For 3 weeks before and 4 weeks after the surgery, I could not use the oral targeted therapy, but it was a bet I had to take. After surgery, the pathology reports showed that about 80% of the initial tumor was gone, thanks to the medicines I was taking, and that the surgeon had removed the vast majority of the cancer!
As of August 2022, my scans have shown that the cancer had not spread during the time I was off the oral medication regimen for several weeks before and after surgery. I will continue to take the combination regimen of oral therapy and immunotherapy for the next 2 years, and I feel more confident about my survival.
I have retired from work, and at last count completed 303 triathlons. I can now set new goals to reach.