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Mike's Story Sarcoma

Mike Fender, Sarcoma Survivor

At 44, Mike Fender was inarguably fit. He ran his own construction company and took a hands-on approach to his work, routinely digging holes and lifting 150-pound boxes before he asked anyone else to do it. Away from the worksite, he alternated between biking, running and playing competitive basketball.

So when Mike developed a pain in his left groin late in 2013, he assumed it was a simple strain he picked up playing basketball. But it got progressively worse over the winter, to the point that Mike had a hard time even tying his left shoe. Come May, his wife had seen enough. She scheduled an appointment for him with a local orthopedist. That was late on a Friday afternoon. Early Monday morning, the office called to say that they were referring Mike to Kristy Weber, MD, Chief of the Penn Medicine Orthopaedic Oncology Division.

An MRI confirmed that Mike had a large tumor affecting the lining of his left hip joint.

“I remember Dr. Weber saying she couldn’t believe that I was still walking,” Mike says.

Hearing the words large mass caught him off-guard, but he quickly collected himself and began approaching his treatment with a matter-of-fact mindset. “Initially, the experience was a little foreign to me. I’d never had any major health issues to that point in my life,” Mike says. “But I had things to do. I have a wife and three kids who were on their way to college.”

Looking Under the Microscope

Dr. Weber removed the tumor, and a biopsy indicated that it was benign. But six months later, Mike noticed another small lump in the same area. An MRI confirmed that it was another tumor causing extensive hip arthritis. Dr. Weber referred him to Charles Nelson, MD, Chief of the Penn Medicine Joint Replacement Division, who removed the tumor and replaced Mike’s hip with an artificial one.

“I have a good pain tolerance,” says Mike, who never took anything more than Tylenol before or after his surgeries. The night after his hip replacement, he was already walking stairs. “I felt great with the new hip. I had more flexibility than I’ve had since my playing days.”

But a couple of weeks before his six-month follow-up with Dr. Nelson, Mike felt another small lump in the same area where the first two had been detected. An MRI confirmed it was a tumor. Under a microscope, it appeared benign, just as the first two had. But, because it was behaving as though it was cancerous, Dr. Weber now knew she had to treat it as if it was.

Getting Around the Tumor

The characteristics of Mike’s tumors were consistent with a low-grade chondrosarcoma, a rare type of cancer that doesn’t respond to chemotherapy or radiation. “The diagnosis was made after an exhaustive dialogue among the Penn sarcoma team,” Dr. Weber says.

At that point in Mike’s treatment, though, the diagnosis was a formality.

It was clear to Dr. Weber that removing the tumor each time a new one developed wasn’t a long-term solution. “The only option he had was amputation, because we couldn’t get around the tumor with anything less than that.”

Because of where Mike’s tumors were growing, he needed a hemipelvectomy, which meant that his entire left leg, hip, and half of his pelvis would be amputated. His surgery was scheduled for October 26, 2017.

Mike was scared. His family was scared. “But we all rallied around the thought: This is the hand we’ve been dealt, so let’s play it,” he says.

It was a 13-hour surgery, performed by Dr. Weber and plastic surgeon Stephen Kovach III, MD, the Herndon B. Lehr, M.D. Endowed Associate Professor in Plastic Surgery at the Perelman School of Medicine. Because Mike’s buttock muscle was cancerous too, Dr. Kovach needed to do a free fillet flap, a complicated procedure that involved using the calf muscle and skin from the amputated leg to cover the gap from the amputation.

Still, Mike was able to sit up on his own a day after the surgery. And he asked his nurse to arrange for a therapist to visit him at 6 a.m. the next morning so that he could get out of bed. Which he did. “I tried to do a lot before the surgery with my eyes closed because I thought that would help with my balance,” he says. “There’s really no other way to prepare yourself.”

Confidence, Work Ethic and Grit

A week after the surgery, he was already walking the stairs at home. Two weeks later, he began training for his external prosthesis. “My advisor at Penn told me I’d have to have a strong core for the type of prosthesis I’d need,” Mike says. So, every day over the six weeks leading up to his fitting for the prosthesis, Mike did hundreds of pushups and sit-ups, and he held his body in a plank position for 30 minutes. “I was going to do everything in my power to ensure the new leg was a success.”

He arrived at the Prosthetic Care Facility of Virginia for a sort of week-long crash course. By early afternoon on his first day there, Mike was outfitted with his new prosthesis. A little later, his prosthetist stepped out of the room, and Mike attempted his first steps.

“He came back in and saw me and said, ‘That’s awesome. We’ve got a great shot.’ And I just took it from there,” he says.

Back on His Feet

A few months before Mike’s amputation, he participated in the one-kilometer-walk portion of the Steps to Cure Sarcoma, an annual fundraiser for the Abramson Cancer Center. He finished it, but he needed to stop three times because of the intense pain in his hip. He returned in 2018, about seven months after his amputation. This time, he finished the kilometer, nonstop, in 27 minutes. It was a stabilizer for him. With that, he started to realize his life would be different, but he would be OK.

“What I’ve experienced is that, all of a sudden, I’m different,” Mike says. “But, I tell my kids, ‘I don’t know what kind of adults you’re going to become, but I know you’ve had great examples in your mother and me of confidence, work ethic, and grit. Even before I lost my leg, my life revolved around those three qualities. And, as long as I continue to embody them, I can handle what comes along.”