Thinking back on it now, the dream feels like an eerie premonition.
When he was 17, Nick Brumfield had a vision of a shapeshifting dragon, chasing him through a thick grove of oak trees. It was swift and ever-changing until it forced him into a raging river. And then the dream ended as abruptly as it began.
The next morning in class, he drew the dragon on wide ruled notebook paper instead of taking science notes.
A year later, the usually athletic Nick, a kickboxer and avid outdoorsman, suddenly struggled with headaches, body weakness and shaky balance. This time, the swift shapeshifting force threatening his life wasn’t a dragon. It was cancer.
When they recall that time, Nick’s parents, Joe and Latina, remember their son’s illness coming at the worst possible time for the family. Not that there’s ever a good time for cancer.
It was the summer of 2010. The family of five was in the middle of a big move from Memphis to Springfield, Missouri, where Joe, a pastor, was about to lead a new church and congregation.
They were at a farewell party hosted by friends in Memphis when Nick, an experienced swimmer, nearly drowned in the pool and had to be pulled out by his father. His legs and one arm suddenly felt heavy and weak, Nick told his family.
He was rushed to a nearby hospital, where scans showed Nick had brain cancer known as anaplastic astrocytoma.
“It’s horrifying. It’s a train wreck in your life,” Joe said. “As a parent, you don't go through your life imagining, well, what will I do the day that my child is diagnosed with cancer? So, when you hear that your child has cancer, it hits you so hard because you don’t anticipate it. There is absolutely nothing to prepare you to hear those words.”
Nick’s tumor was soft like jelly and had developed in the thalamus – a deep-lying part of the brain responsible for relaying signals of sensation, such as temperature, pain and touch, and signals for movement.
He was quickly referred to St. Jude Children’s Research Hospital®, where doctors gave the family more sobering news. Nick’s tumor was aggressive and likely to spread quickly. Joe and Latina said doctors told them Nick would have less than two years to live.
Nick the hero
Because Nick was 18 when he was diagnosed, he was old enough to listen and understand as the doctors discussed his prognosis; and he was legally old enough to make decisions about his treatment, too.
What makes St. Jude unique, his doctors told him, is that they work closely with scientists to conceive, launch and run their own clinical trials.
This model, doctors told Nick, sometimes allows St. Jude to bring patients care that is not available anywhere else. There’s a sense of urgency behind this work, too. After decades of steady rise — in part facilitated by research led at St. Jude — cure rates for cancer in kids plateaued. So, St. Jude increased investment in basic science research and clinical trials to develop newer, more effective and less toxic therapies, hoping to boost cure rates. This robust investment in research gives St. Jude scientists and doctors data to share with colleagues and clinics across the world.
As Nick sat in his hospital bed, he was about to leverage that cumulative knowledge built over decades through collaborations with experts in pediatric cancer from around the world.
Doctors were honest with Nick: It might be too late to help him survive his cancer, but what they would learn from his case could help another child live.
Nick listened quietly as they went through those details, and then before he signed himself into the study, his parents heard him say, “Well, if it will help somebody, then I'll do it.”
Nick’s father Joe wasn’t surprised. He knew his son was fascinated by hero stories, movies like “Braveheart” and “The Last of the Mohicans.” Stories that explore a dark time and the sort of character it takes to vanquish it.
“From the beginning of his diagnosis, Nick saw himself as a hero of sorts,” Joe said.
Nick had several surgeries that succeeded in removing portions of his tumor but not all of it because of where it was in his brain. He received more than six weeks of radiation and then nearly 15 months of chemotherapy, which made him nauseous and weak.
As difficult as his symptoms and treatment were, Nick told his parents he had a plan to enjoy at least one good thing every day. Sometimes, that good thing was eating a donut. Or a walk outside for just a few minutes. And on the days his nausea wasn’t too bad, it was enjoying his favorite Mexican meal.
“We knew from the beginning that his prognosis was not good and yet St. Jude did everything they could,” Nick’s mom Latina said. “If he couldn’t keep food down, they made sure that he was nutritionally getting what he would need through an IV. He had some deficits walking and using his arm, so he received physical and occupational therapy. St. Jude made sure that whatever time he had left would be quality time for him and for us. That meant the world.”
Nick passed away in October 2011, 16 months after his diagnosis. He was 19. He donated the tissue from his brain and tumor to St. Jude to help doctors and scientists better understand the brain cancer that took his life.
“I don't think it's really possible to put into words the loss of a child. It's terrible, awful. Because raising children — raising this other human being that you love so incredibly much — it changes us,” Joe said. “So, when that person is gone, you lose a bit of yourself, too. A part of you dies with them.”
Inspiration in life — and death
In Nick’s last days, what his brothers and parents most remember is the peace Nick embraced knowing he had lived life on his own terms, in the fullest way he knew how. Seeing how he lived — and died — inspired the family’s closeness, and faith.
They carried on the best way they knew how, with Joe and Latina focusing on family and finding humor and grace whenever possible. They spent their days helping their surviving teenage sons, Jacob and Josh, as they navigated high school, found first loves and became active in church mission projects.
They talked about Nick casually in conversations, during family dinners and birthdays, hikes and church youth trips because he was still a part of them even if he wasn’t there.
They recalled the strangest details when they least expected it. Random things like when Nick dragged Jacob to the woods to catch cottonmouth snakes in the river bottoms. Or his daring habit of choosing the tallest tree to climb or the biggest hill to skateboard down and, of course, go the fastest. They even joked how they never would’ve guessed it would be cancer that finally got him.
Nick lived his life at full tilt, his younger brother Josh said, “constantly at 110 percent.”
His athleticism, his aloofness, his defiance made Nick such a dynamic and charismatic figure in their lives. His loss left them feeling hollow, but also grateful that they’d had the chance to know him as long as they did.
Joe and Latina decided to form a team and run in the half marathon during St. Jude Memphis Marathon Weekend in December 2012 to honor Nick’s memory and the work the research hospital did to help him.
But suddenly, just months before they were due to run the marathon, their son Jacob woke them up in the dead of night in October and said he’d just collapsed and thrown up.
He had a seizure as they tried to help him. And a terrifying reality hit Joe: Is this happening to us again? Another son with brain cancer?
Down the hall, their youngest son Josh said he panicked.
Am I about to lose another brother? he worried.
The next day, doctors at their hometown hospital confirmed the family’s fear: Jacob had a mass in his brain. This time, in the frontal lobe, a different location from Nick’s tumor, but it was irrefutable proof: Brain cancer had hit their family again.
“My immediate reaction was anger,” Joe said. “This is wrong. This is unfair. For us to have two children in one family just felt punitive. It just makes you question everything.”
Sense of hope
Pediatric brain tumors are the second most common type of childhood cancer, but they are rare, affecting fewer than 5,000 kids in the U.S. each year. That’s roughly five out of every 100,000 kids. Joe and Latina found themselves in a rare class.
But Joe and Latina said in that moment they felt a surreal sense of hope because they knew exactly where they hoped to take Jacob: to St. Jude.
Within hours, the family’s oncologist in Springfield referred Jacob to St. Jude and the family was on an ambulance to Memphis. Jacob was scheduled for surgery within days. To the family’s relief, the surgeon was able to completely remove the tumor. Jacob didn’t need further treatment like radiation or chemotherapy.
When they removed Jacob’s tumor, Joe and Latina said doctors and researchers at St. Jude tested it against tissue samples from Nick’s to see whether they shared similarities. There were none. But Joe and Latina said they were thankful for that moment when the loss of their older son helped doctors know more about how to approach treatment for their second son’s condition.
The family also received genetic testing at St. Jude to see if there were mutations or patterns that predispose them to cancer. At St. Jude, genetic testing is done to help doctors and scientists better understand the origins of cancer in patients and families and discover the unique mechanisms at work that make the disease so devastating. In the future, genetic testing and sequencing could also lead doctors to develop ways to cure cancer, or even stop cancer from occurring in the first place.
Since both his older brothers had brain cancer, Josh asked for a scan, too. Shockingly, doctors found a dark spot on his brain as well, a “lesion” they called it. It was a shadow, a threat of something abnormal, but it wasn’t cancerous.
Barely six weeks after Jacob’s brain surgery and Josh’s scans showing a lesion, the family was in Memphis running the half marathon to support St. Jude. They had 96 members on the team.
They had been through something few families had, having lost one son to brain cancer and then having had one rebound so quickly from it. Both treated at the same place, without receiving a bill from St. Jude, and a third son monitored for a brain lesion.
“It's been crazy to think that this is the way that life has gone, to even think that all this happened,” Jacob said. “It almost feels like a memory in some ways. It's like some kind of dream. A crazy story that you don’t really fully believe. But then you’re like, no, this actually happened to me, to my family.”
Given his history, Jacob was monitored over the years. He also enrolled in the St. Jude Long-Term Follow-Up Study protocol to help St. Jude collect information about the effects that childhood cancer and treatment has on survivors.
Enduring and emerging stronger
“Our family owes such a debt of gratitude to St. Jude for everything that they've done,” Josh said. “Because of St. Jude and the way that they took care of us, there was always this silver lining of hope. We were constantly getting care from people that really want to see you do well.”
And a decade later, both Jacob and Josh are doing well.
Like his father, Jacob became a pastor in a church in the foothills of the Ozarks in Northwest Arkansas. He is married and has a young son whose middle name is Nicholas to honor the uncle he will never meet, but who he will hear about, like legend.
Jacob has a barely visible scar on his head, the only obvious mark left of his time with brain cancer, aside from the occasional dark joke he cracks about surviving it.
Josh got married, too, and has a young son born within weeks of his brother’s. He works on a crew that installs roofs, enjoys hunting and fishing like his late older brother, and is popular among his coworkers for making the best venison breakfast tacos. He lives a few miles from his parents’ home in Kansas.
Josh’s son is just about ready to start taking his first steps and likes to hear his father play folk songs on his guitar. When he goes in for occasional scans, doctors still see a lesion on his brain, but it has not grown or changed, so Josh doesn’t focus on it.
“I've got a beautiful family. I've got a house to live in. I've got a job that I enjoy doing. Friends that mean the world to me, a church family that is supportive and I know I can rely on. And I've got two good dogs,” Josh said.
“What else I could ask for?” he said.
Meanwhile, Joe and Latina are cherishing their lives as grandparents and are active leaders in their church.
On a breezy afternoon, as Joe pushed one of his grandsons in a swing under a large oak in their front yard, he said it is not always easy to reflect on what his family has endured, though he can say they are now stronger for it.
“Childhood cancer is horrific. It should never happen. There's that saying, ‘Look on the bright side of things.’ Tell me what the bright side of childhood cancer is. There's not one,” he said.
“But there is St. Jude. And St. Jude is a difference maker. Because at a time when you need it most, hope is extended to you. Grace is offered, blessings are extended. You see that happen at every corner of that place.
“And it's hard not to be encouraged in a place like that where you're there because something horrible has happened to you. But what you find there is people helping you pick up the pieces of that busted up dream that you had of how things were going to go. And they tell you keep pressing, keep living.”