Branden Lombardi

"Cancer happens to the whole family. Sometimes it's hard, but we're thankful."

Branden Lombardi had the perfect teenage life. He was a typical 17-year-old, spending time in school, playing golf and hockey, and dating girls. And more than anything, he looked forward to college. He had already scouted schools and received an early acceptance to Miami University in Oxford, Ohio. "I fell in love with it — the brick Georgian columns in the middle of the crop fields. I wanted to go there more than anything." It seemed Branden would cruise through his senior year before heading off to fraternity life.

But in 1998, Branden's life changed with a snap-crackle-pop. Branden had been training hard as a goalie on the Desert Vista high school hockey team in suburban Phoenix, AZ. Weeks of practice been tough on his joints. "Playing hockey, you go up and down a lot. My knees would get sore from time to time, and sometimes they would pop." During one long October practice session, Branden went down to block a shot and heard an extra-loud pop in his left knee. "I didn't know what it was. I was wearing thick pads. But I could feel a sharp pain every time my knee went to the ground."

Branden played through the pain and even continued drills for three more weeks before it became too much to bear. He went to see his family's general practitioner, who referred him to an orthopedic surgeon.

The diagnosis: a torn meniscus, the tissue within the knee that helps to evenly distribute body weight. "Great," Branden thought. "Let's fix this knee so I can heal and get back to playing sports. I have things to do."

But things weren't so simple. Tests also showed an unusual knot in Branden's tibia, the bone that extends below the knee. According to the orthopedist, the knot could have been one of several things, including dead bone, a burnt-out fracture, or even a tumor. "Right — a tumor," Branden thought sarcastically.

Further tests were arranged, including bone scans, white blood cell studies, MRIs, and even a bone biopsy, in which a sample of bone tissue is taken for study by a pathologist. Weeks later, the Lombardis received the answer: Branden was diagnosed with osteosarcoma, a form of bone cancer.

Difficult Diagnosis

Bone sarcomas are rare, with approximately 2,500 cases per year diagnosed in the United States. Osteosarcoma is the most common type of bone tumor. Scientists aren't sure what causes this type of tumor, but it tends to occur more frequently in adolescents and young adults.

Treatment requires the expertise of an orthopedic oncologist, a physician who specializes in treating cancers of the musculoskeletal system. Currently, there are only two such oncologists in the Phoenix area. Branden chose to see Dr. Chris Beauchamp, chair of the Department of Orthopedic Surgery at Mayo Clinic in Arizona.

"Branden had a difficult kind of diagnosis," Dr. Beauchamp recalls. Osteosarcomas vary greatly in their features, so it can be difficult to differentiate them from other bone tumors. "We relied on the assistance of our Mayo pathology and medical oncology colleagues to diagnose and identify the best course of treatment."

In addition to pinpointing Branden's type of osteosarcoma, the Mayo Clinic treatment team conducted tests to determine whether the cancer had metastasized, or spread, to other parts of Branden's body. The cancer most often spreads to the lungs, though it may spread to other bones as well. Thankfully, Branden's lungs were clear; the cancer was localized.

Treatment of osteosarcoma used to involve amputation of the affected limb, but thanks to medical advances, now often only the cancerous portion of bone is removed and replaced with an artificial device or prosthetic, such as a metal implant. For Branden — a young man who had been so active — Dr. Beauchamp recommended using donor bone from a cadaver instead of a metal implant to replace the cancerous section of his tibia. Muscles tend to bond better to human tissue, and the end result is a better recovery for the patient.

In addition to surgery, pre- and post-operative rounds of chemotherapy shrink the tumor and kill any cancer cells that remain in the body. Branden received chemotherapy treatments through an oncologist at a non-Mayo facility, which required close coordination between the different members of his treatment team. "We participate in all facets of a patient's care as much as possible," explains Dr. Beauchamp. "When patients need to receive treatment outside Mayo Clinic, it's important to integrate their care.

"Physical therapists, radiologists, the family physician — a whole group of people are involved," Dr. Beauchamp continues. "One operation is a small part of the whole thing. We talk on a daily basis to communicate and plan the treatment, surgery, and physical therapy."

This well-coordinated team approach to care was exactly what Branden and his family needed, because the diagnosis couldn't have been more overwhelming. One day he was an active young man with a clear college path ahead of him; the next, he was shaving his head in preparation for the chemotherapy treatments that would begin the week after Christmas of his senior year in high school.

Branden underwent six cycles of chemotherapy, and in March 1999, Dr. Beauchamp removed the top, cancerous portion of Branden's tibia, replaced it with donor bone, and performed a total knee replacement.

Determined to be Healthy

Following surgery, Branden underwent more chemotherapy and intense physical therapy to learn to walk again. But nothing could keep him down. "I knew that life wasn't going to stop, so I just had to catch up and do the best I could." Senior prom was coming up shortly, in early May, and Branden intended to go. "I was on crutches at the time, and was real sore. But I danced for two songs," he says proudly.

Branden graduated later that year, but it was decided that instead of heading straight off to college, he should stay home for a year to get healthy again.

That fall, Branden's life started to return to normal. He resumed playing golf and spending time with his friends. However, says Branden's dad Bruce, "It changed a lot of things we could physically do." Branden and Bruce used to play one-on-one basketball and kept a running score. The Lombardis also skied avidly — something Branden could no longer do.

"Cancer happens to the whole family," says Valerie, Branden's mom. "We chose not to do things Branden couldn't do. Sometimes it's hard, but we're thankful."

"I used to have nightmares about waking up and only having one leg," Branden adds. "The thing is, I always knew if that happened, as long as I was still alive, that I would be okay and that I would get through it."

But during a follow-up appointment in November 1999, a CT scan showed some enlarged nodules in Branden's lungs. The cancer had spread.

Aggressive Therapy

Branden's treatment team expanded to include Dr. Victor Trastek, a thoracic surgeon and now chair of the Board of Governors at Mayo Clinic in Arizona. "Dr. Beauchamp had talked to me previously about Branden's case," Dr. Trastek recalls. "Because all our departments are located in one place, in the same building, we're able to work together very easily. And because we were on the same page, we could give the best care."

Dr. Trastek removed more than a dozen nodules from Branden's lungs, and in January 2000, Branden resumed chemotherapy treatment outside of Mayo Clinic.

By August, Branden felt strong enough to start college at the University of Arizona. He lived in a freshman dorm and even rushed a fraternity. "It was great," he says. "Everything that I thought, and more."

But in December 2000, one week before finals, another follow-up exam revealed more nodules in Branden's lungs. The cancer had recurred again.

"We'd clear the disease, and then it would return," says Dr. Trastek. Treatment required Branden to leave school and undergo four more lung surgeries, in December 2000 and January, March, and May 2001, followed by still more chemotherapy.

"Without Dr. Beauchamp and Dr. Trastek, I wouldn't be here today."

After so many recurrences, Dr. Beauchamp was concerned the cancer would not stay at bay. "We need to look for something more," he said. Eventually it was decided that Branden's best chance for a cure was a bone marrow transplant. At the time, Mayo Clinic in Arizona did not offer bone marrow transplant procedures, so the operation was performed at a hospital in Tucson, Arizona, in October 2001. As before, the Mayo treatment team worked closely with Branden's family and his pediatric oncologist.

"Dr. Beauchamp really helped me survive this, as the mom," Valerie says. "No matter what, he was always there to talk to me."

"Part of my life"

Five years and fifteen surgeries since his diagnosis, Branden recently passed the milestone of two-and-a-half years cancer-free. "Cancer was going to be something that just happened to me — it wasn't going to be that big of a deal," Branden says. "I didn't want to talk about it, I didn't want to think about it. But now I realize cancer will stay a part of my life for several reasons."

One of those reasons is the Branden Lombardi Foundation.

"I had spent eight hours a day, five days a week, every two weeks, getting chemo at the oncologists' office," Branden says. "And it was so boring. I didn't know what to do with myself — an 18-year-old kid surrounded by 60-year-old people." There was an unused television in the room, so Branden decided to bring video games to play while he received his treatment. He soon noticed that his games had attracted an audience. "These people were watching me play, and they enjoyed it. So instead of playing sports or violent games, I'd bring games like Jeopardy! — something they could participate in.

"It took their minds off the fact that they had cancer. I mean, the doctors and nurses are doing the best they can, but you need that escape, that entertainment, while you're there. I thought a lot about it."

Branden's thoughts led to action. He asked the management of a local golf course to sponsor a tournament to benefit cancer patients, and when they agreed, he told personnel at the cancer treatment facility that he'd like to use the tournament money to buy patient amenities. With help from his mom and the facility's development office, everything fell into place, and Branden finished up his round of chemotherapy just a few weeks before the tournament. "We had a full field, and had to turn people away," he beams. The tournament raised $20,000.

Now in its fifth year, the Branden Lombardi Foundation's Tournament to Fight Cancer has furnished cancer treatment centers throughout the Phoenix area with patient amenities including satellite televisions, stereo systems, computers with Internet access, books, CDs, movies, handheld video games, board games, blankets, pillows — even massage therapy programs and snacks every month.

Branden's fiance, Celeste, now works in a bone marrow transplant and oncology unit. They will marry in November 2005.

Branden now spends his summers as a counselor at Camp Rainbow, a retreat for kids with cancer. He's also back in school, full-time, at Arizona State University. And in May, Branden got engaged to his long-time girlfriend, Celeste, who is just finishing nursing school and works in a bone marrow transplant and oncology unit. "We knew each other when I was undergoing cancer treatment. Now, when she sees her patients going through what I went through, it registers on a deeper level," Branden says.

"We're getting married in November 2005. We're still haggling over the guest list, but one thing's for sure — we're inviting Dr. Beauchamp and Dr. Trastek to the wedding. Without them, I wouldn't be here today."