by Tom Wilson, writer/editor PCToday. Photos by Cindy Davis Meixel, except as credited.
Late assignments, missed classes and "The dog chewed my laptop" excuses are par for the courses that faculty teach. And John J. Messer, his knit cap covering an array of life-saving transducers on his shaved head, strikes an attentive pose when those inevitable occasions arise. "I really do try to be sympathetic when a student says, 'I have a lot going on,'" said the assistant professor of computer science at Pennsylvania College of Technology. "But sometimes, I just have to give them that look that says, 'Really? You don't have nearly as much going on as I do.'"
This is not the haughty attitude of an academic prima donna, arrogantly dressing down a tardy student from high atop a fabled Ivory Tower. Messer's pragmatic stance is born of gratitude, the freely admitted good fortune to even be in that classroom.
To be anywhere, quite frankly.
Barely two years earlier, a bout of irritability, headaches, blurred vision and nausea led him to his family physician. The general practitioner steered him toward the first of an eventual series of MRIs, which detected a brain tumor: a cancerous tumor of the most aggressive type, in fact, that goes by glioblastoma multiforme and comes with no known cure.
It was a staggering diagnosis, made even more frightening by his older brother's death from the same condition in February 2008.
With painful clarity, one of Messer's closest friends for more than a decade remembered the moment the thunderbolt struck.
"It was not long after he lost his brother (that) he got the news about his brain tumor," said Denise S. Leete, an associate professor of computer science. "He called to tell me. It was the most heart-wrenching phone call I ever received."
As the bombshell reverberated, Messer – so attuned to what makes artificial brains tick – nervously navigated the "What if's?" surrounding his own internal wiring.
"My first thought was, 'I'm never going to teach again,'" Messer recently recalled, the emotion in his voice as raw as the memory. His mind then turned to his parents, who had watched with near-helpless love as his brother slowly and agonizingly succumbed.
"My first thought was, 'I'm never going to teach again.'"
"I had to start thinking about a will, a living trust," said Messer, the one-time mentor to the college's Outdoor Adventure Club whose youthful energy masks his 48 years. And there was his job to consider, with student advisees and a full course load that included a leading role in the college's fledgling Web and interactive media major.
"I can't answer any more questions," he told faculty colleagues as his symptoms worsened. "Whatever you do will be better than what I can do."
Messer took medical leave, surrendered to his treatment and closed his office door … perhaps for the last time.
He underwent surgery at Geisinger Medical Center in Danville on Dec. 8, 2010, and a follow-up MRI confirmed successful removal of the tumor from the right frontal lobe of his brain. He spent most of that month recovering, aided by what he called an "outpouring of prayers, thoughts, mojo, love and support."
In his case, "The Big C" has been no match for "The Four F's": family, friends, faith and Facebook. Relatives started a social-media group to keep well-wishers (especially those following from a distance) apprised of his recovery, and Messer found solace in a local support group.
He took off the following semester to begin what is considered the postoperative "standard of care" for a glioblastoma patient: six months of radiation, daily doses of oral chemotherapy and an MRI every 16 weeks.
As he convalesced, gathering his strength, visiting family and exploring other treatment options, he learned in April 2011 that he was eligible to participate in a clinical trial for an experimental device called Novocure Tumor Therapy Fields that uses an alternating 200-kHz electric current to continually pass through his brain and disrupt the division of cancer cells.
His surgeon, Dr. Steven A. Toms, Geisinger Health System's director of neurosurgery and co-director of the Geisinger Neuroscience Institute, explained that the device (like radiation and chemotherapy) exploits a long-known, even primitive reality about cells: If their growth is impeded, they will self-destruct.
During division, the DNA molecules of a mother cell are duplicated. The mother cell then splits into two daughter cells much like a balloon that's stretched and pinched in the middle. Applying an electrical field, however, inhibits those duplicated DNA molecules from being distributed appropriately, and the daughter cells – in this case, cancer cells – do not have the necessary genes to survive.
The skepticism that Toms first held about the device, which was developed about a decade ago in Israel, has been supplanted by endorsement as benefits of the therapy are experienced by hundreds upon hundreds of patients.
"It's truly remarkable," he said. "The results from this have been spectacular." The physician cited a Czech study in which TTF treatment has kept patients healthy for five to seven years, findings that are as hopeful as they are exciting.
Messer is required to wear the apparatus as much as possible during the two-year trial, a minimum of 80 percent of each day. He replaces the transducers several times a week, reshaving his scalp to ensure good contact.
He returned to full-time instructional duty in Fall 2011, meeting cancer with candor. He prepared a 10-minute PowerPoint presentation that he shares with his classes, orienting students to his unconventional appearance and a device that occasionally beeps from a loose connection or low battery.
The device, approved by the U.S. Food and Drug Administration for those with recurrent tumors, is covered under many health-insurance plans and has been expanded for use in lung cancer cases. Whether it represents a far-reaching breakthrough is anyone's guess, but Messer concurred, "It's the most successful thing we've seen so far. I believe I am on the cutting edge of cancer treatment: one that may be a cure for brain cancer, not just an extension of one's life."
On "average," he said, glioblastoma patients have a recurrence within the first 15 months after surgery. Messer barreled well past that milestone, saying farewell to chemotherapy and racking up some 23 months of tumor-free living.
An MRI detected a 3-millimeter growth in another part of his brain, news that he termed "disappointing, but not unexpected."
Toms immediately put into motion a plan to deal with the setback, including reconfiguration of the transducer pattern on Messer's head. Other strategies are under discussion for the patient, bowed but far from broken, whose "can-do" attitude is life-affirming.
While some people would understandably treat the recurrence as a sign to take it easy, if not stop working altogether, Messer is still on the job for Spring 2013 (his fourth semester of teaching since his surgery).
"I have been granted a reduced schedule ... to allow me to focus on getting better, to be flexible in any additional commitments I might have and relieve some of the stress of teaching new material," he said. "I am very grateful to Ed Henninger (dean of business and computer technologies) and Paul Starkey (vice president for academic affairs/provost) for having a true understanding of what I am going through, for going to bat for me and treating me fairly."
Co-workers are not surprised, given the dragon slayer's demeanor with which Messer has met his condition ever since the initial diagnosis.
"As I reflect on John's experience, I have to say he was so strong and so brave," Leete said. "His entire life was reeling in a moment's notice, but he found the courage to look fear in the face." Turning his situation around, she said, Messer has remained positive, motivated, physically fit and focused on staying healthy.
"Being diagnosed with a possibly life-threatening disease is so jarring. It is an opportunity to sit down and look within yourself to find the answers. You also find that you're stronger than you've ever been," she said. "John has been a true testament to the human spirit, with the ability to achieve the incredible against all odds. A true inspiration!"
Indeed, many of the same traits that make Messer an engaging professor have contributed to his success as a patient.
"John's just such a great guy," Toms said. "He's bright. He's engaged. He's battling cancer while taking care of life."
He is also an advocate for his own wellness, the type of person more amenable to clinical trials and so diligently compliant with their often-burdensome requirements that better results are more likely.
"John is in the leading-edge cohort of this treatment, a pioneer who's helping us move the ball forward," he said. "You're never really finished with cancer, but this has the potential to be a game-changer. As heartbreaking as it is to share bad news, I think we're finally in a good place ... a place where I can tell patients, 'I'm optimistic that we have options.'"
In assessing his own progress, Messer cited a number of possible points in his favor. His first tumor was caught fairly early (much more so than his brother's), and he draws significant vigor from exercise and his stimulating interaction with students.
"What was I supposed to do? I was handed something and I'm dealing with it," he said. "I told myself, 'I can go back to work. I need to go back to work.'"
It was a watershed decision, though Messer's inspiring optimism is obvious in the choices he continues to make.
"In July, I took a trip to Colorado, where three old friends and I backpacked for four days – llamas helped carry our gear for 20 miles and over three passes of more than 11,500 feet each – in the Eagles Nest Wilderness area of the Rocky Mountains," Messer said. "Backpacking was something that I had done a lot of when I was younger, but had gotten away from it recently. It seemed like the right time to do it again, and my doctors allowed me to take a break from the device for an extended period of 12 days."
In recent months, he booked a flight to visit his 97-year-old grandmother in Iowa, has obtained a home-equity loan to build a garage and is planning a Spring Break ski trip out west.
Clearly the behavior of a man passionately embracing life, rather than passively relenting to the spectre of mortality – no matter how many obstacles are strewn in his path.
"A buddy of mine who was in the Army instilled in me, 'Eyes forward,'" he said. "Rather than looking back, he just kept telling me, 'Eyes forward, eyes forward.'"