July 18, 2019
Chance Fouts grew up a Royals fan. Yet the Johnson County, Kansas, native never thought he'd be sitting behind home plate in the Buck O'Neil Legacy Seats. The honor for Chance, his wife, Jini, and their 2 young sons to enjoy a day with a bird's-eye view of the field came as part of brain tumor awareness day at Kauffman Stadium.
The Fouts family attended with neuro-oncologist Michael Salacz, MD, part of the team at The University of Kansas Health System that is treating Chance, 26, for brain cancer.
The day everything changed
Jini Fouts remembers January 12, 2018, well. It was a typical day for the stay-at-home mom in Bonner Springs, Kansas, where the family moved to their "forever home" 2 years ago.
"Chance said he wasn't feeling very well when he came home from work, and he went to the bathroom," Jini recalls. "I don't know why, but some gut instinct just told me to check on him." Jini found Chance having a seizure. She immediately called 911.
In the short time it took emergency responders to arrive, Chance stopped seizing. He passed the cognitive exam the medics performed.
"He had a terrible headache, but since he passed the tests, there didn't seem to be a life-threatening reason to take him to the hospital by ambulance," Jini says.
Still, she sensed something was very wrong. She called Chance's mother, who agreed he needed to be assessed by doctors. Chance didn't need convincing. Just over an hour later, Jini and Chance arrived at the emergency department at The University of Kansas Health System.
"We went all the way to Kansas City, Kansas, because I just trusted them more than anyone else," Jini says.
Given Chance's symptoms and history of severe headaches, physicians ordered a CT scan of Chance's brain. They found what they had hoped to rule out: a racquetball-sized mass. An MRI confirmed the initial findings. Within a week, Chance had surgery to remove the cancerous tumor, and his life changed forever.
Aggressive disease, aggressive treatment
Chance's tumor was located in his brain's right frontal lobe, the seat of many crucial functions, including motor skills, problem solving, memory and language. The same region is critical to impulse control, personality and behavior. The challenging and somewhat unpredictable disease, known as malignant glioma, requires aggressive treatment.
"Think of gliomas like a cup of rice that's been dropped on the floor," says Dr. Salacz, the region's only fellowship-trained, board-certified neuro-oncologist – a specialist in cancers of the brain and spinal cord. "When you drop the rice, grains go skittering off in all directions. You sweep up as much as possible, but you might miss a few. Like those tiny, scattered grains, gliomas infiltrate the brain and are particularly invasive."
Surgery to remove the tumor is like the broom used to clean up the rice. It reaches most of it, but if 1 or 2 microscopic grains remain, the tumor can recur. Because the risk of recurrence is significant with this type of brain cancer, radiation and chemotherapy follow surgery to help destroy any remaining cancer cells.
"The prognosis for people with malignant glioma is hard to predict, but in this era of new treatments, like some of the newer chemotherapy drugs, I've had patients survive for 10 years," Dr. Salacz says. Data beyond that is unavailable, as the types of drugs now being used emerged only a decade ago. Patients given these drugs may survive much longer, and researchers continue to follow them over time. "We don't know the true effects of these chemotherapy drugs on long-term survival yet, so we'll be watching carefully."
Dr. Salacz emphasizes the importance of the team approach used at the health system and The University of Kansas Cancer Center. Neurosurgeon Roukoz Chamoun, MD, a skull base surgery specialist, performed Chance's delicate brain surgery. Neuropsychologist Caleb Pearson, PsyD, works with patients like Chance who have postsurgical cognitive changes.
"This type of cancer doesn't always have good outcomes even if you do everything right," Dr. Salacz notes. "But you'll definitely have less positive outcomes if you're not maximizing the treatment. This type of complex surgery and treatment requires a highly specialized, collaborative team to achieve the best outcome possible."
Learning to live with losses
Chance's postsurgical treatment included 34 rounds of radiation and 12 rounds of chemotherapy. When he completed his final chemo treatment in May 2019, he was cancer-free and extremely grateful. But his positive outcome came at a price.
"I can't remember things like I used to, and I'm pretty scatterbrained," Chance says of his cognition following treatment. "And I react to things differently than I used to." The previously mellow and stable Chance now periodically morphs into an irritable and short-tempered man.
"It's been tough," Jini admits. "We just take it a day at a time, pray a lot and take deep breaths. I try to help him with his irrational thinking and bring him back to realizing what's really going on and how he could have reacted instead." Jini cares for Chance full-time, as he is unable to work. A back injury that occurred when he fell during his seizure causes chronic pain and further complicates their lives.
The changes caused by Chance's lifesaving treatments also affect Chance and Jini's sons, Kaysen, 6, and Lucis, 3. "It's hard when they want to play with Daddy, and he's not able to play the same kinds of games," Jini says.
"I think the boys worry about me a lot," Chance adds.
"My heart goes out to them," Dr. Salacz says. "Chance has done very well to this point, and I'm hopeful that will continue, but even so, his family struggles with some of the complications he's endured. That's one of the biggest costs glioma patients pay."
Grateful for every day
Despite his changed circumstances, Chance is grateful for every day and credits the team at the health system and cancer center with saving his life.
"It's easy to feel victimized," he says, "but you can't let those feelings overcome you. This last year opened my eyes and gave me a greater appreciation for life."
Chance also finds hope and companionship with new friends through Head for the Cure, an organization with a mission to raise awareness and funding to inspire hope for the community of brain cancer patients and their loved ones.
The Fouts family is grateful for the life they continue to live together.
"He's definitely my warrior," Jini says.