Sarcoma Doesn't Sideline Football Player's Dreams

Hayden Carroll thought he had a simple cyst. In June 2023, the college freshman noticed a lump on his upper arm. Yet as a healthy, athletic 18-year-old, both he and his parents assumed it was nothing serious. They were wrong.

Now, after an unexpected journey that threatened to derail Hayden’s burgeoning college football career, the young athlete is back on the field not only as a quarterback – Hayden is a cancer survivor, and it was his treatment at The University of Kansas Cancer Center that put him back in the game.

After Hayden discovered the lump, he visited his family physician in Jefferson City, Missouri, who diagnosed the lump as an unconcerning cyst and scheduled a simple outpatient procedure to remove it. Under local anesthetic, Hayden was alert when, during the procedure, his physician paused.

“Mid-procedure, the doctor and the nurse just stopped,” remembers Emily Carroll, Hayden’s mother, who was also present in the procedure room. The medical team immediately knew after making the incision: The lump was no mere cyst. The physician continued to remove the growth, sending it to pathology for testing. The results were devastating.

Hayden’s lump was a cancerous spindle-cell tumor. “You hear about this stuff, but you never really expect it to happen to you,” Hayden says. “They told us not to look into Google too hard,” Hayden recalls after receiving the initial pathology report. Emily ignored that advice and found that her son’s rare diagnosis was “terrifying.” Making the situation even more frightening was the discovery that cutting into the tumor potentially spread the cancer cells.

Seeking expertise in sarcoma care

At that point, the Carrolls sought help at The University of Kansas Cancer Center, the region’s only National Cancer Institute-designated comprehensive cancer center and 1 of fewer than 60 nationwide. Initially, they met with medical oncologist Benjamin Powers, MD, and orthopedic oncologist Howard Rosenthal, MD. As medical director of the cancer center’s Sarcoma Center, Dr. Rosenthal brings more than 30 years of experience to the treatment of bone and soft-tissue sarcomas.

Hayden’s father, Jay, recalls being immediately impressed with the physicians’ optimism and ability to offer treatment options. Emily adds that the cancer center’s nurse navigator was crucial in helping the family understand what was needed for appointments, information-sharing and next steps as they began the treatment journey. “(Drs. Rosenthal and Powers) were so relatable,” Emily says. “They talked to us … they never made us feel they had somewhere else to be.”

“I say all the time, my patients inspire me,” Dr. Rosenthal declares. He explains that the greatest problem with sarcomas, a group of cancers affecting the musculoskeletal system, is the difficulty in diagnosis. Most lumps on the body are harmless, as Hayden’s physician believed initially. With no additional symptoms, no standard screening or blood tests and no specific risk factors, sarcomas can be overlooked or misdiagnosed. Hayden’s age made the diagnosis even more surprising because most sarcomas are found in older people.

Saving lives, saving limbs

Hayden’s care team at the cancer center immediately began treating his spindle-cell sarcoma, an aggressive form of connective tissue cancer. The primary treatment for this type of cancer involves surgery to remove the tumor completely along with tissue from a wide margin around the site̶̶̶ ̶ ironically in Hayden’s case, removing tissue in the shape of a football. Hayden’s surgery left him with a scar, a reminder of his ordeal and a symbol of the sport he was determined to continue playing.

“Our main goal is to save life, and the secondary goal is to save limb … the second goal is also to preserve function,” Dr. Rosenthal says. While it’s important to remove all the malignant cells, it’s also important to save skin and muscle so the patient can regain function. “Well over 95% of cases we do in a limb-preservation fashion, which means salvaging the limb with a good functional outcome.”

Sarcoma treatment is a newer field in cancer care, developing over the past couple of decades. Dr. Rosenthal has been there through it all, from the development of prosthetic reconstruction to new techniques that enhance the ability to salvage limbs and leave the patient cancer-free. “We are, in fact, curing most of these cancers, and we’re doing it in a personalized fashion,” he adds. This personalized approach means patients’ lifestyles are considered when deciding on treatments to manipulate muscle, skin and even nerves.

“Even if we have to do an amputation, we can do certain procedures during that amputation to prevent phantom limb pain,” Dr. Rosenthal notes. Children can receive prosthetics that will grow with the patient. “For a patient like Hayden, who’s going to use that arm pretty aggressively, more so than the average person, we’re going to do it in such a way that those muscles are going to be stronger and are not going to be at significant risk of rupture or any kind of damage at all. So, it’s all tailored to what that patient desires for their life.”

Immunotherapy, molecularly targeted chemotherapy drugs and radiation therapy are additional treatment options discussed by patients’ care teams at weekly meetings, where sarcoma specialists share information and develop specific multidisciplinary plans.

For the love of the game

Hayden healed quickly, and after a couple of months he was able to use his arm as before the surgery. “The mom in me wanted to protect him and have him in a bubble,” Emily adds. “But Hayden had other plans, making it clear that he was not giving up the game he loved.”

“I didn’t know if any of the schools were really going to want a quarterback that had cancer,” Hayden recalls. After visiting several colleges with his father on a road trip, Hayden stopped at Southwestern Oklahoma State University, a Division II college about 40 minutes west of Oklahoma City. SOSU football coach Andrew Rice met with Hayden and immediately knew “This is somebody I’m really going to be able to push because he’s already overcome something that’s far bigger than just the game of football … With college football there’s a lot of adversity and mental toughness required, and he checks those boxes.”

Hayden joined the team as quarterback, and while he looks forward, he also recognizes what his cancer journey means for his personal growth. “I don’t know how I couldn’t be grateful for it,” he says. “I spent my entire life playing football, and it helped remind me of why I do it and why I love it … I was lucky I could find doctors I trust at The University of Kansas Cancer Center… Just keep going in life, and you’re going to get where you’re going.”