When Jacob Federman, a junior sports management major, went out to celebrate his 21st birthday last weekend, it wasn’t at some dimly lit dive bar or at a glitzed-out, neon tourist trap. He went to the George Mason University Relay For Life.
The now-21-year-old doesn’t have the proclivity for strong drink or smoke that characterizes many people during their college years. He doesn’t want to subject his body to that after twice beating Hodgkin’s lymphoma.
Relay For Life was held in Federman’s honor two years ago, when he was mired in his second fight against cancer. Federman first beat Hodgkin’s lymphoma — a cancer of the lymph tissue — when he was in high school. After chemotherapy treatments and radiation knocked out the cancer, his doctors told him that if it were to return, it would come back within a year.
Three and a half years later, Federman, then a freshman at Mason, was back home in New York for spring break. He went in for his routine visit, and that’s when the doctors found something during their checkup. They said they would be in touch when they knew what it was.
“I went back to Fairfax the next morning and saw my friends who already knew what happened the first time around,” Federman said. “I said, ‘Hey, there’s a good chance that this is my last week at Mason.’”
Shortly thereafter, his mother left a voicemail he heard when he got out of class. The cancer had returned.
The First Bout
When Federman was 15, he accompanied other teens on a six-and-a-half-week tour of the United States. As soon as the trip began, Federman felt like he had a cold — there was coughing that doctors in Seattle and Los Angeles attributed to his asthma — but when his mother picked him up at the end of the trip, she knew something was wrong, and it was time to see another doctor.
“They thought it was asthma that could have been out of control,” said Marci Greenberg, Federman’s mother. “I figured it must have been pneumonia, but I wanted a chest X-ray.”
Before Greenberg and Federman even arrived home, Greenberg received a phone call.
“We did see something,” the pulmonologist said of the X-ray. Next came a CT scan on the Friday of that week, before they went to visit Greenberg’s parents. It was Friday afternoon that Greenberg received the call from the pulmonologist confirming the prognosis: stage 2 Hodgkin’s lymphoma.
Greenberg and Federman went ahead with the visit to her parents, and Greenberg didn’t tell Federman about the cancer until Sunday night, hours before returning to Columbia University Medical Center to begin planning treatment.
“I kept the secret because I didn’t want to ruin anything,” Greenberg said. “How do you explain to your teenager that he’s probably going to have chemo, radiation, lose his hair, feel horrible? How do you do that?”
Greenberg said she told Federman that there would be sick kids at the hospital and not to be unduly worried. It was there that Federman asked Greenberg if he was going to die.
“I said, ‘No, you’re not, Jake. Don’t even ask me that. It’s not going to happen for a long, long time,’” Greenberg said. “He never looked back after that. He never questioned it. He never got depressed. He never cried.”
Federman said it was daunting to receive the news.
“I was 15, so the only thing I knew about cancer was ‘OK, you have it. Now you’re going to die,’” Federman said. “I was in disbelief.”
While Federman’s friends from the cross-country trip were enjoying their summer, Federman spent long hours in doctors’ offices prepping for biopsies and a run of outpatient chemotherapy treatment cycles that stretched from Aug to Nov of his soph. year of high school. After over 40 clinic visits, Federman’s results impressed his doctors.
“They were so impressed with the way my body responded that they presented my case to the board of oncologists,” Federman said. Though he was tired from long days at the clinic, he hadn’t experienced some of the more adverse effects of the drugs and chemotherapy.
Next came a radiation treatment that lasted from the beginning of December to Christmas. Though the doctors believed the cancer was gone, they said a precautionary radiation treatment was a good final step in ensuring the cancer had been eradicated.
Then, right around Christmas, came the news Federman and his family had been waiting for: The cancer was gone. The residual scarring from the biopsies would go away over time. The hair he lost from the treatment would return.
The Second Time
Federman is now the president of fraternity Alpha Epsilon Pi, which he joined during his freshman year after some of the brothers helped him move into the dorms and then invited him to a barbeque.
When Federman received the voicemail from Greenberg confirming the cancer was back, he turned to the fraternity brothers for support.
“I remember sending out a mass email to all the brothers saying, ‘As most of you know, I had cancer. Turns out I just got it again,’” Federman said.
Though he returned to New York for treatment almost immediately after receiving the prognosis, he was able to return to Mason once during the semester to attend the fraternity formal in May, an end-of-the-year event where the brothers get dressed up and go out to a nice dinner.
The treatment for the second bout of cancer was much more aggressive than the first, as Federman’s doctors didn’t want to take any chances. He went in for surgery so the doctors could insert a catheter to pump the chemotherapy treatment into his bloodstream.
Instead of four outpatient chemotherapy cycles of treatment like the first time, Federman was assigned to inpatient status where he was constantly connected to a 24-hour drip containing multiple chemotherapy drugs. His doctors prescribed two aggressive inpatient sessions followed by a rescan to check not only the status of the cancer but for long-term side effects that result from such aggressive treatment.
“They said, ‘If there is still a trace of the cancer, [we’re] going to go back and nuke [your] system,’” Federman said. “If that’s what had to happen, there was a good likelihood I wouldn’t be able to return to Mason in August. I needed to get back to Mason. That’s really what kept me going, wanting to come back here. I needed to be back so badly.”
The “system nuke” would have consisted of a stem cell transplant called a “rescue” in the medical field. The stem cell transplant works by replacing damaged stem cells with healthy stem cells harvested from the person’s body. Though the actual transplant is quick, it leaves the patient in a weakened state and confined to a hospital room for a month while the body recovers from losing its white blood cells. After the monthlong stay in a hospital comes a yearlong recovery at home.
“After the first two treatment cycles, we were looking for the cancer to be 75 percent clear,” Greenberg said. “If he’s not 75 percent, we would have had to do the stem cell transplant.”
Fortunately for Federman, the oncologist had good news: The cancer was 100 percent gone. After two more rounds of less-intense chemotherapy and a month off, Federman received a month of outpatient radiation to ensure that the cancer was gone.
The summer months were consumed with the radiation, with more blood exams, more CT scans and more cardiology work. After that, Federman worked to get his life back on track. So when he woke up with a fever after spending the night at a friend’s house near the end of the treatment, he knew something was wrong.
Federman learned the surgically inserted catheter had caused an infection, which meant another week in the hospital.
“I had a joke with friends and family that ‘If I’m going to do this, I’m going to do everything,’” Federman said. “People consider me to be a funny guy, and my humor never really changed.”
The last bump in the road came when rashes broke out across his body. He had shingles, and that meant more treatment. But after that, he was done and has enjoyed good health during his sophomore and junior year.
Relay For Life
Federman has organized his fraternity’s participation in Relay For Life during the past two years. The event had been an important reminder of Mason during his second fight with cancer; the event was organized in his honor, and he received an outpouring of support from his fellow students.
“I remember getting a giant box of handmade cards from fraternities, sororities, faculty members, a lot of people I didn’t even know,” Federman said. “I remember sitting there for hours reading every card.”
Federman was able to partiipate in the Relay For Life events that fell during his sophomore and junior years.
“Last year was special since I was able to be at Relay For Life,” Federman said. “They have a survivor’s lap, so everyone who has had or is currently fighting cancer walks hand-in-hand on the first lap while everyone applauds.”