Recovering From Cancer, George Karl May Return for Second Round

DENVER -- Doctors like fractions and percentages. So the one for cancer-stricken Denver Nuggets coach George Karl provided one Monday both for Karl's coaching return and for his long-term health.

Dr. Jacques Sarri, Karl's personal physician, said Karl definitely will miss the first round of the playoffs. But Sarri put the chances at "two-thirds'' Karl could be back for the second round if the Nuggets advance.

Sarri said Karl's treatment for squamous cell head/neck cancer has been "very positive.'' He said there recently were markers returned from a part of his throat tumor that was sent to Johns Hopkins Hospital in Baltimore, and the results greatly pleased medical officials working with Karl.

"It indicated a very favorable prognosis,'' Sarri said in an interview with FanHouse. "There is a 15 percent chance his cancer may come back after two years.''

That's 85 percent it won't, which is better than the free-throw percentage of every player on the Nuggets except Chauncey Billups (91.1).

Sarri said there are still 12 more tests to get back from Johns Hopkins, but this one was a very good start. Karl also will have a PET scan in about 11 weeks, when it will be determined whether Karl's 1½ months of radiation and chemotherapy treatments that concluded last Wednesday got out all the cancer.



ShareFor now, Sarri sees a chance of Karl, who has missed Denver's last 13 games and 17 of the past 18 while assistant Adrian Dantley has run the team, being able to return during the postseason, which begins Saturday or Sunday. If the Nuggets start at home, it will be Saturday.

"I would say there's a two-thirds chance he would be back for the second round,'' Sarri said. "But that's a rough estimate. There's still a margin of error. ... There is no chance for the first round. He will need the rest.''

Overall, there is much optimism in the Karl camp. His partner, Kim Van Dereaa, said Karl, 58, has shown improvement since the end of his treatments.

"The last couple of days he has been much more interactive. He's still not talking much,'' Van Dereaa said of Karl, who experienced great soreness trying to speak for about a month, which were normal effects related to his treatments. "You can see some improvements. They say that in the first week you don't see a lot of improvement but then in the second week it gets better after that.''

Sarri concurred. That's because chemotherapy drugs are still in the body during the first week.

But Sarri expects Karl to now start making very noticeable improvements, and he's likely to begin eating solid food this week for the first time in about a month. Sarri said the feeding tube Karl had installed March 8 in his stomach could remain there for another three months as a precautionary measure.

Guard Coby Karl, the coach's son who signed Sunday with the Nuggets, said he noticed a big difference in his father just between visiting him Sunday and Monday.

"Just seeing his energy and his face and his demeanor, he's definitely doing better and improving,'' said Coby Karl, who is a thyroid cancer survivor.

George Karl, who overcame prostate cancer in 2005, was diagnosed with head/neck cancer in January and publicly announced his condition Feb. 16. Sarri said Karl's cancer started from a viral infection.

In a statement released by Karl last Wednesday, he said the "past six weeks have been the toughest of my life,'' referring to the treatments. Sarri said that, although Karl's cancer fight was much more difficult than the coach had envisioned it would be, what he endured was not unexpected considering typical results.

"Everybody thinks that they're special,'' Sarri said of patients believing treatments won't be as rigorous as described. "But cancer brings you back down to earth. (Karl's treatment) went pretty much as expected. ... But he's a very strong person, and that helped. He's not your average bear.''

"One of the reasons that George has been doing so well is that he has such a positive outlook. ... He's had his family around him, and now you've got Coby signed up. That's huge.
- Dr. Jacques Sarri Van Dereaa said the lump that had been on Karl's throat, which he discovered Dec. 30 and led him to get checked, is no longer visible. Sarri concurred that is a positive.

Now, Sarri would like Karl to get about three weeks more rest, which is why he might be available for the second round of the playoffs. Sarri said it could unnecessarily wear Karl down if he were to come back for the first round.

The next big medical event for Karl, whose tumor had grown to be the size of a walnut before being treated, will be the PET scan. That's scheduled for 12 weeks after Karl completed his treatments last Wednesday.

"(The scan would show if) there's a residual tumor that was not killed off,'' Sarri said. "If that's the case, he would need a radical neck surgery. It's a very involved surgery.''

However, Sarri said the results gotten back from Johns Hopkins "confirm a good prognosis.'' While there are no guarantees in cancer, Sarri said that makes it "look favorable'' Karl wouldn't have to undergo that sort of surgery.

During Karl's treatment, he suffered from dehydration and had very bad mucus buildup, which required a special machine to treat but which Van Dereaa said is now subsiding. Van Dereaa said the radiation made Karl's "neck look like he was a burn victim,'' and a burn cream had to be applied two or three times a day.

There was one very difficult moment. On March 21, Karl was admitted to the hospital due to blood clots in his lungs and legs, and remained there for four nights.

"That was scary,'' Van Dereaa said, "to have to go to the emergency room. Blood clots in both your lungs, and one in his leg went from his knee to his groin.''

Sarri, though, said the incident is "behind'' Karl, and said it didn't result in any overall harm to his cancer recovery. Reasons for the blood clots included Karl being immobile for long stretches, the chemotherapy affecting him, and a clot in his leg actually related to an old surgery.

Karl has lost between 25 to 30 pounds since he started the treatment, dropping to 262. His doctors, though, don't want him to lose any more because that would weaken him too much.

But Karl is clearly getting better, and every bit helps. Sarri said Karl having learned 1 ½ weeks ago the Nuggets were going to sign his son has had a good effect on the coach's mental state, important for someone battling cancer.

"That's huge,'' Sarri said of the signing of Coby Karl, the first man ever to play for an NBA team coached by his father. "One of the reasons that George has been doing so well is that he has such a positive outlook. If you look on the blog (the family has set up on Karl's cancer battle), he's got pictures with smiles on his face. He's had his family around him, and now you've got Coby signed up. That's huge.

"He's been hoping that they would sign him for two years. It's a dream come true for him.''

Karl has had other reasons lately for his spirits to be lifted. Van Dereaa estimates he's gotten over a thousand cards and letters from well-wishers, and she's not counting ones still waiting to be delivered from his office. She said Karl got a text message from legendary cyclist and cancer survivor Lance Armstrong, and he's heard from "every head coach in the NBA.''

On April 5, about half of Denver's players visited him in different shifts at his Denver home. Van Dereaa said an excited Karl ended up "talking more that day that he had in the previous three weeks.''

"He was in good spirits, cracking jokes,'' said guard Anthony Carter, who went with his wife and two children. "It was just great that he let us come over and visit him in the situation he was in. I know he felt bad about us seeing him that way (his body beaten down from battling cancer). We stayed there 10 or 15 minutes. He told us to get on out of there because he doesn't like people seeing him like that. It just shows he can be a normal person in the way his face and stuff were looking. ... But he was upbeat.''

Karl was upbeat enough last week that he finally started watching Nuggets games for the first time in several weeks. Previously, it had primarily been NCAA tournament games being viewed in the house.

"He wasn't really watching NBA games at all,'' said Van Dereaa. "He just didn't want to stress himself out by watching the games. The last thing he needed was additional stress.''

Karl figures to be in front of the television Tuesday for Denver's season finale, and the team's biggest game of the season. If the Nuggets (53-28) win at Phoenix (52-28), they will clinch the West's No. 3 seed, assuring them of homecourt advantage in the first round of the playoffs. If they lose, they could drop to as low as No. 5 and have to start the postseason on the road.

Obviously, the Nuggets want to have homecourt. That would help their chances considerably of winning a series and perhaps having their coach back on the bench in the second round.

"That would be great,'' Carter said of a possible playoff return by Karl. "He's our leader and we miss him over there on the bench, just his experience, just his rotations and things like that; it's a big difference now. But just by having him over there and hearing his voice, it would make a big difference. Or just him sitting on the bench with A.D. (Dantley), and he can kind of tell A.D., and then A.D. can speak for him. ... It would be a blessing (to have Karl back in the playoffs).''

Sarri says it's possible for the second round. With that in mind, he's hoping the Nuggets will "win one for the Gipper'' in the first round.

Chris Tomasson can be reached at tomasson@fanhouse.com or on Twitter @christomasson