Chondrosarcoma Diagnosis Doesn't Stop Strongman

Zac Craig trains hard every day and competes in Strongman events. He’s also an athletic trainer/strength and conditioning coach and teacher at Lansing High School, where he was the 2016 Teacher of the Year.

He’s even served as a strength and conditioning coach for the Minnesota Vikings National Football League team and worked with the Louisiana State University Tigers during its football championship season in 2007.

It’s good that the Kansas City, Missouri, resident knows a little something about working hard and training harder – because these experiences prepared him for his toughest challenges yet: overcoming 2 types of cancer.

Double whammy

Zac overcame a diagnosis of melanoma when he was 24. Now 34, he has beaten the odds against chondrosarcoma in his shoulder. Chondrosarcoma is a sarcoma, or malignant tumor, of connective tissue. It’s also difficult to treat because it’s resistant to standard treatments such as chemotherapy and radiotherapy.

Problems began in January 2014 when Zac injured his left rotator cuff, a cluster of muscles and tendons that stabilize the shoulder.

“During one of my competitions, I hurt my shoulder and had to have surgery,” he says. “In Strongman, it is not a matter of if you are going to get hurt but rather when you are going to get hurt. I had chronic pain in my shoulder due to a torn rotator cuff because of the type of training I do, and finally I decided to have surgery.

“Within a couple of months, my doctor noticed it was healing like it should but I was still in plenty of pain. After an MRI, I was told I had bone cancer and was referred to Dr. Howard Rosenthal at The University of Kansas Cancer Center.”

Howard Rosenthal, MD, orthopedic surgeon specializing in sarcoma treatment, confirmed Zac’s diagnosis. Together, they decided the best treatment was to freeze the tumor and bone with liquid nitrogen. Dr. Rosenthal performed the procedure, which involved drilling into the bone, injecting it with liquid nitrogen and waiting for the cancer cells to die while healthy cells regenerated.

“I thought I was recovering well. I was getting back to lifting and trying to get back into a modified routine,” says Zac.

“I thought he was doing great, too,” shares Dr. Rosenthal, “but his CT scan delivered other news.”

The scan indicated that the cancer had returned. Dr. Rosenthal and Zac quickly made extensive plans about how to deal with the tumor that had grown back.

Sophisticated sarcoma treatment

In May 2016, Dr. Rosenthal performed a complicated surgery that would remove the cancer and spare Zac’s arm function. Technically, the procedure was a radical en bloc resection of the left shoulder blade with reconstruction, using a custom-designed left total scapula replacement and reverse shoulder replacement.

What Dr. Rosenthal did was remove the left shoulder blade and cartilage around it and reconstruct a new one, using a mirror image of the right one. “This new version is not an exact replica; it’s better. Any imperfections that could cause problems later were removed in this version,” explains Dr. Rosenthal.

“We reattached 27 muscles and I expected him to have up to 30 degrees of range of motion,” Dr. Rosenthal adds. “It’s a very rare procedure, and we are one of the only facilities in the country doing work like this.”

When Zac came in for the first follow-up appointment after his surgery, he and Dr. Rosenthal compared notes about his recovery. “Dr. Rosenthal had told me my goal was to lift my arm to my waistband but he wanted me to push myself as much as possible. I told him I could do full sets of 20 pushups. He told me to prove it. So I dropped to the floor and did it. Right there!” Zac says. “Dr. Rosenthal is great! He’s a brilliant man and saved my life. But I think I surprised him a little.”

“We expected the procedure to cure him of the disease and give him good, functional movement. He shocked us with his outcome,” says Dr. Rosenthal. “I’m in awe.”

Staying strong as a sarcoma survivor

After more discussion about Zac’s physical capabilities, Zac promised to video himself in the weight room during his training, which far exceeded standard physical therapy.

“I admit it. It hurt  ̶  bad! The rehab was intense. Other rehabs I’ve had (ACL, shoulder, etc.) didn’t compare to this. But I knew I had to bear down and get it done. I wanted to get back to being myself,” says Zac.

Dr. Rosenthal says Zac’s chondrosarcoma prognosis is great. He will continue to see Zac for follow-up appointments for 5 years. Zac looks forward to spending more time with his wife, Chelsea, and 2 sons, age 3 and 5 months. He also plans to resume Strongman competitions in August 2017 as well as a duathlon this summer.

Zac also hopes to eventually go back to school to become a nurse.

“I love what I do, but I want to work with others like me. I know that having had cancer will help me help others. It’s not just physiological care that patients need; they need someone who understands them too,” says Zac. “I had that when I was at The University of Kansas Cancer Center. My care couldn’t have been better. Everyone was courteous, took their time with me and relieved my fears, anxieties and stress. It’s a great place to be when you need cancer care.”