Burkitt's lymphoma is a strange, hungry cancer. It was first noticed in young black children in Uganda in the 1930s, where it showed up as a lesion on the jaw and then caused the heads of its victims to balloon. Over the last 70 years, drugs have been developed that make it one of the most treatable of all cancers. But the same can't be said of a more unpredictable, unforgiving strain that has traveled to the West. Just ask Saku Koivu.
The captain of the Montreal Canadiens was diagnosed with Burkitt's last September, when he had just reported to training camp in what he thought was the best shape of his life. In cancer time, that was eight cycles of chemotherapy, 40 needles in the spine, 30,000 get-well e-mails, 17 lost pounds, and a head of hair ago.
So what will the future hold for this soft-spoken NHL all-star?
"What Saku has gone through is face his own mortality and look at it squarely," says Chris Carmichael, the trainer who coached cyclist Lance Armstrong back from testicular cancer. "That's why he can't pick up where he's left off. He's a different man now. There are a lot of unknowns. There are a lot of survivorship issues. It doesn't feel the same as before. Lance quit in the middle of his first comeback because of the emotions."
By now, we're used to pro athletes coming back from cancer. But when Armstrong and Mario Lemieux were diagnosed, they could take comfort in the fact that drugs had successful track records against their cancers. Koivu's situation was more dire. He walked into the hospital thinking he had food poisoning, and walked out having learned that he had a disease that kills 50 percent of its victims within five years.
What does a man find out about himself when he hears that?
Saku gives us a look in the current issue of The Magazine, when he describes being sent home after his first round of chemotherapy, going into his bedroom, closing the curtains, and spending a weekend in cancer's darkest precincts, screaming, writhing, feeling the drugs burn away at his cells. He went to the edge and back, having never felt pain like that before ... or since.
He intuitively understands that he's been changed, though how much he still can't know. "The most important thing is to stay positive," he said when he sat down for an interview at the Molson Centre in Montreal, tanned but still bald after a restful vacation in the Cayman Islands. "People said it to me in the beginning, but I don't think you can really understand it until you've been through something as giant as this."
Because he is the star of a starless team, and his diagnosis was front-page news north of the border, Koivu didn't have the private space that most cancer patients get to retreat into. But most cancer patients don't get seven-minute standing ovations from 20,000 fans on opening day either.
That outpouring helped him soldier on with the treatments, even after his spine became raw and his white blood cell count went from 10,000 to 100 -- lower than some AIDS patients. His red blood cells, which carry oxygen, were so depleted that he couldn't walk up and down the stairs of his home.
Over the next six months, he stopped being a professional athlete and became a full-time cancer patient, with a life that revolved around hospitals, injections and an oddly peaceful routine at home with his fiancée, whom he's due to marry late this summer. Every so often he'd stop by the locker room or make an appearance at a game. But he concedes: "I felt like an outsider. The only time you get to really know guys is on the ice, and I couldn't be there."
That's because he was too busy killing the thing that was trying to kill him.
In February, with all the chemo cycles completed, he faced one last test. A glucose solution was shot into his veins -- a kind of candy syrup designed to lure any hungry cancer cells that were still in his system. In his interview with The Magazine, he says he wore out the carpet of his house pacing in the days leading up to it. Every ache and pain sent his mind racing. What the hell is going on inside of me? He couldn't be sure until he got the injection, then received a magnetic scan that showed the syrup was clear. No cancer cells remained.
Now, Koivu has been given a green light by doctors to start training again. He wants to return to the ice in time for the playoffs. But whether he makes it or not is irrelevant. It's his effort that should be front-page news. Because as a matter of science, Koivu is pushing the envelope to a place it's never been.
"There's a body of evidence that indicates exercise can stimulate the immune system," says Dr. Ron Herberman, who treated Lemieux at the Pittsburgh Cancer Institute. "But those studies have been done using non-athletes and moderate exercise. We haven't really looked at elite athletes because these cases are so rare."
Saku's friend and team doctor, David Mulder, says Koivu is "working in uncharted waters." High dose cancer drugs usually wreak havoc on muscle mass, endurance and reflexes. Saku is trying to restore them at a record physiological pace.
The emotion in Montreal has been at a fevered pitch since opening day, and especially since the weekend when the scrappy Canadiens passed the Rangers in a bidfor the last Eastern Conference playoff spot. It hardly seems fair that the Rangers can add Pavel Bure to their roster try while the Canadiens have to fight on without their best player.
"It's been tough for me being away from the game," Saku says.
When he does come back -- whenever he comes back -- he knows the game will feel better, sweeter, and more profound. But not better, sweeter, or more profound than the way he feels now. He won't be considered cured until 2006 rolls around and he's still cancer free. But in his heart, and in the bones where cancer begins, Saku Koivu feels it.
He's beaten Burkitt's. For now.
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