Dialog reporter
Diagnosed with leukemia in June, Nick Pautler has been getting a first-hand education in health care
WILMINGTON — A year ago, Nick Pautler was looking for a sport that he would enjoy when his grandmother signed him up for a camp at the Wilmington Youth Rowing Association. And while his initial experience at the WYRA has been cut short for now, his time there may end up saving his life.
The fall season seemed normal, but when he began his winter training, Pautler noticed some pain in his hips. He was checked by an orthopedist, who diagnosed some problems with his hips, but nothing he couldn’t work through. So Pautler adjusted his mechanics to alleviate the discomfort and enjoyed a successful spring season, with his team winning a regional championship in Princeton, N.J., in May.
“That was just crazy that weekend,” said Pautler, now a senior at St. Mark’s High School. “I was studying for an AP test, I had a research paper due, and there were regionals.”
More pain followed, this time in his quadriceps. He thought it was from rowing, but he went to get checked again, just to be sure. A doctor at Children’s Hospital of Philadelphia confirmed the hip impingements, but the doctor wanted to see an MRI, which caused concern. Blood tests looked normal, so Pautler had a bone-marrow biopsy. On the Friday after Memorial Day, he received a phone call and learned the diagnosis: acute lymphoblastic leukemia type B.
Within days, he was getting treatment.
“During the summer is pretty much just … I was admitted, I got out. I was getting chemo,” Pautler said.
His mother, Maria, a St. Mark’s graduate, gave him the option of taking a break from high school, but he wanted to be at school. St. Mark’s has worked with him to accommodate his medical needs.
“I’ve just had days when I’m so tired that I can go to school and I can go home, and that’s it,” he said.
When he was admitted to the hospital during the early part of the school year, he called into his classes via Facetime. His friends have helped by carrying his things when he needs a break, and they have distracted him from thinking about his leukemia.
He is leading as normal a routine at St. Mark’s as he can. He is involved with the yearbook and is vice president of the psychology club. He participates in the Senior Service Club, Spartan Morning News and the Key Club, and he is the editor of the school’s literary magazine, Markings.
Pautler, 17, a Newark resident who attended Immaculate Conception School in Elkton, Md., said he was lucky to find out about the disease. The pain he experienced during rowing turned out to be crucial.
“I think I’m better off than the average cancer patient because the only time they discover the cancer before you get symptomatic is if you’re getting tested for something else,” he said.
And rather than just go through treatment, Pautler has “tried to make the process of treatment a learning experience and not just kind of accept it.” He said he has always been good at math and science, and he and his doctor in Philadelphia have had lengthy discussions about leukemia and why certain drugs work and cause various side effects.
“I want to know what’s happening to me,” he said.
Pautler said there is still detectable leukemia in his bone marrow, and the chance of relapse is significant. At Children’s Hospital, he is undergoing immunotherapy, which involves “engineering patients’ own immune cells to recognize and attack their tumors,” according to the National Cancer Institute at the National Institute of Health, and CAR T-cell therapy. That is a more experimental approach that takes a patient’s T cells, which are then engineered “to produce special receptors on their surface called ‘chimeric antigen receptors’” (CAR). The CAR cells are grown in a laboratory, infused back into the patient’s bloodstream, and if the infusion goes as planned, the T cells multiply, then recognize and kill cancer cells, the National Cancer Institute says.
“In some people, it keeps the leukemia gone for good,” Pautler said, “and in other people it comes back in three months.”
Without that option, however, he said he would be looking at a bone-marrow transplant.
At St. Mark’s, Pautler is enrolled in the health science class being taught by a University of Delaware professor, and he will take another in the spring. He hopes to do something in health care.
“But I’m not the type of person who would be seeing the patients,” he said. “I’d be the doctor who is doing research or tests.”
He said his college search will likely be close to Philadelphia so he can be near his medical team. He hopes to begin college next fall but may take a year off to finish treatment.
“Whatever I can do to stay alive.”
