Tammy and Ryder Marshall wait for Dr. George Poore to call them into his office, where he will remove a subdermal port in Ryder's chest that was used to administer chemotherapy to fight Hodgkin's lymphoma. NEWS&GUIDE PHOTO / PRICE CHAMBERS
 

If I ask you a question, will you tell me the truth? Ryder Marshall asked his stepmother.

Yeah, Tammy Marshall replied.

Am I going to die? the 11-year-old asked.

You heard what the doctor said.

Flash forward a year.

As an oncologist in Rexburg, Idaho, made small talk, Tammy released the breath she hadn’t realized she was holding. Then the words came.

The cancer was gone.

On May 3, 2007, Ryder was diagnosed with Hodgkin’s Lymphoma. He was in stage 3 of 4.

Eighty percent of kids survive, the doctor said.

What happens if I don’t do this chemo? Ryder asked.

You will die, the doctor said.

So Ryder did the chemo. He lost his hair. He lost his eyelashes. His face swelled from the steroids. His skin paled.

He stayed inside on summer days, sometimes in isolation from all but his immediate family. When he was allowed to play baseball, he couldn’t sit in the dugout with his team, the risk for infection too great from the treatment that pummeled his body.

But that was last summer. And as any preteen knows, a year is a long time.

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Tammy Marshall and Dr. George Poore welcome Ryder back to the waking world after the minor surgery to remove the port in his chest. Ryder sits up with a smile, knowing he's beaten his cancer. Although he doesn't remember the procedure, he's excited. "My buddies stopped calling me the three-nippled man," he said. NEWS&GUIDE PHOTO / PRICE CHAMBERS

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On March 6, Ryder struggled to sit still in the office of Dr. George Poore. He flipped his phone open and closed. Doctor offices still made him nervous.

But unlike the dozens of other visits, this was a good one. In his chest, a puckered circle raised against his skin, pushing from underneath, a tube threading from it across his chest.

 Today, the port used for chemotherapy would come out, meaning doctors were confident he wouldn’t need it anymore.

A nurse squirted medication into his mouth to help him relax.
Ryder’s face scrunched in disgust.

“It’s like they attempted to duplicate cherry but didn’t make it,” he said.

Ryder knows medication flavors. In the past year he has tasted them all, including root beer, pina colada and grape. All are bad, he said.

But soon the medication took effect, leaving Ryder slurring and stumbling.

“Can we get some of this to go?” he asked as he was ushered to the back room.

His eyes glazed as he held Tammy’s hand. She watched as Poore began to cut.

“Your eyelashes are all long and thick again.”

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Tammy and Ryder’s father, Kevin Marshall, prickled with worry, hardly saying a word on the drive to the Rexburg doctor’s office. But the news May 27 was good. Ryder was officially cancer-free.

Ryder was “overwhelmingly confident.” He can’t explain why, but he knew he was done with cancer.

With his clean bill of health official, Ryder put his illness behind him. He no longer thinks about it, he said.

The things he longed for – getting back to school, being able to work outside – lost their novelty within a week.

He doesn’t remember not having hair, but just months ago he was a ghost of himself in appearance and stamina, his skin translucent, his face bloated.

His brother Chance returned from college to find the healthy little brother he hadn’t seen in more than a year. Ryder’s hair had grown back dark, his color had returned, and he’d gained 15 pounds but looked leaner, shooting past 5 feet tall. He was ready and able to go to the lake, excited to be outside.

He doesn’t know how, but Ryder says he knows he won’t have cancer again.

Now he’d much rather talk about girls – he exchanged more than 300 text messages with one in only a few weeks –  than cancer.

Throughout Ryder’s treatment, he was self-conscious about his hair loss and weight gain.
“Now he’s a little Casanova in middle school,” Tammy said.

The only physical mark cancer has left is a thin scar on Ryder’s neck from a biopsy when he was first diagnosed. But when people ask about it, Ryder avoids a serious conversation with a wild story, saying the scar is his “chick magnet,” a battle wound from a knife fight.

Some people even believe it, Ryder said.

The scar is now indistinguishable from rope burns, bruises and cuts he’s gotten roughhousing with friends. They gather in his room, the new epicenter of his social life with a 50-inch flat screen TV with surround sound. The bass is so intense it can shake things in the kitchen. Behind the massive system is a Make-A-Wish banner, a single clue someone here had cancer and a reminder of where he got the setup.

Ryder plays video games simulating playing music on guitar by REM and Metallica, his fingers flipping over the buttons as he conquers the expert level. His older siblings take turns and sometimes sing along. Sometimes Ryder has to kick the older ones out of his room, he said.

And despite complaining last summer about being trapped inside, sometimes his parents have to kick Ryder out of his own room and make him play outside.

At first Ryder’s parents worried about his denial of having had cancer.

But now they see it as a way for him to move forward, Tammy said.

Ryder’s oncologist, Jeff Hancock, said families should retain as much normalcy as possible and focus on the future. Kids shouldn’t feel like cancer is a scar they will have forever.

But there are ways cancer will follow him.

Chemotherapy creates a heightened risk for other types of cancer in the future, Hancock said.

Ryder will see a doctor for chest X-rays every three months for the next two years, Tammy said.

Then he’ll see a doctor every six months until he hits the five-year cancer-free mark.

His parents make him give his own medical history each appointment as practice for when as an adult he’ll see doctors without his parents.

He has learned to check in with his body and catch any changes.

Hancock uses the term “cured” after a child has been cancer-free for a year since treatment.

There is a 10 percent chance of relapsing, but of those who do relapse, most can be treated back to remission, he said.

Hodgkin’s lymphoma is one of the most common kinds of childhood cancers, although the cause is unknown, Hancock said.

Tammy has accepted there isn’t a reason why Ryder got cancer.

But she thinks twice now about things like bug repellent or certain cleaners she uses in the house.

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Ryder does cartwheels down the third baseline during a game at the Alpine Field on June 4. Just a year ago, Marshall couldn't sit with his teammates as his condition made him more prone to infection. NEWS&GUIDE PHOTO / PRICE CHAMBERS

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On a summer day Tammy and Kevin, who were married in June, went for a walk.

They knew their wedding not only marked them as husband and wife, but also served as a symbol of normalcy, as everyone in the family was healthy enough to celebrate a life milestone. Ryder was allowed to invite several friends, and they had their own party while the adult guests danced at the reception.

As the couple walked, talking about the wedding and the rest of the summer, they stopped beneath a chokecherry tree in bloom. The scent hit them.

Do you remember this tree smelling this good last year? Kevin asked.

The tree probably smelled the same as it did the year before, but the couple had too much on their mind to notice, Tammy said. But now, everyone in the family has a clear enough mind to notice the small, mundane, yet beautiful details of life.

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Read more about Ryder's battle with Hodgkin's lymphoma here in a story from the Aug. 15, 2007 edition of the Jackson Hole News&Guide.

//onblass.com/news1 

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