Firefighters rally for paramedic with terminal cancer

Sarah Fox, with her twins, Alexander and Anika, has been told by doctors she has one year to live.Courtesy photo

By Adam Leech

aleech@seacoastonline.com

April 10, 2010 2:00 AM

PORTSMOUTH — Other than a limp from her recent surgery and a tad bit of nausea from the pain medication, Sarah Fox is feeling fine. She spends her days at home with her 2½-year-old twins and 7-year-old daughter and tries to embrace each little moment as it happens. Because she knows everything is not fine.

Doctors have told Fox, 38, a Canterbury resident and paramedic for the Portsmouth Fire Department since 2000, she has one year to live. There is really no knowing how quickly the cancer could spread from the large tumor attached to her left femur. Surgery is out of the question and clinical studies are being considered. Radiation treatment is under way, but her odds are not good.

So if she gives the twins, Alexander and Anika, a little more slack nowadays, you can't blame her.

"When the kids are naughty, I think this could be one of my last days left, so as naughty as they're being, I know this is an important day. Because it could be one of my last," Fox said. "Then there are days when they're so damn cute. Those days are really hard. It makes me more emotional to think I won't be here to see them grow into adults.

"I have faith I'll be here for their third birthday and that I'll be here for Christmas, because I really can't fathom not being here. ... I feel totally normal. So to get my mind around the fact that this could take over my body in the next year is really crazy."

Dealing with an extraordinary mix of emotions at one time is something to which Fox has become accustomed. She received her breast cancer diagnosis literally hours before the twins were born on Oct. 10, 2007. Fox, who was relegated to helping the city fire prevention and inspection office because she was eight months pregnant, said she went into work and felt "weird." She went home and was in her driveway when her doctor called her with the biopsy results. She had breast cancer. While she had him on the phone, she told him she felt she was going into labor.

Fox and her husband, Matthew, went to the hospital and were sent home, only to have contractions speed up. They went back to the hospital, where Anika and Alexander were born, healthy and chubby for twins. They were ready to go home after five days, but Fox developed pregnancy-induced hypertension, which resulted in a pulmonary embolism and an extended hospital stay.

With the joy of newborns came the fear of the unknown. Because of her unique case — she wanted reconstruction after a mastectomy and to go back to work as a paramedic — he was sent to Beth Israel Deaconess Medical Center in Boston. Because of her embolism, doctors felt it best to do chemotherapy first. But an infection at her biopsy site delayed treatment. Chemotherapy restarted in January 2008 and surgery took place May 20, 2008. Radiation began shortly after, followed by physical therapy to get her ready for the physical demands of her job. By August 2008, she was back on the force.

"Then I started having some head pain. But each time, I thought I had a good explanation," Fox said. "Then, last November, I had an episode where I thought I pulled my groin."

It was not a groin pull. An MRI in March revealed a "significant tumor" on her left femur, and spots on both sides of her pelvis. Eight days later, she had a metal rod installed on her femur to try to prevent a crippling break.

The breast cancer metastasized and is considered triple-negative, a type of breast cancer characterized as more aggressive and less responsive to standard treatment. Doctors hope radiation will knock the tumor down a bit; to at least relieve some of the pain, but trying to remove the tumor would cause it to spread quicker.

"The cancer doesn't respond as well to chemotherapy and, because of that, the prognosis was approximately a year to live," Fox said. "They don't know how aggressive it is, but they know the last time they checked — about a year and a half ago — I didn't have it."

A group of medications called parp inhibitors are in clinical trials, which gives Fox some hope. She's hoping to take part in the trials by summer.

Fox said she feels fortunate to be on disability and still have health insurance. But the first bout with cancer required the family rely on credit cards to cover co-pays and pay many of the household expenses. The couple owns Fox Country Smokehouse in Canterbury, and felt like they were just recovering from the credit mess when the cancer returned. They're trying not to use credit cards this time, and so far that's working, but the busy time at the smokehouse is not until holiday season and the couple are determined to keep their house, even if they can't keep her.

"We're not feeling it yet," she said. "But it's definitely coming."

Sensing the need for a different kind of rescue, her fellow firefighters are raising money by selling special decals made for Fox — $5 for fire helmet stickers, $10 for vehicle decals. The decals can been found on the helmets of firefighters throughout the Seacoast. Rick Condon, president of the firefighters union, said he hopes the Portsmouth community will also donate to the Portsmouth Firefighter Charitable Association, a registered nonprofit created to help firefighters with disabilities.

"Sarah is one of the most respected members of the department, and all of us are looking to help in anyway we can," Condon said. "Firefighters do really well helping people through tragic incidents, but sometimes even we need to reach out and ask for help from others."

Fox said she and Matthew have begun preparing for what they hope won't happen. At 38, she said she never thought she'd feel a sense of urgency to create a will. She's worried about her children. Patia, 7, still cries about missing her grandmother, who died in November 2008.

"Emotionally, I just imagine how this will affect her life. My heart just aches, thinking about it," Fox said. "But in a lot of ways, I think it's easier to be me in this situation than anyone else. Because I'll be the one that's gone."

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