Heart BEAT

Just to get an idea how rare Tim Fuller's cancer is -- one only needs to do the math.

About one in every 200 Americans each year is diagnosed with some form of cancer. The kind of cancer Fuller has only afflicts one in every 10,000 Americans.

But what's worse for the 45-year-old Dayton man and his family than knowing his disease is rare is knowing that there's no way to figure out what kind it is, where it came from and where it's going.

This makes Fuller's oncology treatment a moving target, to say nothing of his life as a husband and father.

"Everything (treatment types) seems to work for a while but eventually the cancer comes back," Fuller said in a recent interview. "And it gets larger each time."

Fuller's cancer is known as CUP or "cancer of unknown primary (origin)," a case in which the malignant cells are found in the body, but the place where they first started growing cannot be determined. About 32,000 Americans - roughly an equal number of men and women - are diagnosed with it each year, though "diagnosis" may be a misnomer.

Having CUP is a bit like having a leak in your roof. You can see where the water is dripping down, but that's not necessarily where the hole is. Each time it rains, the water drips down somewhere else.

Because the location of the primary cancer site dictates the treatment and benchmarks its progress, not knowing where it is (or was) poses a lot of challenges for oncologists and for patients, who often end up feeling the diagnosis was incomplete.

In Fuller's case, he discovered after playing his usual amateur game of basketball one night that he had a lump above his ankle and had it x-rayed. That was in 2007, a few months after his younger daughter Kinsey was born and he and his wife Kelly were in the midst of building a new house.

"It was a bad winter," said Fuller, looking back.

Traditional cancer programs brought it under control in his leg after doctors considered amputation, but then it popped up in his lungs, and in May of this year, it was found on his liver.

No oncologist at the world- renowned Mayo Clinic in Minnesota, nor doctors at a special clinic Fuller went to in Cleveland, Ohio, could locate the source of the cancer cells.

Many residents of the Touchet Valley, particularly in Dayton, know Fuller as the park ranger at Camp Wooten, where he's worked for 16 years.

He grew in the town of Curlew near Republic close to the border with Canada, where he graduated from high school in 1985 before attending community colleges in the Spokane area.

After getting an associate's degree and completing parks management courses, he got his first seasonal job at Sun Lakes State Park near Coulee City. After several more seasonal jobs around the state, he landed his first full-time time job at Knolte State Park in Enumclaw in 1993, then transferred to Camp Wooten in 1996.

He divorced from his first wife in 1999 and his oldest daughter, Courtney, went to live with her mother in Idaho until she came back to live with the Fullers three years ago.

Fuller's health insurance covers a good portion of his actual treatment, but his weekly road trips to his doctors in Spokane, which he estimates at about $400 to $500 a month, come out of his own pocket.

That doesn't leave the Fullers when any resources to spend quality time together when they need it most.

"They've depleted all their funds to do something as a family," said Liz Philips, a close friend of the Fullers who is organizing a fundraiser that will help pay their way to Disneyland.

Philips said his doctors already describe Fuller, who has outlived his cancer for four years now, as a miracle, which everyone hopes will continue. But despite his will to survive, Fuller appears to be one corner from the end of the road.A medication his doctor recently prescribed because it has been successful in other cancers is Fuller's last shot at checking the spread of his disease. After that, there's no "Plan B," as he puts it.

"We're in unchartered territory," Fuller said. "That's why we want to do something while my health (strength) is still good."

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