“We had to keep moving the appointment times to line them up with the sunrise, and then of course there was daylight savings in the middle,” Krieger said. “The only times I didn’t bike were because of weather.”
In the process, Krieger trekked almost 1,000 miles roundtrip. Depending on the day, different friends came along for the ride. For this last trip, six people joined the pack, including Chris Hall, a friend of Krieger’s who had approached him years earlier with an idea that would be forever tied to Krieger’s own diagnosis.
In January 2014, Hall asked Krieger to help him establish the Breakthrough Bike Challenge, an event to raise money for research at Penn’s Abramson Cancer Center. Just two weeks later, Krieger received his diagnosis, and the ride’s mission instantly became a lot more personal. His initial treatment required surgery, performed by Thomas J. Guzzo, MD, MPH, chief of Urology at Penn. After that, he continued to have blood tests every six months to monitor his prostate-specific antigen levels, or PSA, to look for signs of disease.
By June 2019, Krieger’s radiation oncologist, John P. Christodouleas, MD, told him the elevated PSA levels meant the cancer had returned. After the diagnosis was confirmed, Krieger snuck in one last cycling trip to Montana in late July, then started hormone therapy the day he got back and began radiation at the end of September.
Over the course of the two months that Krieger made his daily trips to Penn, he not only got to know his treatment team and the staff, but also the other patients going through their own care, an experience he says forged a bond among people who would otherwise never have met.
“Everybody walks into the waiting room from totally different backgrounds, different locations, different socioeconomic statuses, different races, different genders,” Krieger said. “But once you change out of your street clothes, all of those distinctions just completely disappear. It doesn’t matter who you are or how expensive your clothing is or what you do for a living.
“Once you put your gowns on everyone is equal. It’s really struck me because the people I’ve encountered are from every conceivable walk of life, but we’re all the same. We’re all cancer patients waiting for treatment and hoping for a cure.”
Krieger says his story shows the importance of PSA monitoring, and he hopes that by sharing it, he can encourage more men in their 50s and 60s to get tested at annual physicals. He also says staying positive and physically active during his treatment helped him combat most of the side effects of treatment. The friends who joined him on his daily rides became his unofficial support group, giving him a lift he didn’t expect and showing him the importance of asking for help as you go through treatment.
“Many patients don’t ask for assistance because they don’t want to be perceived as needing help, but having my family and my riding buddies gave me a huge boost,” Kreiger said.
Just as Krieger’s diagnosis came just weeks after the founding of the Breakthrough Bike Challenge, his final radiation treatment came just weeks after presenting the latest check for money raised during the 2019 event. This year’s ride, held in September, raised $300,000, bringing the total amount to $1.4 million over six years.
The event raises money for pilot grants that fund early stage cancer research. Krieger says these support faculty members with big ideas who can have a hard time getting funding. Once an idea gets off the ground, it can be easier to receive grants from the federal government or larger funding entities. The Breakthrough Bike Challenge is specifically geared toward helping investigators take their first steps.
These projects include innovative ideas to stop cancer from coming back, like using immunotherapy to prevent recurrence in patients with multiple myeloma, a project funded by the 2018 ride and led by Alfred L. Garfall, MD, MS, an assistant professor of Hematology-Oncology. Other projects are geared toward early detection, such as an effort to improve colorectal cancer screening led by Shivan Mehta, MD, MBA, MSHP, the associate chief innovation officer in the Penn Center for Health Care Innovation, funded with money raised during the 2016 ride. And it’s fitting that the research includes projects focused on prostate cancer, including efforts to understand why the disease is sometimes resistant to treatment, a project funded in 2017 and led by Irfan A Asangani, PhD, an assistant professor of Cancer Biology.
All of these projects owe their support to the riders and donors who take part in the Breakthrough Bike Challenge, and the chance to continue to ride in support of the event’s mission now has a whole new meaning for Krieger. He says he’s already looking forward to pedaling toward a cure in next year’s ride, which is set for September 13, 2020.
After his final dose of radiation, Krieger’s wife Kim and his son Ben joined him as he rang the bell in the waiting room, a tradition signaling a patient has finished cancer treatment, and which elicited thunderous applause from everyone in earshot. His daughter Kate, who lives out of town, is flying in for Thanksgiving, which Krieger says will keep the celebration going.
After sharing hugs with friends, family, and members of his treatment team, Krieger didn’t linger. He couldn’t. He had to get to a meeting across town. He took his bike.
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