Jan 29, 2015The Toughest Opponent
Cancer is something no athletic trainer wants to think about. But if one of your athletes is diagnosed, you can play a critical role in helping them face the physical, mental, and emotional struggles.
By Chad Newman
Chad Newman, MS, LAT, ATC, PES, is Associate Athletic Trainer at the University of Tennessee. He can be reached at: [email protected].
“Remember the Alamo” is a famous phrase known to millions, but it holds a much different meaning for me than for most people. I will always remember the Alamo, because I was standing in front of that famous fort when I received a phone call that forever changed the way I define my job.
In March 2007, the University of Tennessee men’s basketball team was in San Antonio for the NCAA Tournament. We had made the Sweet Sixteen, flying high in one of the most successful seasons in school history, and a lot of that success was due to standout guard Chris Lofton. The call informed me that he had failed an NCAA drug test.
Chris was the team’s leader–the foundation of our success–and the news took me by surprise. I immediately thought there must be some other explanation besides street drugs or performance enhancers. When I found out I was right, that there was another explanation, I was even more shaken: Chris had cancer.
As athletic trainers, we’re used to helping athletes through sprained ankles, broken bones, common colds, and countless other injuries and ailments. Cancer isn’t something we usually have to think about–the people we work with are young, strong, and seemingly invincible. But as many thousands of Americans learn every year, cancer can strike anyone at any time.
My journey with Chris was unlike anything I had experienced before in my career. This article tells the story of Chris’s battle and comeback, and shares what I learned about treating an athlete–body, mind, and soul–during one of the most difficult challenges life has to offer.
AFTER THE NEWS
Chris’s drug test had revealed evidence of human chorionic gonadotropin, also known as beta hCG. This hormone is found in elevated levels in pregnant women, and it’s used to kick-start testosterone production after steroid use, which is why the NCAA tests look for it. It can also indicate the presence of cancer in people with certain types of germ cell tumors.
Once we learned of the positive test, Team Physician Chris Klenck, MD, and I immediately began researching beta hCG and gathering as much information as we could. Our first concern was that Chris may have unknowingly taken some type of tainted supplement. As we learned more, we realized cancer was also a strong possibility.
All this was occurring just eight hours before tip-off of our Sweet Sixteen game. Now in a state of distress, I had to focus on my pregame responsibilities to the team while acting as if nothing was wrong to protect Chris’s privacy. This was one of the hardest things I have ever done.
Knowing it wouldn’t harm Chris to withhold the information from him until after the game, Dr. Klenck, Athletic Director Mike Hamilton, and I decided not to address the situation immediately. Needless to say, watching the game was gut-wrenching. We lost a close one, but the final score meant little to me by that point, as all I could think about was what challenges Chris might soon be facing.
That evening we informed him, his family, and Head Coach Bruce Pearl of the situation. Everyone experienced shock and disbelief. This was a lot to process. Luckily, he and his parents trusted us when we assured them we would do the best job we could for Chris.
Later that night, I spent several hours talking to Chris about what we might be dealing with in the days ahead. He is an extremely tough, determined individual and a very private person, so I knew he was concerned both about his health and the effects this news would have on his daily life. He and I had always been close, but this meant I would have to be there for him more than ever, and I told him he could depend on me for anything he needed.
The day we arrived back in Knoxville, Chris underwent blood work and a CT scan. The tests confirmed our worst fears when they revealed testicular cancer. We quietly scheduled surgery for late March to remove the affected testicle.
Cancer is currently the second most common cause of death in the United States, surpassed only by heart disease. This year, more than 500,000 Americans are expected to die of the disease. Testicular cancer is the most common form among men ages 20 to 34, and it is highly treatable, even when it has spread beyond the testicle.
In Chris’s case, the positive drug test proved to be a blessing in disguise. It had revealed the cancer in a very early stage, before it had spread elsewhere in his body. At this point, while all of us were deeply worried, there was reason for long-term optimism.
SURGERY & TREATMENT
From the outset, Chris and his family asked that his illness be kept private. Since he was in many ways the face of Tennessee basketball, we knew this would require special effort. To accommodate his request, the hospital scheduled the surgery an hour before such procedures were usually performed, and his name was not placed on the surgical board. Throughout his treatment, we were very careful about who we let into our circle of communication.
Upon removal, the testicle was analyzed to determine the exact type of cancer Chris had. There are two basic types of testicular cancer–seminoma and non-seminoma. It was determined he had stage one seminoma, which is generally less aggressive than non-seminomas. The stage one distinction meant the cancer was limited to the testicle.
After surgery, he spent a month resting while the wound healed. His parents came to Knoxville for his surgery and part of his recovery, but in an effort to not bring attention to the situation, they remained home during his subsequent treatment.
We met with the oncologist to determine what to do next. Since seminomas are sensitive to radiation therapy, it was decided Chris would undergo radiation five days a week for four weeks.
Any University of Tennessee athlete walking into the hospital would raise suspicion in the community–especially if it was happening five days a week, and even more so if the athlete was Chris Lofton. With that in mind, he was always scheduled as the last patient of the day. The first time we exited the elevator near the radiation room of the hospital, a worker noticed us and stopped to watch where we were going. I acted like we’d gotten off on the wrong floor and we pretended to leave. After that, we used the staircase to avoid being noticed.
The first days of radiation went well. Chris felt no side effects and continued his normal workout schedule for this time of year, including pick-up games, shooting, and light lifting. He may have started believing this wouldn’t be so hard after all.
But as the dosage increased, the radiation began to take its toll on his stomach and his energy level. It made him extremely nauseous, and he called me many nights to tell me how he was hurting, vomiting, and barely able to move. I constantly reassured him that this would pass and that it was making him better. I always tried to offer positive thoughts. I wanted him to know that he could wake up the next day and fight the next fight.
Chris underwent radiation from April 25 to May 21, receiving 21 treatments in all. Afterward, a comprehensive blood workup was performed and showed none of the abnormal values seen in earlier tests. The doctors were confident that all cancerous cells had been removed.
From that moment on, our goal was to get Chris back to the game he loves. But before planning any workouts, we decided it would be best to give his body some time to recover from the effects of radiation. Resting was definitely not his first choice, but he grudgingly agreed. He went home for two and a half weeks to spend some quality time with his family.
When Chris returned in early June, he immediately started working out with his teammates, and quickly realized that everything he’d been through had taken a physical toll. Gone were his trademark endurance and lower-body power, and he struggled to maintain his usual intensity on the court. At one point he said he felt like a freshman again–the advances in conditioning and skill during his college career had been erased, and he would need to work harder than ever to regain them.
Strength and Conditioning Coordinator Troy Wills and I knew that we weren’t dealing with a traditional injury, and Chris was still adamant that his teammates not know about his illness and treatment. Therefore, we couldn’t just give him a typical rehab plan or simply excuse him from working out. Chris had suffered a sprained ankle earlier in the season, so we used that to explain why he was following a different regimen than the other players.
To slowly rebuild Chris’s conditioning, we divided his weekly training schedule into four sessions, each with its own priority. Monday was a lower-body explosive day, when he would do plyometrics, clean pulls, and speed squats. Tuesday was for upper-body power and strength, so he’d do bench work with chains, medicine ball throws, and weighted pull-ups. Thursday’s lower-body strength endurance workout included squats, walking lunges, and Romanian deadlifts. Friday focused on upper-body strength endurance and included DB complexes and upper-body drop sets. He also used stair climbers, Jacob’s ladder, and running throughout this time to enhance his conditioning.
One lingering effect of the radiation was that Chris recovered more slowly after each workout. If he didn’t feel he could perform certain exercises, or if he needed to reduce the weight for some lifts, we encouraged him to listen to his body and make the needed adjustments. This continued throughout the summer as he gradually regained his strength and aerobic capacity.
Chris wanted to deal with his comeback on his own terms, and not let the radiation side effects dictate what he could and couldn’t do. He knew he wasn’t ready for the U.S. national team tryouts, as his body was still recovering and trying to get stronger, but he attended anyway and gave it his best shot. It was clear to the coaches that he wasn’t the same player he had been the year before, and he didn’t make the squad.
In August, our basketball team went on a European tour. Chris had improved considerably by then, but still found himself tiring much more quickly than before. Throughout the fall, he continued working hard to regain his old form, but once the season began, he struggled with consistency in his game.
Knowing nothing about the ordeal he’d been through in the past year, Volunteer fans wondered aloud: What’s wrong with Chris Lofton? Chris admitted that his poor early-season performance got into his head, creating another source of stress. He couldn’t always run, jump, or shoot the way he could before, or do all the other things that made him such a special player. It was impossible to know how much of his struggle was purely physical, and how much was consciously or subconsciously related to the stress he was under.
Early in the 2008 SEC season, a member of the media approached Chris with knowledge of his battle with cancer. Chris asked that nothing be released during the season, still not wanting to divert attention from the team and its performance, but he agreed to an exclusive story to be released at season’s end. He continued to keep the news from the team, but finally did confide in his roommate and teammate, Jordan Howell.
It seemed from that point forward Chris began to play much better. I could almost see the weight of his private battle being removed from his shoulders. He now knew that everyone would eventually understand why his on-court performance had suffered, and there was a good chance his story might help others.
As his physical condition gradually improved, so did his confidence, and he led the team through its stretch run of conference play. His inspired performance helped us to a school-record 31 wins and a repeat visit to the NCAA Tournament’s Sweet Sixteen round.
WHAT I LEARNED
Everyone’s experience with cancer is different, and there is no handbook on how best to help an athlete through the process. Mentally and emotionally, your response depends on your relationship with them. Physically, decisions about training and return to activity should be made in consultation with the doctors, surgeons, and other professionals responsible for providing care. But my experience with Chris taught me some things that may be helpful to anyone else facing a similar situation.
First, I realized it was important for me to become conversant in and knowledgeable about the condition. That day in San Antonio when we learned of Chris’s positive drug test, I scoured the Internet for possible explanations. After his diagnosis, I learned as much as I could about testicular cancer. My knowledge of the illness and ability to help Chris and his family understand every part of the process gave them comfort. Knowledge truly is power.
Physically, symptoms vary widely from patient to patient, and for Chris, his abdomen took the brunt of the radiation treatment. This caused him extreme nausea and seemed to erase three years of hard work in the weightroom. It also led to debilitating fatigue. Despite this, I realized that getting him back onto the court–into his comfort zone and an important part of his “normal” life–was a key step. It helped him to focus and re-establish his purpose and goals. Even when his performance in practices and workouts was far below what it had been the previous year, I still encouraged him to participate with the team as much as he felt was possible.
His decision to keep the cancer secret from almost everyone was important to him, and I worked hard to protect his privacy, but I know it added some stress to his situation. Everyone wanted to know why his performance had dropped off, never suspecting that cancer had rocked his world. In some ways his silence was extremely difficult, but I still believe it was critical to respect his wishes. With so few people in the loop, it was essential for us to be there for him whenever he needed to share his worries and doubts, or just talk about how he was feeling.
Chris’s emotional healing and support came from just a small circle of people. He had long, frequent discussions with his parents, and they were his rock. He and I would often talk long after his teammates had left the gym. This was a time for him to worry out loud, laugh about the past, talk about the present, and hope for a healthy future. Those conversations helped us deal with the emotions and stress we carried every day. The stress of silence was hard, so we needed to rely on each other for strength.
The most important lesson I learned is to treat each athlete as a whole person. We should never just work on the injury or illness. Too often, we underestimate the important role we play in athletes’ lives. At the end of the day, we must remember that our charges are young men and women who need support, encouragement, and guidance.
Chris’s cancer was the greatest challenge of my 15 years in the profession. At the end of the season I was mentally and physically exhausted, but I knew all the strain was worth it. As athletic trainers, we are in a unique position to tend to the physical, mental, and emotional health of some very special people. As for Chris, I’m proud to say our story has a happy ending: Chris Lofton is cancer-free.
You have to be the best trainer …first c-lo now Negedu…for that iam speechless my dad is in remission we are huge basketball fans …me since 1976. awesome story awesome result! it just shows us that life is the toughest and most important game ! Thanks, John Edwards Oak Ridge