The Beginning

Welcome to my blog! For the longest time, I never envisioned myself starting one, but circumstances have a way of making things happen that you don't envision. In my case, it was cancer. Until now, I have yet to reveal my diagnosis to my entire circle, but from those I have already shared the news with, I have received so many amazing messages of support that answering them individually (my preferred style) is just too overwhelming. And so, I have created this blog.

The ordeal all started in early October of last year, with intense bone pain where my left foot meets the ankle. I've had a history of pain in that foot, mostly in the 5th metatarsal, the upper part of which I had broken back in May 2000. Up to that point, the pain was occasional and connected mainly to overuse when running, and never too serious. This was something different. Much more intense, with some swelling too. Still, I had put in a good amount of running in August and September. It must have been connected to that, right?

The pain subsided after 3 days, but I had kept the foot immobilized for a while longer thinking I'd give it time to heal. In the meantime, I saw doctors to see if there was anything else going on. A huge battery of blood tests came back normal, no specific cause was found, and I began physical therapy looking forward to getting back in the saddle. Turns out I was not done. After more bouts of pain in November and December, I started to get the feeling this was something bigger. The latter flare-up was the really telling one, because it came right after a week of once again keeping the foot immobilized. Now that's a sign of something that's not an injury.

Still, I didn't think it was possible I had cancer. I never could entirely expel the thought from my mind -- a student in my very Ph.D. program had passed away from bone cancer a couple of years before -- but I still thought there was no way that was what was happening with me. An MRI had revealed bone "lesions" in 5 bones of the foot (one of which was my original injury site, the 5th metatarsal) plus one in the shin bone where it meets the ankle, but lesion is a generic term that can encompass many things. It could have been accumulated damage from years of wear and tear. And the doctors told me that what I had was a highly unusual presentation for cancer. There was no big lump, and if all those lesions were cancer, then I certainly would be worse off, with spread likely in many places in my body, which should show up in my blood work, no?

Nonetheless, since the thought of cancer was still there in my mind, I asked for a biopsy, for which I was referred to an orthopedic surgeon. He removed bone from two of the lesions so that it could be looked at to see what exactly was happening. Eight days later, I got the bad news. The pathologists at the local hospital did not have an exact diagnosis, but it definitely was cancer, and they thought it was most likely Ewing's sarcoma, a cancer most often seen in bone, but that sometimes also occurs in soft tissue. I remember a quote of the odds of this being 1 in 100 million, given the rarity of bone cancers to begin with and that they usually occurred in children and adolescents, with cases in adults over 30 being very rare. The surgeon sounded pretty grave, saying it would need specialist treatment at one of the big national cancer centers. Thankfully, he was able to get me an appointment one week later at Sloan-Kettering in New York.

And so, I headed out to the Big Apple, with my parents and fiancee making the trip as well, to see what I were up against and to get treatment. The first doctor I saw was their chief orthopedic surgeon, who has many years of experience with bone cancer. He ordered many scans to check for spread. The scariest days were the ones between my diagnosis and when the scan results came in. I was fearing the worst, namely massive spread. Miraculously enough, there was no definitive spread found outside the 6 bone tumors. Surgical removal of all the tumors was possible given their location, but it would require amputation of my left leg below the knee. The Sloan-Kettering pathologists were also able to confirm that my cancer was in fact Ewing's sarcoma.

It would have been nice if surgery was all that was necessary, but that was not the case. The day before my operation, I saw the head of Sloan-Kettering's pediatric sarcoma team. Yes, pediatric. That is the team that treats Ewing's sarcoma at Sloan-Kettering given its prevalence in children. The thought of being a 31 year old pediatrics patient was strange at first, but not to worry, I was told -- his team has seen even older patients. I would need a lot of chemo in addition to the surgery to ensure that there would be no recurrence of the cancer, and to eliminate any currently undetectable spread of the existing cancer, which I was told was a distinct possibility.

The surgery itself went smoothly. I had in fact had a recurrence of intense cancer pain the day before, so I was in a quite unique position of being in less pain after surgery than before it (the post-surgery painkillers were of course necessary to ensure that, but even so, pain was not a big issue for me post-surgery in spite of pain being the most frequent thing I was asked about by the doctors and nurses). After 5 nights in the hospital, I was done, and set to start chemo the week after my discharge. That's what I'm in the midst of now, just about to start the third of 17 cycles of treatment. I'll be writing in detail about that shortly. It's by far been and will continue to be the most intense part of my treatment, and will naturally get a lot of attention. Other things I'll talk about are life as an amputee, the long road to running again (yes, that's my goal; good thing there are advanced prostheses these days!), and balancing the remainder of my Ph.D. program with cancer treatments. Though this is going to be a long battle, I am in it for the long haul, here to fight it and win while still living my life.

Released from the hospital after surgery. First of hopefully many victories.