Thanks to St. Jude, Broox Middleton hits his stride.

Strength. Endurance. Perseverance. Speed.

For most cross country runners, those attributes are an outgrowth of training.

As eighth grader Broox Middleton anticipated a high school running career, he figured he already knew a little about perseverance. Years before, he had survived a brain tumor. Then, as a middle school athlete, he had run through rain and mud and suffocating heat. He had inhaled the acrid scent of dust and desire. He had grown stronger, tougher, faster.

Perseverance? Yeah, Broox knew a lot about that.

And then he got cancer. Again.

For a competitive athlete, one faltering step can mean the difference between victory and defeat. For a 5-year-old boy, one rogue cancer cell can have the same outcome. In 1995, Broox was more interested in rounding the bases on a T-ball field than in running a 5K. When he began suffering from headaches and nausea, his parents, Fara and Alvin Middleton, suspected the culprit might be migraines. During a subsequent checkup, the physician prescribed a pain reliever, and then said, “I don’t really have a reason to order an MRI, but let’s just go ahead and do one to be on the safe side.”

That intuitive move may have saved Broox’s life.

The MRI revealed a large brain tumor situated near the center of his brain. Immediately, the neurologist sent the scans to several cancer centers.

“All of the hospitals said that they could remove part of the tumor, but probably couldn’t get all of it because it was in such a dangerous area. They said he would also have to undergo radiation and maybe have a shunt in his head,” recalls Fara.

In the midst of the decision-making process, the Middletons received advice from a parent whose child had been treated at one of those hospitals: “If I had it to do over again,” she said, “I would go to St. Jude.”

The Middletons’ neurologist sent Broox’s scans to Amar Gajjar, MD, director of the Neuro-Oncology Division at St. Jude Children’s Research Hospital. “When we saw the films, we knew that this was a juvenile pilocytic astrocytoma and that we could take it out,” Gajjar says.

According to Gajjar, each year about 500 children in the United States are found to have this type of tumor, which arises from star-shaped brain cells called astrocytes. Broox had a low-grade astrocytoma, which is a localized, slow-growing tumor.

The Middletons arrived at St. Jude just in time. The night before the operation, Broox permanently lost his vision on the right side.

Stepping out in faith

The day of Broox’s brain surgery, Alvin and Fara prayed and paced, their hearts beating like feet on pavement. “I was terrified,” Fara says. “The only thing that gave me comfort that day was reading the book of Psalms and knowing that God had placed us in the hands of the best doctors in the world.”

St. Jude surgeon Robert Sanford, MD, was able to remove the entire tumor. In addition, the 5-year-old did not have to undergo the radiation therapy that had been a standard treatment offered by other hospitals.

Broox has clear memories of the days following the operation. “I remember when they moved me from ICU to a room, I felt pretty good,” Broox recalls. “But the first time I tried to walk, I had no feeling in my right leg.”

Broox regained the ability to walk within a couple of weeks and soon returned home. For the next few years, he visited St. Jude for regular checkups with Gajjar and eventually transferred to the hospital’s After Completion of Therapy (ACT) Clinic, which provides long-term follow-up for patients whose disease has been in remission for five years.

“At that point, I thought, “Wow. I can put this behind me. I never have to deal with this again,” Broox says.

A different course

During middle school, Broox discovered that he had a gift for running. By Christmas of his 8th grade year, he was already anticipating an exciting athletic career.

“He had high hopes of making the cross country team as a high school freshman,” Fara says.

Then—thanks to the education he had received in the ACT clinic—the 14-year-old identified a suspicious lump. Surgeons at a local hospital opted to remove the mass. Before the operation, a physician tried to reassure Fara. “I’ve consulted with about 10 of my colleagues, and we don’t think it’s cancer,” she said. “There’s just no way that a child could have two unrelated cancers.”

“Dr. Gajjar had always told us that you never really know for sure until you do a biopsy,” Fara says. “So I just thanked her. But when the doctor came out of the ER, she was crying. She said, ‘I’m so sorry. I am just so sorry. It’s cancer. What can I do?’”

“I was shocked,” Broox recalls. “I thought I was through with being the ‘cancer kid,’ and then out of nowhere I found out that I had it again.”

Fara and Alvin called Gajjar, who advised the family to return to St. Jude, where Broox could undergo treatment under the guidance of Sheri Spunt, MD, who specializes in solid tumors.

“Dr. Spunt is another angel in our lives,” Fara says. “She was so calm and was such an inspiration to Broox.”

Spunt explained that Broox was, indeed, facing a totally different type of cancer. This time, he had an embryonal carcinoma, a malignant tumor that develops when germ cells divide rapidly and erratically. Since the local hospital had removed the mass and had identified no metastases, the physicians decided to monitor Broox’s condition closely.

“OK, I’m back to my old self,” Broox thought.

But a few months later, the cancer returned. “They said it was mostly in my lymph nodes,” Broox recalls. “Once again, I was totally shocked.”

Running toward recovery

In the film Chariots of Fire, runner Eric Liddell muses, “Then where does the power come from, to see the race to its end? From within.” Like Liddell, Broox quickly learned to lean upon his faith and to draw on inner reserves of strength. Chemotherapy treatment, he discovered, would not be a sprint, but an endurance race.

The grueling cycles of chemotherapy seemed to drag on forever.

“When he was hospitalized for chemo, there were times he was too weak to even brush his teeth,” Fara says. Between each cycle of chemotherapy, Broox would return home to recuperate. “A few days after we’d get home, Broox would try to run,” Fara recalls. “His dad and I would walk alongside for a mile, and Broox would huff and puff and try his best to make it.”

Thus Broox began his slow run toward recovery.

“When I was in the hospital, all I could think about was getting out and making more of my life,” he says. “During middle school I had not been serious about running track. But after I had cancer, I needed to do it. I wanted to prove that I could do it after having chemo and cancer.”

Gradually, Broox regained his stamina and, when he tried out for track during spring semester of his freshman year, he made the team.

“That spring, I wasn’t very good,” Broox admits. “I came in last place in several races, but I was just so happy to be out there.”

As his strength returned, his times improved, eventually allowing him to make varsity and twice compete in the state’s cross country championships.

Finishing the race

Although Broox hung up his cross country spikes when he enrolled in his university’s industrial engineering program, he still enjoys a daily run and frequently participates in area road races. But running is no longer his sole passion.

“Because of my experiences, I have a whole new outlook on life,” he explains. “Nobody can really understand what it’s like unless they have gone through it.”

That’s why Broox spends time counseling young cancer survivors at summer camps. He helps construct houses for the poor. He serves meals to the homeless. He raises money for St. Jude.

“If other people hadn’t helped St. Jude,” he says, “I wouldn’t have been able to go there for treatment.”

Altruism has even played a role in Broox’s career choice, which he says combines his aptitude for math with an interest in helping others. “Industrial engineering will help me do both,” he says.

That attitude of gratitude runs in the family. Fara recently co-chaired a new St. Jude fundraising relay from Memphis to Mobile, Alabama. (Visit www.stjudeonthebay.com  for more details.) Unfortunately, because of final exams at college, Broox was unable to participate in this year’s event, but he hopes to do so next year.

“When Broox got cancer, I would have sold all my worldly possessions to get the best treatment for him,” Fara says. “But thanks to St. Jude, I didn’t have to do that. I do the fundraising work because I have benefited. I also do it for friends we made at St. Jude who lost their lives. I want to see cures; I want other children to benefit like Broox did.”

Strength. Endurance. Perseverance. Broox and his parents are experts on those topics.

And cures? Yeah, Broox knows a little bit about that, too.

Reprinted from Promise Spring 2010

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