Friday, March 22, 2013

Inoperable and untreatable brain tumor isn't slowing marathoner Iram Leon down ... he only enters races that allow his daughter Karina to participate. "I want her to have as many memories of me as possible," he said. "I want her to remember us having fun together, not me being sick."


In competitions against the clock, some athletes display an ability to seize control. Think of the Clark-Kent-to-Superman routines that John Elway and Michael Jordan often pulled in the final seconds.
But Iram Leon stands on the sidelines of his own race against time. Lodged in his brain is an untreatable and inoperable cancerous tumor that statistics suggest will kill him before he is 40, eight years from now. Medical science is advancing at a rate that doesn't preclude the development of a treatment, but it's not clear if it will come in time.

"No one knows what technology will be available in five years," said Allan Friedman, Duke University Hospital neurosurgeon in chief, who in 2011 removed as much of Leon's brain tumor as possible.

The torment of enduring that wait can paste a cancer patient to the couch, a surrender heavily associated with deadlier outcomes. Some seek escape in their careers, but that is no longer an option for Leon, who early this year was forced to step down as a juvenile probation officer in Travis County, Texas, a position he had held for almost seven years. His thinking is no longer clear, said Leon, adding, "I was making too many mistakes on the stand."

But Leon can still run. Two years after his brain-cancer diagnosis, he recently ran a sub-five-minute mile for the first time since high school. What has startled the medical community even more is what Leon did this month in Beaumont, Texas. He won the Gusher Marathon, finishing in 3:07:35. That was one second slower than his personal record in the 26.2-mile event, set days before he underwent brain surgery in early 2011.


But that lost second can't be blamed on his disease: During the run, he was pushing his 6-year-old daughter, Kiana, in a stroller. "She had a blast listening to Disney DIS -1.11% songs and getting food from volunteers," said Leon, an Austin resident.

Leon's high-speed finish provides cancer survivors with an athletic role model only weeks after the defrocking of Austin's more-famous cancer-battling competitor, Lance Armstrong. After being stripped last autumn of his seven Tour de France titles, Armstrong publicly admitted doping during his cycling career.

That Leon is competing amid his battle for survival may make his case all the more instructive to fellow cancer patients. Recent research clearly shows that exercise improves outcomes for cancer patients. "Few other leads have shown as much promise as physical activity in extending the lives of cancer survivors," said an editorial last year in the Journal of the National Cancer Institute.

In a nation where healthy people don't often exercise, persuading the ill to do so is all the more difficult. Research shows that there are lower exercise rates among cancer patients than among the general population, a problem often exacerbated by oncologists who urge their patients to take it easy. Never mind that the American Cancer Society and other medical groups now encourage exercise among cancer patients—including encouraging breast-cancer survivors to lift weights. "Among clinicians there continues to be a reticence," said Kathryn Schmitz, a University of Pennsylvania researcher on exercise in cancer patients.

"Mr. Leon gives us someone to point to when a person fighting cancer says, 'I can't do it,'" says Dr. Schmitz. "Start where you are. Walk laps around the dining room table. A cancer diagnosis doesn't give you a get-out-of-jail-free card."

Leon was still in the hospital in late 2010 when—stunned by news of his terminal diagnosis—he felt the need to run. "A friend came by and ran with me around the hospital—against doctors' advice," recalled Leon.

When the first neurosurgeon Leon consulted cautioned against running, he sought out Friedman at Duke.

Friedman did more than give Leon the OK: After initially recommending immediate surgery, Friedman agreed to put it off a couple of weeks to accommodate a marathon for which Leon had logged months of training. "Here's a young guy with a brain tumor who likes running, who's good at it, so why not?" said Friedman, citing "defensive medicine" as the main reason other physicians might say no.

Leon sensed another factor behind the neurosurgeon's encouragement. "Friedman knew it might be my last marathon," said Leon.

During that surgery, Friedman removed most of the tumor. The remainder resides in sections of the brain beyond the reach of surgery. At the moment the tumor isn't growing, said Friedman, but the majority of such tumors prove fatal.

There is hope. In one case, Friedman removed from the spine of the novelist Reynolds Price a tumor initially diagnosed as inoperable, but that was eventually made reachable through new technology. Price chronicled the story in one of the many books he wrote in a quarter century following that experience. While waiting and hoping for the surgery that eventually saved him, Friedman noted, "Reynolds wrote—he didn't let the cancer stop him." In 2011, Price died at 77 from causes other than cancer.

While hoping for a similar fate, Leon runs. The anti-seizure medication he takes sometimes causes him to vomit during runs. Once he blacked out during a run, not knowing what had happened until he woke up in an ambulance. Running alone is out of the question because he's easily disoriented, a vulnerability that makes it difficult to lead the pack. At the front of this month's marathon, he said he had to focus carefully on the cyclist who was showing the way.

The payoff? "When I'm in a race, when I'm climbing a hill, for a few moments it feels like I'm pulling ahead of my problems," he said.

Leon said he wants to set a new marathon personal record. But he is only racing these days in events that will allow him to bring along his daughter, Kiana, for whom a scholarship fund has been established at www.donationto.com/Sports-Society-Fund-for-Iram-Leon.

"I want her to have as many memories of me as possible," he said. "I want her to remember us having fun together, not me being sick."


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