Diagnosis & Treatment

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.

9 Responses to Diagnosis & Treatment

  1. Marra Chinn says:

    Hi Ryan, I haven’t had the pleasure of meeting you, but my sister speaks highly of you. I thank you for extending your kindness to me when my sister asked you for a favor. It’s obvious you have a strong will and great love for your family and life. I wish you well and pray for the strength, positive spirit and courage you need during your battle with cancer. I’m glad you are sharing your story, and I hope you continue to inspire others through your words. It’s amazing how you continue to learn and evolve with everything you have going on — I admire the passion you have for your wife and children and the will to survive. I pray your good health be restored soon. Be well.

    Marra Chinn

  2. christy Mcdonald says:

    I have never met you, but you seem to just shine! May God bless you and your family!
    I will pray for you and your family and help out financially. I have been very upset this morning, as I wanted this material thing, and its not going to happen on my watch, or maybe even this summer. I then thought of every negative thing that has happend with myslef and my family, and got all worked up and thought why am even here,things never go the way I want them on my time….. everything is so hard….,just life! But then as i was crying, I seen your profile through a friend and so I clicked on it, and read it all!! How amazing, and you just put me back into check! And now I started to cry thinking how dare I !! When somone like yourself and wife and family are going through this…. And like you said…..timing is everything!! God put me here and i clicked on your page ..God wanted me to see that I do not have it so bad, and stop crying over stress or just meterial things. Now, I am totally overwhelmed with uncouragment for you and your family. Thank you for helping me, and I pray that God keeps helping you and please keep strong!! Remember like you said…everything happens for a reason! you have a beautiful family!! God will get you through this…. One day at a time right?! Keep us all posted please… Get some rest….. Christy

    • Kayti Copeland says:

      Christy, Isn’t Ryan such an inspiration?! I am so glad that you were able to see this website today :) I was hoping that exactly this, you (or anyone of my friends) would come to see the website. I am amazed by Ryan’s words and his strength everytime he posts something. I admire him. Thank you again Christy

  3. Ida Dahlberg says:

    Hi Ryan, I’m the FA that was working the Eagle flight in 09 when you went to The Mayo Clinic for your tests. I told you then that I would pray for you. I didn’t know then what you were being tested for but I knew it was obviously serious. I don’t recall if your wife and mother were with you or maybe both. I’ve so often thought of you and wondered how things went. I’m so greatful that I was sent this websit so that I can keep up with your progress. Prayers are powerful so I’m happy to hear that you have faith and trust in the Lord. I love your positive outlook. Keep it up. Once again, my prayers are with you and your family. God Bless Ida Dahlberg

  4. Jonathon Widener says:

    Ryan,
    You are not alone. we can fight together. I used to be a gate agent with American Eagle at OHare from 2004 to 2011. Left to start my own very successful event planning company called A White Tie Affair and was in negotiations with The Food Network. My roommate was Liz Wall, an FA with AE (she just moved out in August 2012 because she got engaged…yay). Three days after her moving out (she was like a sister to me), I was flying back on a friend’s private jet from STL. I was there for a weekend of crazy frolic and fun. Just before boarding the flight with the capt and first officer carrying my bags and me carrying my little dog (who mind you has flown all over the world and loves to fly) was freaking out and panting like crazy (my dog knew what was coming), I stepped onto the aircraft and BOOM, my arm went stiff, my face contorted, my dog, thankfully jumped out of my arms and onto the adjacent seat. It was a grand mal seizure. I must have been out for a while. I woke in an ambulance speeding to the DuPaul Medical Center in STL. I was quickly rushed into an MRI to find out what caused me, a 38 year old, physically and athletically fit male to have a grand mal seizure with no history of illness. There on the MRI was the answer–a large brain tumor. For a week, I was kept in the hospital until I was stable enough to return back to my home in Chicago. Upon my return, I was faced with many decisions that ultimately, I believe, have defined who I am. After three neurosurgeons refused to operate because the risk of permanent paralysis or death, I found one neurosurgeon at Northwestern who said yes! My craniotomy was on my 39th birthday, January 22, 2013 at 5:45am (the exact time I was born–and that was unplanned btw). I survived!!!! 33% of the tumor was removed. The remaining 67% could not be removed without major damage. So now, the pathology is Stage 2 Glioma and a partial stage 3 portion. Radiation begins this next week! I spent a month recovering quickly in the Rehabilitation Institute of Chicago (#1 in the country) learning to walk, talk and use my hand again since it affected my motor skills on my right side. All this to say, I never got down. Even still, this is an exciting and challenging adventure to me. One that has made me stronger and love deeper and realize how amazingly lucky I am to have the friends that I have. I fight for them because I know I am needed and loved. I know there is so much left for me to do on this planet. Facebook has been a huge help in not only keeping 700 friends around the world updated, but the wonderful, positive responses have kept me floating on a cloud. I have a feeling, you must be in the same mindset. I am told,that is why there are cancer survivors because the attitude is number one in fighting. I am proud you are one of those people and I tell my story so you know I understand and I will fight with you. Encourage you. Just remember this is an adventure. A little like Alice In Wonderland. It’s far from perfect but the life lessons, interesting people and strange lands (hospitals and chemo treatment centers) can be a lot of fun if you keep your spirits up. Tally Ho, mate!

  5. Ida Dahlberg says:

    No doubt about it Ryan, Jonathan is the man. He is so optomistic and strong just like you Ryan. I am happy to call Jonathan a good friend and believe me he is a fighter. I’m praying for the both of you. Ryan I still remember the day you went to Mayo for your first tests, you didn’t know what was going with your health at the time but I knew you were very concerned. I was your FA on eagle. I was so happy when you posted on the Eagle page on fb , that’s where I found your blog. God Bless you and your beautiful family.

  6. Kara says:

    Hi. We’ve never met, but I saw your story via a Facebook link. Just wanted you to know I’m praying for you and your family. I graduated from wmu college of aviation also…flight science switched to admin…2005. And I’m also married with a little boy (just 1 so far :) ). And I too have stepped away from aviation due to medical complications… my son had a stroke. I would love to go back to work in the field sometime…but Gods using me in other ways for now :)
    A small world it would is! Gods blessing to you, my fellow christian, parent, spouse, wmu alum, and aviator :)

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