July of 2009 is when I first started to have symptoms. It began with a morning cough that contained what looked like blood. Andrea and I were celebrating our anniversary. and the decision that we felt we were ready to start adding to our family. Our life seemed perfect at that time. Andrea was working as an engineer for the State of Michigan and I was a pilot flying for American Eagle. At first I didn’t think it was anything serious, but after it became a daily event I agreed to have some tests done
I had a CT scan followed by an angiogram because it was suspicious for an AVM (arteriovenous malformation) but this was negative. I also had a bronchoscopy but this also was inconclusive. At first they were not sure what the “spot” in my L lung was but all seemed to agree it needed to be removed. We also found out this same week that our dream of starting our family was coming true and Andrea was pregnant with our first child. I tried to refocus all the energy on positive feedback to my beautiful wife and the excitement we felt at having a child.
After discussion with multiple specialists including pulmonologists and cardiothoracic surgeons, I had a wedge resection of the mass at Mayo Clinic in September 2009. The mass initially appeared benign but as we arrived at the airport to return home after being released from the hospital I received the phone call that changed my life. The pathology came back positive angiosarcoma. We chose to consult with Dr Baker at University of Michigan. There was some discussion between the pathologist at U of M and Mayo as to the whether this was an endothelioma vs angiosarcoma. I had a full body PET scan along with MRI of brain which showed no evidence of any further areas of concern. Dr Baker recommended no intervention besides close observation. He felt because the size of the tumor was small and the margins were clear that recurrence was unlikely.
I was given a new lease on life. We were truly blessed when our amazing son Landon was born very healthy in May of 2010. I never realized how much I would enjoy being a father and it was now time to truly start moving forward with my life. The FAA refused to approve my medical for at least 2 years so unfortunately I was not able to fly again. I made the decision to take this opportunity to reevaluate the direction of my life. I found all my experiences as a patient lead to more and more interest in the medical field. I spent the next two years taking premed courses, shadowing physicians and volunteering at the local ER. Over this time I became more convinced that practicing medicine is where I belonged.
I continued to follow up with Dr Baker every 3 months for X-rays and blood work. I continued to receive encouraging reports with no signs of the cancer returning. As I approached my 2 year cancer free anniversary we learned there would be another addition to our family. Andrea initially was a little confused how this happened but we were so excited. Having another child to surround with the love of our family was a dream come true.
Since the initial surgery, I have had a persistent morning cough but never any more bleeding. Sometimes I would feel a little ache in my chest, but these were all attributed to postoperative discomforts. I knew I was more in tune with little changes in my body and didn’t want to make a big deal of every little ache and pain.
In February 2012 I began having a different type of discomfort in my chest. Initially it was vague and intermittent but over the next few weeks became more frequent and I began to feel short of breath with exertion. There was always an ache in my lower jaw when the chest pain would come which made me more concerned. On April 4th I had my first CT scan since my initial series after diagnosis which showed a concerning mass in the L mediastinum (in the center of my chest tucked in between the L bronchi and the heart). A repeat PET scan was very suspicious for possible return of the cancer.
I was nearing the end of a very challenging semester of classes and preparing to begin studying for the MCAT (medical school admission test). My professors were very supportive and extended the 4.0 I was already carrying in my classes to my final grade without the stress of taking the final exams. I spent the next few weeks consulting with oncologists and cardiothoracic surgeons at U of M to try and develop a new plan. We (my support team and I) decided to make the journey back to Mayo and were once again thrilled by the efficiency and organization of this institution. We arrived at the oncologists office 30 minutes before the office opened in hopes that he would fit us into his busy day. We only waited about an hour before we were called back. Dr Okuno spent an hour reviewing all the previous and current scans and pathology results and agreed before we could make a plan we needed to gain more info. He wanted more blood work, a new biopsy and an echocardiogram and made plans to get these tests done. I was able to see the surgeon later the same day and he was concerned about another lymph node in the center (subcarinal area, station 7) that looked suspicious and made arrangements for the bronchoscopy and biopsy to be done the next morning. The echocardiogram proved my heart was in excellent condition and would be able to withstand the vigorous chemotherapy they were anticipating. The final pathology confirmed the mass was a recurrence of angiosarcosma along with the station 7 lymph node.
We met again with Dr Okuno to develop the final plan of attack. We compared the options of receiving the chemo at Mayo or locally in Michigan at Sparrow. The medicine dose would be the same either way but locally can be administered slower with the hope of less side effects and the benefit of remaining close to home with the anticipated birth of our child due in the next few weeks. We have decided on the doxyrubicin/ifosphamide/MESNA which will be given continuously over a 3-4 day period while hospitalized and repeated again in 21 days.
A repeat chest CT and PET scan will be done following the second round to assess the improvement from the treatment before we can plan the next step. The options after this are likely more chemotherapy and possibly another surgery in the future. We are also planning a follow up at Sloan Kettering Sarcoma Clinic following the first two rounds for further advice.
I am blessed to have a strong support team between all of my consulting specialists and my family and friends who continue to encourage me to fight. My wife is my rock and I gain strength from her unwavering love. My son and his unborn brother give me the motivation to continue fighting when I am ready to give up. My mother and my aunt who are both health professionals and help in navigating the medical systems and ask the questions I want the answers to but am afraid to ask.
Every friend and family member who has taken the time to send words of encouragement are making me that much stronger. I know what I am up against and tend to be a realist, but I promise I will fight this with every ounce of strength I have.