The gyms had closed in March 2020 for COVID and I was scheduled for a powerlifting meet in April. The last day the gym was open we tested our lifts. For me it was a 395 Squat, a 285 bench, and a 530 pull. I felt confident I was going to blow past my best meet total of 1240. Male, age 58, 215lb, 5ft 10in. On May 15th, 2020, a few months into the COVID lockdown, I had a seizure and a trip to the emergency room.

In the ER, I had all kinds of tests and was asked all kinds of questions by a collection of experts. Shit. The MRI clearly showed a brain tumor. (I also had an elbow bursitis from doing stupid calisthenics in absence of a gym.) It was a large lump that the Doctors were very interested in. I did tell them that my vision had gotten worse, and a recent exam (Nov 2019) showed a lot of debris from the posterior vitreal detachments (PVDs) I had several years back. PVDs are common and mostly go unnoticed. This information, however, was urgent in the context of the seizure and tumor, so an eye specialist was brought in with full kit. Fortunately, for me, I was in a bit of a haze and not fully processing things. Unfortunately for my wife and son, they were fully present for every moment. I was scheduled for brain surgery stat to get a biopsy and moved into the neural intensive care unit.

The biopsy showed malignant brain cancer. PET scans, spinal taps, and other unpleasant tests revealed nothing else and the tumor was neither secondary nor (yet) metastisizing. I had a diagnosis of Primary Central Nervous System Non-Hodgkin’s Lymphoma (PCNSNHL) with occular involvement – this is fairly rare.

Prognosis

An oncology team was magically assembled. Dr. Tim Fenske (hematology and lymphoma), Dr. Jennifer Connelly (brain), Dr. Chris Schultz (radiation), and Dr. William Wirotsko (eye), all at Froedert Hospital in Milwaukee, and all professors at the Milwaukee Medical College. I was anxious at this point, only a few days post-seizure, and especially sensitive to sorting through medical requirements as well as the silly shit like rehab, nutrition, fitness, etc. I was all jacked up on dexamethasone, a corticosteroid used to prevent further seizures. It is horrible drug but a wild ride.

However, thanks to Starting Strength, I was loaded for bear. During my lifting journey I actually would think about getting bad medical news and how I would react. This, of course, while setting PRs for the adrenaline rush (is that weird?). But, I knew that strong men are harder to kill, if your lifts are going up you can’t be dying – all of it. I viscerally and intellectually knew this was true and really lived it.

My meetings went surprisingly well. They understood my continued professional interests, that I was involved in national security and I was a deployable nuclear emergency responder. They were not only interested in my competitive powerlifting, they were excited about it! We talked about how fortunate I was for having such a solid physical base. We talked about all things strength. Rules, PRs, Valsalva, systemic lifting. To this day, I don’t know how that happened. Do I have a silver tongue? Maybe a little. Am I deluded or are they uniquely enlightened? Maybe they saw it in my face, but I swear it, it’s all in my official medical records that continued pursuit of heavy lifting is fully medically endorsed and encouraged. They told me do not lose weight, do not take advice from your crazy aunt, and do not google anything. Keep doing what you’ve been doing. They were proud to have me as a patient, I think.

Although my brain cancer is rare, the treatments, if you’re healthy enough, start the same. Strong freaking chemo. The brain has been engineered to resist toxins in the blood supply – the blood-brain barrier. For me, the treatments were five in-hospital sessions lasting 3-5 days each, and repeating every two weeks. I got a medical port surgically installed in my chest. Oral chemo continued for a full year. Yes, it all sucked. Traditional PT was offered (and politely refused) during hospital stays, and I was free to lap the halls in the ultra-clean hospital ward, IV in tow. Then the gyms in town started opening with COVID rules. I had a medical thumbs up to go but it was recommended to use common sense for hygiene, but certainly no hysterical MSM precautions. Germs happen.

The secondary treatment protocol following the in-hospital chemo was either whole-brain radiation or stem cell transplant – my choice. As an aside, my friends and family all divided right wing/left wing between radiation and stem cell. The confusion being “stem cell transplant” sounds likes “stem cell therapy” (see where I’m going?). But it isn’t. It is a technique where your own stem cells are harvested, then you get an even worse dose of chemo, and eventually they try to put your stem cells back in. If it all goes well you have no immune system for a month or so and will be in real no-shit quarantine. Not the COVID-compromised-immune-system-put-a-mask-on-you-selfish-piece-of-shit kind – the no-immune-system-boy-in-a-bubble kind. And if the transplant doesn’t take...

Whole-brain radiation was prescribed as 30 sessions, two a day for 15 days. About 1Gy (Gray) each dose, which is roughly 4x the annual occupational dose, and about a fifth of the LD50, every session. Unlike stem cell transplants, each treatment only takes a few minutes (mostly setup), and you can do whatever you want in between, such as working or lifting. It does have a fair bit of risk for short and long term brain damage.

Of course I was also dutifully informed of the overall survival (OS) rate as part of my prognosis. I was shown how it’s calculated but also why most of it does not apply to me – most 60-year-old men can’t deadlift 500lbs. I didn’t and still don’t know exactly how to mentally process any of this, but I heard what I liked and ignored what I didn’t. You can look up the numbers yourselves; I don’t need to know.

Stem cells or radiation? Easy. I went with the one that lets you lift. In response to his generous offer I called Coach Rip for advice, started a lifting log, and a commitment to linear progression or death.

Side Effects and Lifting Progress

Both Chemo and Radiation are designed to kill fast growing cells (cancer) faster than healthy cells. In this battle, I’m sure Sun Tzu rules apply. My initial in-hospital chemo wasn’t too awful, but the bad effects are cumulative. Rip’s recommendation was hang on to strength above all else. I tried and went to a private powerlifting gym. It was awful, I was shaky and atrophied; partly from disease and partly from COVID lockdown. I guess I was a little more worried about being in a public gym than I wanted to admit. I got an Airdyne ergometer for home use and did sprints throughout the entire 10-week chemo cycle. I peaked at almost 800 watts and rationalized that I wasn’t dying just yet.

I kept all of my hair except eyelashes. Nausea was manageable. Appetite went from poor to worse. Taste and smell were so fouled that purified water tasted like chemicals. One of the fundamental principles of gaining strength is to eat in surplus. That was a very, very tough requisite. I still had a year of oral chemo, and the appetite was not resolved until several months after that was completed. All told I lost 25lbs.

Radiation treatments started soon after. It did remove most of my hair and burnt my skin. Radiation kills the hair follicles it hits. The good news, I suppose, is it removed all the grey ones (on my head) and preserved the dark ones – the stronger soldiers. Radiation also causes a slew of cognitive and neurological problems. I’ve been clinically evaluated three times, once for a baseline and a second to look for worsening factors. Without details, let’s just say that I enter my lifting data into my log sooner rather than later.

The worst thing, I think, is radiation notoriously makes you exhausted. But I started my novice lifting progression anyway. It’s all in my log, and while I suffered a lot of starts, stops, and resets (the oral chemo continuously sucked too), I got my triples up to low 300s for squat, 240s for bench, low 400s for DL. This was basically a year after treatment started.

I also had my eyes reevaluated. One eye had gotten a lot better, and the other a lot worse. I was destined for surgery to remove the bad vitreous humor (vitrectomy). It happened in Jan of 2022 and the biopsy showed active lymphoma. This wasn’t a recurrence, but it hadn’t been killed off either. I am now getting a direct chemo injection into my eye once a month, 8 more to go. The surgery required some recovery, so I lost some lifting progress, again. However, the injections – which are as horrific as you can imagine – require no lifting restrictions, and this is in my official medical records as well. I also started a true (according to the app) Starting Strength Novice Linear Progression. It ended at (all sets of 5) Squat 265, Bench 190, Deadlift 315, and Press 125.

My training has continued, and as of the second year anniversary of my seizure I have squatted 365, Benched 260, Pressed 170, and deadlifted 500. I am back to 215lbs and will be 60 in June. I am still being treated and continuously evaluated but I am also lifting fairly well. So when people ask me how I’m doing, I always say, “Better than some, worse than others.” Any questions?

---

Discuss in Forums