07/30/06

The following was originally printed in the News of Delaware County - July 26, 2006

Ironman faces his toughest race

By Diane McManus, CORRESPONDENT

07/26/2006

Stephen Brown knows about challenges.

In September, he plans to participate in the Chesapeakeman Ultra Distance Triathlon: a 2.4-mile swim, a 112-mile bike ride and a 26.2-mile run. As a seven-time Ironman finisher, he is familiar with this distance. He also is optimistic about completing it successfully. After all, as grueling a race as this is, he faced an even tougher one in 2006: a race against cancer.

Although Brown thrives on challenges, he prefers to choose which ones to attempt.

No one is required to enter an Ironman or run a marathon in order to survive, and many people live long, healthy lives without ever seeing the starting line of so much as a 5k.

Not so with cancer, for which there is no entry form and no option except fight it or die from it. Take an active role in the treatment or be a passive recipient of others' decision-making.

Because Stephen Brown is an Ironman, the choice was obvious.

Brown, a 1978 Haverford High graduate, played soccer, basketball and baseball in junior high and high school. A longtime Upper Darby resident, he visited a doctor early this year due to difficulty swallowing. His first assumption was tonsillitis. Born with large tonsils, he had escaped the almost-routine tonsillectomies performed on children in the past, and at 45, he was not eager for the surgery.

However, he finally took the needed steps, including pre-admission testing, and saw the procedure as something to get out of the way so that he could move on with his racing season. He even began to see the positive benefit of the surgery: "I figured, 'what the heck?' Maybe I'd breathe better and even get a little faster," he reports.

Not quite. After the testing, the surgeon who was to do the tonsillectomy confronted him with more disturbing news: an elevated white blood cell count and a referral to a hematologist/oncologist for more tests.

As it became clearer that the diagnosis was cancer-chronic lymphocytic leukemia, Brown's first reaction was one of disbelief. He was, after all, an athlete, living a healthy lifestyle. Cancer did not fit, even a relatively treatable form of it, such as his. "I was still struggling," he says, "with the reality that fun-loving, energetic, laugh the day away, race and train triathlon loving me and the word cancer would now be used in the same sentence. This is not how things are supposed to be. People call me Ironman. And I take that with much pride. 'Chemoman' doesn't quite conjure up the image that I want."

All the same, Brown dove into the role with the passion he had reserved for his racing. Indeed, he entered this new arena the mental equipment that had gotten him through the events he preferred, the ones he chose rather than had foisted upon him.

First, he was not about to stop the triathlon training: scale back, perhaps, when needed, but not stop. This much he made clear when the doctor suggested "giving that stuff a rest."

Indeed, Brown even ran home from some of his chemotherapy sessions - his way of letting the disease know who was in control. As he says, "Health and exercise are not a mere hobby of mine. They help define my core existence. And if that were also taken away, our problems would be far greater than just cancer."

Instead, exercise became a potent weapon in his battle against cancer. "I'm convinced," Brown says, "that staying active helped dilute all of those chemo side effects."

The path wasn't necessarily smooth, of course. Some side-effects are inevitable, even with healthy, fit patients such as Brown. During his first round of chemotherapy, these were milder than many cancer patients experience, and he bounced back quickly. "I would wake up," he explains, "with enough energy to build a house, then fade a little and take a nap. Then wake up again and feel well enough to run a few miles."

But in the second round of chemo, a new drug, Rituxin, was introduced, and as soon as Brown received it via IV needle, he experienced an unsettling reaction: high fever, chills, and shaking, to such an extent that, to Brown's disappointment, the treatment was stopped after only twenty minutes. Fortunately, the suspension of treatment was only temporary; the infusion was resumed once the symptoms abated somewhat. Brown compares his experience to being pulled out of a bike race while climbing a steep hill, expressing relief that "I was allowed to saddle up again, resume the race, and finish that day's 'stage.'"

The next day, he felt considerably better, and subsequent treatments with the same drug did not produce the side effects he experienced the first time. After this second round, he was pronounced "in remission," although his doctor explained that caution dictated finishing the four rounds to lessen the likelihood of any recurrence.

Through all the ups and downs of diagnosis and treatment, Brown believes that he had an invaluable support system: his family, his friends, his medical team, and very importantly, his sheer will to win the battle. Certainly, there were moments of discouragement: for instance, an internet search that yielded more bad news than good had Brown fearing the worst and almost yielding to despair. Yet, as an athlete, he had to bring to bear the tools of his training: focus, self-discipline, courage and endurance in order to regroup, to continue to fight and to continue to hope.

But this is not a battle to be fought alone. For Brown, family support has been crucial. His wife, in particular, he describes as "the perfect blend of companion, spouse, nurse, best friend, confidant, cheerleader, and press secretary," while his sister Chris offered both emotional support and "vitamin M" (Merlot), and his mother, recovering from heart surgery, made her son's health her first concern. Brown was especially concerned that the family stay strong and stay together. He had recently lost his father, and his children, their grandfather, so it was especially important to him not to give in to cancer or to self-pity.

His triathlete friends also offered a valuable network. "After family," Brown says, "they provided the most help and the best insights." After all, endurance athletes know about pain and persevering during rough patches.

Finally, it's important for a cancer patient to find a doctor he or she can trust and to get the best advice possible, including second and third opinions. In that respect, Brown felt fortunate in his cancer treatment center, the Fox Chase Cancer Center in Delaware County Memorial Hospital, and in his oncologist, Dr. Stephen Shore. While skeptical at first about Brown's continuing to train, Dr. Shore agreed to it, within reasonable limits, and his willingness to keep an open mind inspired Brown's trust and respect. The staff at the cancer center also won his confidence, not only because of their professionalism and upbeat attitude, but also, adds Brown, their "slightly twisted sense of humor."

One friend proved invaluable not only for his triathlon but for his medical experience. Brown called upon the support and advice of Dr. Robert Vigorito, a physician, a medical school professor (University of Maryland), and the director of the Chesapeakeman Triathlon in which Brown will participate this fall. Dr. Vigorito's influence was crucial in helping Brown find the best web sites and information about treatment resources-and a valuable source of support in his triathlon efforts as well. The race this September, Brown says, will be especially rewarding, allowing him to show his friend how well he's done with his treatment and his training. He says he feels "better and stronger than I have for years."

Back now to racing as well as training, Brown participated in the Lake Lenape Triathlon in Mays Landing, New Jersey on July 8, then followed that the next day with the American Cancer Society Bike-a-thon from Philadelphia to Mays Landing, a distance of 62 miles. Only a week later, he was back in action again, in the Stone Harbor Triathlon. Although conditions in the Stone Harbor event were too hot for comfort, Brown is happy to be competing again. Whereas before his diagnosis, he would pick and choose races, he is "excited to race as often as I can, have a bunch of experiences and as much fun as possible."

And to show his friend, Dr. Vigorito, just how much fun life has become for him since his illness.

©News of Delaware County 2006