‘Why is this happening again?’ Jack Hoffman’s family faces another cancer fight

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The leaves have yet to turn near the Nebraska sandhills, and Andy and Brianna Hoffman settle into rocking chairs on a white wraparound porch. “Can I hold your hand?” Andy asks Bri, and they clasp fingers. They’re waiting for their son to come home.

It’s a good day. Crickets are holding an afternoon concert with a north wind, and neighbors wave as they pass the Hoffmans’ two-story farmhouse. Whenever someone asks why a lawyer and a pharmacist would choose a remote place like Atkinson, Nebraska, to start a family, the answer is on this porch. Just across the road is the school, and more importantly, 222 steps away is West Holt High School’s football field.

Jack was in diapers when they bought the house, and there was little doubt he was going to be a football player. You don’t put a baby boy in a Cornhuskers onesie without dreams.

But then Jack was diagnosed with brain cancer at age 5. Two years later, he ran for a 69-yard touchdown at Nebraska’s spring game, and the moment took the 7-year-old everywhere, to Los Angeles for an ESPY, to the White House to meet President Barack Obama.

His dad started the Team Jack Foundation, and little old ladies stuffed envelopes for the small-town venture that proliferated into an $8 million fundraising juggernaut for pediatric brain cancer research. (The little old ladies still help out.) In the quiet times when he wasn’t lawyering or running the charity or raising a family, Andy Hoffman would pray. He’d pray that his son, who had undergone two surgeries and 60 straight weeks of chemo, would survive.

And look at him now. It’s around 3 o’clock on the last Friday of September, and Jack emerges from a field, lugging his schoolwork and a corncob head from spirit day. At 5-foot-10 and 180 pounds, he’s bigger than most of the boys in his freshman class. He has his mom’s hazel eyes and humility, and glances at the ground when he notices he’s being watched. Tonight is homecoming, and Jack has a date. His little sisters are curious, but Jack isn’t saying much, only that she’s a friend and that she asked him to the dance.

He’ll probably curse this proximity later tonight, when the music stops at midnight and his parents know exactly when the dance is over because they can hear it.

Here’s the best thing: In a few hours, Jack will play football for the West Holt Huskies. That impossible 222-step journey is complete. Through seizures and nervous trips to Boston for scans, Jack made it. They made it.

They’ll pull close together in the bleachers and watch the boy in the No. 76 jersey on a warm perfect night they know can’t last.

SOMETHING WAS WRONG in July, and Bri was worried. Andy was a little less thoughtful and his driving a little more erratic, drifting over the rumble strips. Always the social one, Andy had begun to withdraw. He started to have trouble articulating what he was trying to say to his clients. He just wasn’t Andy.

The Hoffmans were making s’mores at their cabin near the Missouri River when Andy confided in his older brother Mike that he hadn’t been feeling well. “It’s something deep,” Andy told him, “and it’s something bad.” Andy wondered whether it was depression, because it ran in his family, and he put off going to the doctor because he didn’t want to be prescribed pills. He didn’t really feel depressed either.

On July 19, a Sunday, the Hoffmans were getting ready for church when Andy left without telling anyone. “I know for a lot of people that wouldn’t be unusual,” Bri says, “but it was unusual for our family.” After Mass, they argued. Bri told him that whatever was going on was getting worse; Andy insisted he was getting better. Eventually he promised he’d go to the doctor that week, argument over.

He decided to go on a run. It always seemed to clear his head. Before Jack got sick, Andy carried 275 pounds on his 5-9 frame. On New Year’s Day 2013, he decided it was time for a change. If he was going to advocate for children with brain cancer, he thought, the leader of Team Jack needed to look healthy. So he started jogging, which led to another goal. In 2014, he ran the Boston Marathon.

Forty-one and fit, he frequently ran on the Cowboy Trail, a limestone path that follows the old Chicago and North Western Railway. Two miles in on July 19, Andy’s body went numb and he began to shake uncontrollably. He grabbed his phone and called Bri.

“Come get me,” he told her. “I think I’m having a seizure.”

They rushed to West Holt Memorial Hospital, a 17-bed facility where Jack was born. A CT scan revealed a sea of white in the middle of his brain. Further tests and interpretation would have to come from a bigger hospital, three hours way in Sioux Falls, South Dakota, but the emotional tone from the physician’s assistant in Atkinson was foreboding.

Andy wasn’t going anywhere without his children. If he was going to hear bad news, he wanted his kids with him.

Bri’s sister, Tiffany Miller, is a lawyer in Sioux Falls, and they dropped off Jack, then 14, Ava, then 12, and Reese, 9, at her house that night. Though steeled from nine years of caring for a pediatric brain cancer patient, Bri and Andy are optimists, and on the drive to the hospital found themselves hoping for the best of the worst-case scenarios.

“We couldn’t have possibly imagined how bad the news was going to be,” Andy says.

The tumor had encroached on both sides of his brain. Doctors believed it was glioblastoma multiforme, a very aggressive type of brain cancer. It was not the same cancer as his son’s. It carried an average life expectancy of a year to 15 months.

He wanted to see his kids. COVID-19 protocols wouldn’t allow it. Andy hesitates to say what happened next, because he doesn’t want to get anyone in trouble.

But the hospital, which shall remain nameless, moved him to a place more conducive to sneaking in three children in the middle of the night. Ava and Reese snuggled in his hospital bed while Jack slept on the floor. But he couldn’t sleep.

“I was mostly thinking,” Jack says, “‘Why is this happening again?’

“Sometimes I wonder … Like, a lot of families are affected by a brain tumor. But how many do you see are affected by two?”

THE HOFFMANS WERE almost matter-of-fact in delivering the news to their children: Dad has a brain tumor, and we’re going to get the best doctors in the world to try to beat it.

Andy is a Type A personality who has benefited from persistence. When Jack’s doctors in Omaha told them that most of his brain tumor could not be removed, did Andy give up? No, he researched and vetted and found a surgeon at Boston Children’s Hospital who could. That surgeon, Dr. Liliana Goumnerova, removed 95% of Jack’s golf-ball-sized tumor in 2011, and when Andy was researching his own brain tumor, he called Goumnerova to get her opinion on the doctor who would do his surgery.

Andy decided on Mayo Clinic in Rochester, Minnesota, and was taken there the next morning. But within a matter of days, he deteriorated. The morning of his surgery, he could barely get out of bed. Bri was astonished by the aggressiveness of the tumor. Her husband had just been jogging a few days earlier, and now he couldn’t even say his own name. He’d suffered two strokes and had bleeding on his brain because of the tumor.

“I was afraid it was going to jump out and eat him,” Bri says.

Dr. Nadia Laack, chair of the Department of Radiation Oncology at Mayo Clinic, said glioblastoma multiforme progresses so quickly that patients develop symptoms within weeks rather than months or years. Andy’s tumor was even more aggressive.

He would undergo six weeks of chemotherapy and radiation. Andy would attack it with the same vigor as when he started Team Jack and when he ran marathons. But ultimately, this would be something Andy couldn’t outwork or control.

“Unfortunately, Mr. Hoffman has a terminal brain tumor,” Laack says. “We’ve been very frank with him that this is a very aggressive tumor that at this point our medical community, despite many years of research, has not been able to cure.

“The treatments that we provide are meant to hopefully prolong his life for as long as possible, and also try to maintain his function and quality of life as long as possible. But unfortunately, in the end, most of these tumors will relapse and be fatal.”

Laack said that there appears to be no genetic link between Andy’s and Jack’s tumors. “It’s the most horrendous, awful luck,” she says. She’s been a cancer doctor for almost two decades and could not recall a situation in which a parent and a child were fighting brain cancer at the same time.

She said that in situations when multiple cancers in a household aren’t hereditary, environmental factors are often a cause.

“It’s very hard to pinpoint because the tumors are rare,” she says, “and if it’s something like water or pesticides or pollution or radon or whatever it is, generally you need more than even just one household to have the problem. You need to start seeing more of a community problem.

“There’s not a clear environmental relationship. One of the few factors, unfortunately, that we know can lead to brain tumors is a prior history to radiation. And neither of them, before all this started, had any radiation exposure that we know of.”

LONG BEFORE CANCER, Andy was the emotional one. He is not embarrassed to say he is the crier of the family. Bri is more private and measured.

When Jack suffered a grand mal seizure when he was 5, and only Andy could ride with him on the ambulance to Omaha, Bri loaded a toddler and an infant into her vehicle and drove 3½ hours, not knowing whether her son would live or die.

Her sister Tiffany called her on the way, crying, and Bri calmly answered: “What’s up, Tiff?”

Tiffany was so upset with Bri’s demeanor that she started swearing. “What the f— do you mean what’s up?” Years later, Miller knows why her sister reacted that way.

“You know [the Serenity Prayer]?” Miller asks. “She’s focused on what needs to get done and what she can control.”

The night Bri found out her husband faced a potentially hopeless diagnosis, she cried. It was 2 in the morning. It was only for a minute. She had left the hospital to pick up the children so Andy could be with them, and she called her sister to tell her she was coming and what was happening, and could barely get the words out. Her impenetrable walls came down.

But there was no sign of it by the time she got to Miller’s house. Not in front of her kids.

Brianna Stiner grew up in Burke, South Dakota, a southern speck near the Nebraska border. The oldest of three, Bri was shy and mature. Most of all, she was smart. She forgot her calculator when she took the ACT and still scored a 33 [the maximum is 36].

The rural plains near the Nebraska-South Dakota border could be brutal for a teenager in the winter, but when summer came, they’d go to the river or pile into cars and head to the nearest street dance. Andy first spotted Bri at a dance in Bonesteel, South Dakota, about halfway between Burke and Spencer, Nebraska, where the Hoffmans farmed. It was the summer before their senior year of high school. He asked her to dance, even though he didn’t really know how to dance.

They were seemingly opposites. Andy was outgoing and confident, and always managed to negotiate longer curfews. He was obsessed with football, Cornhuskers football in particular. The Hoffmans didn’t have cable out in the country, and on Saturdays, Andy would hunt down a place where he could find the game on satellite TV. When his big brother Mike walked on at Nebraska, during the glory years in the mid-1990s, that was Andy’s dream. At least it was until he met Bri.

Bri was focused on school, but Andy was persistent. He’d call Tiffany for intel. “What do I need to do to convince your sister to go out with me?” he’d ask.

It took about a year before Bri relented and they started dating. Their timing wasn’t ideal; Andy had committed to walk on at Utah State. They communicated mostly through letters, and after a knee injury, he knew what he had to do. “I left Utah State so I could go to South Dakota to see about a girl,” he says.

He indoctrinated her into the world of Cornhuskers football, dragged her whole family into it, really. Bri pushed him too. In high school, he wasn’t the most focused student, finishing 12th in his graduating class of 24.

All that changed when he came back from Logan, Utah. He wanted to excel in academics, and Bri’s work ethic, he says, was contagious. She was 19 when he bought her an engagement ring, and they were married a year later.

“I felt like I was getting shorter, fatter and balder,” Andy jokes. “I needed to lock it up. When I knew, I figured why wait?”

Andy applied to one law school, at the University of South Dakota, and was accepted. He finished seventh in a class of 90.


THE CORNHUSKERS MET Jack in 2011, in between his first and second brain surgeries. His favorite player was Rex Burkhead, a junior running back whose number graced the back of Jack’s store-bought jersey. Andy emailed Nebraska to see if they could get a picture of Jack with Burkhead, but wasn’t really expecting a reply. Burkhead met them for lunch, took them on a tour of Memorial Stadium in Lincoln and raced Jack on the field. Jack gave him a rubber red bracelet that said “Team Jack — Pray.”

It could have ended there, but then Burkhead wore the bracelet in the Washington game and called on the Friday before Jack’s surgery to wish him well. The Huskers were playing Ohio State that weekend. They fell behind 27-6, and Burkhead tried to fire up a few of his teammates. “Hey, Jack wouldn’t give up,” he told them, “so why should we?”

Nebraska rallied for a 34-27 victory, and Burkhead scored the winning touchdown. A few days later, after Jack’s surgery, he received another call from Burkhead.

“I just wanted to see how he was doing,” Burkhead said. “I didn’t want it to be one of those ‘meet the kid that day, wish him well and move on’ things. I cared about his well-being and wanted to follow up.”

The conversations evolved into a friendship, and on the eve of the 2013 Nebraska spring game, the coaching staff came up with the idea to incorporate Jack into the game.

Jack was a ball of nerves. He thought he was just going to run in front of a few people — not 60,000, six times the amount of people in all of Holt County back home. He wasn’t even sure how he’d stop, because he didn’t know where the goal line was. But Andy was calm and reassuring. He told him to keep running to the fence.

The crowd erupted as Jack raced down the field, flanked by behemoths in red jerseys. “He’s running at midfield …” Huskers play-by-play announcer Greg Sharpe said. “Listen to this crowd!”

The Huskers swarmed Jack in the end zone, hoisting him on their shoulders. Andy stood on the field, trying to find his boy in the pile of red, trying to process what had just happened. That night, when Jack was on SportsCenter and the run was played over and over, it hit the Hoffmans: This was a big deal.

But Jack wanted normalcy, whether he was the only 7-year-old who scored a touchdown at Memorial Stadium or the only second-grader at Atkinson with brain cancer. Andy and Bri would make sure things were as close to ordinary as possible.

There would still be nervous trips to Boston every three months for scans, and a tumor to be treated. Reese, the youngest, has never known a world in which Jack didn’t have cancer. She was 6 months old when Jack had his first surgery.

“We feel like we missed out a little bit on her growing up,” Bri says. “I remember the first time she sat up, it was with my mom. You know what I mean?” She stops herself, because she doesn’t want to make it sound as if she is complaining. She says she’s grateful to have parents who can help, thankful that their daughters are healthy and their son is alive.

Jack has been part of two clinical trials to fight his cancer. The second one, which started in 2018, involves medication used in adults suffering from melanoma. So far, the two-drug combination has kept his tumor from growing.

Dr. Laack, who also treats pediatric patients at Mayo (but not Jack) said brain tumors often stabilize and stop growing when a child becomes an adult.

“We actually want Jack to grow up really fast,” Bri says.

He still takes 22 pills a day and has infrequent complex partial seizures. They can come without warning, which is why he can’t get his learner’s permit to drive.

Jack is nonchalant when he describes the seizures. He says that they usually last between one and five minutes, and that he blacks out and his body is on “autopilot.” He has had seizures while he’s playing football.

West Holt football coach Steve Neptune said the team is prepared. He alerts the officials before every game that if No. 76 is suddenly standing still and not doing anything, they need to stop the play because he’s having a seizure.

Neptune says Huskies assistant Chris Nemetz, along with Jack’s teammates, watch for signs. When it happens, Nemetz will put his hand on Jack’s shoulder, let him know he’s there and walk him to the sideline.

“He doesn’t want a lot of attention,” Neptune says, “and we try to treat him like any other player.

“But we watch him.”

Jack loves football, hunting and his yellow Labrador retriever. Roxy was his Make-A-Wish gift. He named her after a therapy dog he met during chemo.

“He can be annoying sometimes,” Ava says of her brother, “but he’s really thoughtful and he’s really nice. Like, he’ll usually let me have the last piece of cake. He buys me gifts with his own money.”

THE HOFFMAN CHILDREN call Andy “Mr. Fun” because he plays loud music, makes them homemade ice cream blizzards and lets them stay up late. Because of Jack, Andy has never taken anything for granted. Want to see Disney World? Let’s go. Want to go hunting? No problem. Andy would take a week off and shoot deer with Jack, Ava and Reese.

“He was a great dad before that,” Mike Hoffman says, “but after Jack’s diagnosis, he turned into a phenomenal dad. Have you heard the song ‘Live Like You [Were] Dying’? He did that every day.”

For years, Andy wanted to write a book about Jack’s journey, but he never had time. Eleven months ago, he made it a 2020 New Year’s resolution. He wrote at night, when the kids were in bed, and was so busy he wound up having to dictate part of it. He wrote 70,000 words and hit the send button to his publisher this summer. Two weeks before he got sick.

“I said, ‘I want to finish it by the first quarter [of 2020],'” he says. “I wasn’t done, so I gave myself an extension. I said, ‘OK, by the second quarter, you’ve got to be done, Andy. Because this is bulls—.’

“That was a pure God thing. You know what I mean?”

THE HOFFMANS AND Stiners aren’t so much in-laws as they are a giant Midwestern anti-cancer cabal. When word hit in July that Andy was at Mayo Clinic, and that he had brain cancer, they deployed — grandparents, siblings, nieces, nephews and cousins. Everyone had to get to Rochester.

They wouldn’t be able to sit at his bedside — because of COVID-19 — but they could wait at the hotel and take Jack, Ava and Reese to the park or the pool. They could be there for Bri. Visiting hours ended at 6, so every night, they’d stand outside the hospital until Bri came out. They’d walk her “home.”

Ava started making posters. If Andy went by the window, maybe he’d see her out there, waiting and hoping. Bri worries about Ava. She knows how hard it is for her.

Ava is bubbly and full of energy, just like her dad. She wants to do anything to help. When she had to give a speech in school once about what she wanted to be when she grew up, Ava’s answer was easy: neurosurgeon. Ava plays many sports, but she took up running during the pandemic and jogged with her mom until she got too fast for her mom. She decided to join the cross country team.

The children stayed in Rochester until mid-August, but then school started. Bonnie and Kerry Stiner — Bri’s parents — stayed with the children in Atkinson while Andy’s parents kept watch in Rochester.

Ava won the first meet she ever competed in, and a teammate called the Hoffmans so they could watch her cross the finish line on FaceTime. Andy gets emotional when he watches Ava run. She’s doing what he can’t.

Andy worked so hard in physical therapy, and responded so well to treatment, that he went home in mid-September. He had Mayo Clinic staff in tears as he walked out on his own and waved goodbye.

For a few weeks, he had a string of very good days. He went to the cabin and watched his kids play near the Missouri River. He hiked four miles with his family in the Black Hills.

Burkhead, a running back for the New England Patriots and a board member for Team Jack, called, and he and his wife, Danielle, prayed with Andy and Bri.

“Andy’s a fighter,” Burkhead says. “He has unbelievable positivity and toughness.

“Just his mindset about the whole thing is so inspiring and impressive to me.”

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1:47

Andy Hoffman reflects on the morning he was diagnosed with a brain tumor.

THERE WERE TIMES early this fall when Andy did not look like a man with terminal brain cancer. He was doing physical therapy, meeting with his pastor, and walking and talking like any other parent at West Holt High football games. He’d occasionally have trouble getting a word out, but it was barely a blip.

Sept. 25, the day of homecoming, Andy and Bri drove 70 miles to the Ord Invite to watch Ava run on a golf course. She won the meet, then they headed back to Atkinson for the football game. The Huskies cruised to a 62-18 victory against Ainsworth, and Jack came off the bench and played on the offensive and defensive lines. He’s a center, just like his dad.

After the game, he put his arm around Andy and Bri, then got ready for the homecoming dance.

Jack’s birthday was the next day, and Andy walked down to the basement late that night to retrieve his son’s gift, a .300 Winchester Short Magnum rifle. He’d just put a new scope on the wood-grain stock gun. But Andy fell in the basement and couldn’t get up. He had to call out to Bri for help.

“You don’t feel very far from death when you feel like that,” Andy says. “But then there’s mornings when I just feel like I could tackle the world.”


IT WAS A chilly Saturday, the morning after homecoming, and Reese crawled into her mom’s arms as she sat on the porch. She was trying to gather gossip on her brother’s homecoming dance. Bri said when the music had stopped around midnight — the dance was held outdoors because of the pandemic — Jack didn’t initially answer his texts, and Bri pondered walking up to the school to check on him.

“Nooo!” Reese said as Bri told the story. “He was talking to his friends probably, Mommy.”

Thankfully, Bri thought better of it, and Jack got home around 12:20 a.m.

Reese does not fully understand what is happening to her dad, and sometimes, when Bri tucks her in at night, Reese will get scared and say, “Don’t leave me.”

NO ONE, ADULT or child, can fully understand what’s happening. A 15-year-old son shouldn’t have to help his dad shower or use the restroom, but during Andy’s worst moments, that’s what Jack has had to do. He has gone from patient to caregiver.

The highs shouldn’t be immediately followed by extreme lows. In October, Andy felt so good that he wanted to start running with Ava. Then one morning, he woke up and couldn’t walk. He vomited four times and was back at Mayo Clinic the next day. An MRI revealed two new tumors. He underwent five days of radiation, hoping that the tumors would respond and that he would get more good days.

He recently sold his law practice, three offices that he’d spent his life building. He had no choice. His cognition wasn’t there for what Andy calls “heavy client matters.” He wouldn’t want to jeopardize anyone’s well-being.

He says he vacillates between hopeful moments and grim reality. He thinks about the things he’ll miss, the games and graduations. He starts to cry when he thinks about not being able to walk his daughters down the aisle at their weddings. Then he stops. He has never been a man who gives up.

“This is going to sound screwy, but it’s been a blessing,” he says. “We’re supposed to thank God for the challenges that he gives us, and I’ve prayed the thank-you prayer. Thank you, God, for giving me brain cancer.

“Because he knows what he’s doing. And you don’t.”

The latest round of radiation has helped Andy get some of his mobility back. Next week, he will have a consultation about an Optune cap, which delivers alternating electric fields to slow a tumor’s waking-up process after radiation. He would have to wear the cap 18 hours a day.

“It’s going to be a pain in the ass,” he says, “but the way I view it, it’s for the kids.

“We’re staging another comeback.”

His book, “Yards After Contact,” was released recently, and all proceeds go to Team Jack. The book already has raised $20,000 for research into pediatric brain cancer. It’s his legacy. He was supposed to have a book signing, but COVID-19 cases spiked in Nebraska and the event was canceled.

So he sits in their farmhouse, signing books with a black Sharpie. The air will turn colder, the sky will get darker, but Andy can still see his future from his front porch. He wants to go to Florida in January. They’d planned that trip before his diagnosis. He wants to see Burkhead play in New England, and Jack play his sophomore season across the street.

“I need to keep myself busy,” he says. “I don’t want to sit around and die.”

ESPN’s Chris Connelly contributed to this report.

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