The Indianapolis Colts will have to continue their franchise rebuilding project without head coach Chuck Pagano for the time being. Bob Kravitz of the Indianapolis Star first reported that the team's first-year head man has been diagnosed with acute promyelocytic leukemia.
According to the American Cancer Society, "early diagnosis and treatment of acute promyelocytic leukemia is important because patients with APL may develop serious blood-clotting or bleeding problems. This used to be treated with blood-thinning medicines, but is less often a problem now that treatment includes drugs like all-trans-retinoic acid (ATRA). Other treatments might include transfusions of platelets or other blood products."
The ACS reports that early treatment, which may include chemotherapy, brings remission in 80-90 percent of patients.
"I met coach Pagano last Wednesday when he was evaluated for bruising, and that evaluation demonstrated changes that were consistent with acute leukemia," Dr. Larry Cripe, Pagano's specialist, said at the Colts' Monday morning press conference. "He was hospitalized Wednesday night, and we began treatment at that time. I'm here today because the coach has asked me to be here. He wants to deal with this challenge in a very forthright fashion. Before I explain the treatment and diagnosis in general terms, I would like to emphasize a few things.
"First of all, the goal of the treatment I'm about to describe is to cure the disease. That means that he's returned to a fully functional life -- the life that he's worked so hard to earn. And he's looking forward to leading the Colts to some Super Bowls. However, the process is long and complicated, and we're just starting right now. So, for the next several weeks, the process will be day by day. We'll be vigilant and we'll do everything we can to help him reach a full recovery."
Dr. Cripe then confirmed the diagnosis, and said that the condition is a cancer of the bone marrow tissue. He said that Pagano's bruising happened because his bone marrow was no longer producing the factors that are needed for clotting. Dr. Cripe said that Pagano is in what is known as the "induction phase," which is done when the goal is complete remission and normal blood counts. That process, per the doctor, will last 4-6 weeks. During that time, Pagano will complete chemotherapy and remain on the drug known as all-trans-retinoic acid, or ATRA. He will receive transfusions, antibiotics, and other medications to minimize the side effects and complications of treatment.
Once the induction phase is over, Dr. Cripe said, and it is determined that Pagano is well enough, he can return home and continue treatment on an outpatient basis.
"It's been a very difficult week," Colts owner Jim Irsay said. "Coach was feeling some fatigue over the last few weeks, and noticed some bruising on his body that he first thought could have been from contact on the field, or coaching, or playing with his grandkids. Through talking to his wife, Tina, she said, 'You need to get that checked out, because the bruising appears to be more and more prominent.' We had the coach get fully evaluated, and the conclusion was that he did have leukemia. It's obviously a very difficult blow for him and his family. We always talk about 'God, Family, Football' in that order, and certainly this has been difficult for him and for his family. Knowing Chuck, his first concern is always going to be for his children, his grandchildren, and for his wife.
"I feel with every fiber of my body, and I know Chuck feels the same way, that he can beat this thing."
In Pagano's absence, offensive coordinator Bruce Arians will take over as interim head coach. The 51-year-old Pagano has no known medical history that has ever affected his ability to work as a coach before. He and his wife, Tina, have three daughters and two granddaughters, and his brother John is the San Diego Chargers' defensive coordinator.
Pagano was hired by the Colts on Jan. 25 after Irsay fired former head coach Jim Caldwell. That was just one move in a series of many that put the team on the starting line to rebuilding; the release of quarterback Peyton Manning was the most notable. Irsay interviewed Pagano after the Ravens lost the AFC championship game to the New England Patriots.
When Pagano was hired, his former players in Baltimore had kind things to say about his prospects as a head coach.
"He relates to the players a whole lot," defensive end Cory Redding said of Pagano. "He's almost like a player in a D-coordinator's position. The guy has so much fun with us. He treats you like more than a player. It's like we're his sons. He wants us to do well. He keeps it fresh. He knows everybody's strengths and puts them in position to make plays."
The Colts drafted quarterback Andrew Luck with the first overall selection in the 2012 NFL draft and set about a new path. With Arians, there are more multi-tight end sets, and Pagano installed his preferred 3-4 defensive concepts after the Colts had played Cover-2 and Tampa-2 for years.
Asked before he took the job if he wanted to be a head coach eventually, Pagano said that this was indeed the goal.
"When I was a kid growing up, my dad being a football coach, he asked the same question of all the assistants that he ever hired: 'Is your goal to be a head football coach?' He always said if somebody had answered him, 'Not really, I'm OK just being a position coach,' then I don't think he really wanted him on his staff because he wanted ambitious guys. I think if you ask anybody they'd say yeah. That would be something you always work for and toward."
We will report more news of Pagano's condition as it becomes available.
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