MOREHEAD CITY — Craig McClanahan had a pretty good idea of what his retirement after 36 years of teaching would look like.
The 21-year West Carteret boys basketball coach, who retired after the 2018-2019 season, knew it would include a lot of golf, yardwork and long afternoons at Cape Lookout. What the 59-year-old did not expect, however, was a stage IV non-small cell lung cancer diagnosis three months after it started.
A gym rat and a non-smoker all his life, McClanahan was caught off guard by the discovery.
“I’ve never smoked,” he said. “I’ve exercised and taken care of myself my whole life. How does someone like me get lung cancer? It turns out 20 percent of people with lung cancer were non-smokers. There are so many things in your environment that could cause something like this, but you’ll never know exactly what it was. What I’ve learned about cancer is, it doesn’t discriminate. And it humbles you quick.”
Down to 160 pounds, McClanahan is lighter now than he was at his high school graduation in 1978. The growth of fluid around his lungs is finally subsiding, allowing him to manage daily activities a little easier. The first part of his battle in the books, the father of one looks comfortable on his couch with wife of 34 years, Jacqueline, his demeanor placid as he works to save his energy for the conversation.
“I feel good,” McClanahan said. “We’ve got a better handle on it, and (the doctors) have got a better handle on it. I’ve been given the OK to do what I’m comfortable with physically. That includes going to Sports Center or even getting back to golfing in the spring. The problem now is, my endurance level. I’ve just now gotten to where I can stand in the shower the whole time.”
The Newport native isn’t yet jumping to any sort of recovery conclusions, but his outlook is decidedly better than it was a month ago. That’s owed to a relatively new medication, osimertinib (Tagrisso), which targets non-small cell lung cancer patients with a rare (10 percent) epidermal growth factor receptor (EGFR) mutation. Switching from traditional chemotherapy to the once-a-day pill was a risk, but one that has so far paid off.
“We had the hard decision to make,” Jacqueline McClanahan said, “between continuing traditional chemotherapy, which was really hard on him physically, or stopping that altogether and switching to the EGFR pill.”
McClanahan added, “You’ve got a one-shot deal with that. It could go either way. So, we rolled the dice.”
Events move quickly after a cancer diagnosis, but first, the cancer has to be discovered, something easier said than done. The first indicator that something was amiss came in a September physical. Annual tumor markings had never returned any flags, but this year, McClanahan’s human chorionic gonadotropin (hCG) number was at 32 instead of the standard healthy 0.
“I went back in the next week and took another blood test, and the number was already higher,” McClanahan said.
The next red flag was symptomatic with him suddenly unable to keep up with his routine workout. The drop in stamina transitioned to struggles with more basic activities.
“I started losing my breath, and simple things had me winded,” McClanahan said. “I just couldn’t catch my breath. It felt like I was running a marathon.”
The next step for McClanahan was a series of blood tests and MRI, CT and nuclear bone scans to determine the source of his hampered breathing and the climbing hCG number, all sandwiched within a month between his first imaging appointment at Carteret Health Care and a visit to an endocrinologist at Duke Hospital. A diagnosis of pneumonia in November proved wrong, but it led to further tests, in particular the fluid buildup that was restricting his breathing.
“When I couldn’t push the golf cart anymore, that’s when I started having lung taps to get the fluid off my lungs,” McClanahan said. “The fluid was literally pushing my lungs down.”
Unlike the previous blood tests and scans that came before it, the test on the fluid around McClanahan’s lungs came back positive.
“(The doctor) said it had malignant cells in it,” McClanahan said. “I asked him, ‘What does that mean?’ He told me it meant there was cancer in the fluid, and it was outside the lungs which means it had metastasized. I still didn’t know what that meant for me, and he had to spell it out, ‘You have lung cancer.’”
In a cruel twist of irony, Jacqueline, who was by her husband’s side for every single appointment, was due to substitute teach at West when McClanahan received the news. Still in shock himself, all he could do was text the news in a brief message.
“I went numb,” Jacqueline said. “I went into shock. At that point, I didn’t know what stage it was or anything, but my mind was racing.”
McClanahan added, “It has brought Jacqueline and I closer together. We’re each other’s best friend. You think you’re going to grow old together and sit in your rocking chairs on the front porch together. Then something like this happens, and you realize you may not make it to 70. You might not make it to 60. It’s tough.”
This isn’t Jacqueline’s first brush with cancer care either, as her father was also diagnosed with a brain tumor. In addition to caring for her husband, she records every visit, every dose of medicine and every shred of information associated with the disease.
“She’s my primary caretaker,” McClanahan said. “I couldn’t ask for anything better. I’m pretty independent. I don’t usually ask her to do as much as she’s had to do for me in the last four months. It’s a difficult think to adjust to.”
The cancer diagnosis came six weeks after McClanahan’s first physical in late September. Twelve days after the diagnosis, he was having a drain put in his left side, a device that could be used at home. Three days after, that was the first of his recommended four to six chemotherapy sessions.
Despite waning health, McClanahan was able to attend his son Michael’s college graduation in December at East Carolina University.
“I was bad off, but they drained my lungs on a day when they normally wouldn’t so I could make the trip,” McClanahan said. “Carteret Health Care has really been wonderful with us. The doctors, nurses and workers, they’ve all been great.”
McClanahan’s diagnosis came during a tenuous time, during exams week of Michael’s final semester in college. For that reason, the couple decided to wait until after the 22-year-old’s graduation to share the news.
“It creamed our Christmas, but we didn’t want it to cast a shadow over Michael’s graduation, so we waited,” Jacqueline said. “He knew something was up, but he didn’t know the details. We went up for the ceremony, and it was obvious Craig wasn’t feeling well. We still hadn’t found a way to tell him, and he asked me after dinner, ‘Mom, is it that bad?’”
Michael McClanahan was also a visible presence in West Carteret athletics, playing basketball for his dad and serving as the tennis team’s No. 2 singles player his senior year. With each passing year, the young McClanahan is further taking the shape of his father, spending considerable time in the gym and prioritizing health.
“There are no words to describe how I’m feeling, but I am grateful to have such a supportive hardworking father that I know is ready to continue fighting,” Michael said. “I love him as a father, a role model and a coach. I’m ready to show him as much support as he has shown me throughout my life.”
A few weeks later, after his second chemotherapy treatment, McClanahan’s condition worsened, leading to what he describes as the worst stretch of days of his life, in a hospital bed with a heart rate that wouldn’t taper off 160 beats per minute and excess fluid that made it near impossible to breathe.
“It was a 10-day nightmare,” McClanahan said. “It was one thing after another. They couldn’t get it down. They tried a couple different things. One of them was to stop my heart and jumpstart it artificially to get it back into rhythm. They tried that twice. After several hours, they still couldn’t get it down.”
A Cardizem drip finally reduced his heart rate, but on the third morning of his stay, his condition deteriorated again.
“They couldn’t wake me up,” McClanahan said. “Finally, Jacqueline got me up and Rapid Response came to see the reason, which is where they determined I had had a mini-stroke. They were worried. They weren’t sure I was going to come out of that.”
At his worst, McClanahan was getting 2.8 liters of excess fluid removed through thoracentesis and his hCG number had reached 489. Since then, however, his conditioned has progressed, with the number climbing below 200 and bi-weekly thoracentesis appointments switching to weekly visits.
The person the happiest about that news outside the McClanahan home is Robert Lancaster, younger brother of Jacqueline and McClanahan’s assistant coach for all 21 years.
“It has been a battle, and he has been great in the battle,” Lancaster said. “The stay in the hospital had us worried. It was a rollercoaster ride. He’s having some pretty good days now. He has been through it, though.”
Lancaster was still in elementary school when McClanahan and Jacqueline first began dating. When Robert was in the eighth grade, McClanahan was the jayvee boys basketball coach at West.
“He used to come pick me up from the middle school and take me to home games so I could sit on the bench with the team next to him,” Lancaster said.
After time as a basketball manager under Roy Williams at UNC-Chapel Hill, Lancaster found himself a counselor at Carteret Community College. That same year – 1998 – McClanahan took the position of head varsity basketball coach at West.
“He asked me to help him as an assistant,” Lancaster said. “Of course, I said yes. I told him I’d do it as long he had the job and wanted me to help him. We did it for 21 years. I learned a lot of basketball under Craig. He’s a wealth of basketball knowledge and an excellent coach, one of the best I’ve ever been around in the game. He had a way of motivating the kids, and he knew how to get the most out of them. We had some good years and some good teams at West. I wouldn’t trade those last 21 years for anything.”
When McClanahan announced his retirement, new coach Mark Mansfield asked Lancaster to stay on and assist him, and he obliged.
“I thought I was done as well,” Lancaster said. “I didn’t know who the new coach was going to be, and new coaches usually like to pick their own assistants, obviously. Then the perfect fit came along, and Mark asked Craig if I thought I could stay and help him.”
McClanahan had every intention of returning to the bench to join Mansfield and Lancaster for light coaching duties after his state-enforced six-month gap post retirement, but the symptoms from the cancer made it impossible on most nights.
“It was hard to not be out there,” McClanahan said. “I went when I could. I made most of the home games. The kids included me in some of their functions, which was really nice. They put my name on the (2019-2020) conference championship banner, alongside Mark and Robert.”
A few previous players visited McClanahan during his hospital stay, including 2016-2017 graduate Arron Stewart and 2015-2016 alum Nathan Windley. It’s not unusual for coaches to get the support of their former players during times of crisis, but McClanahan is also aware of the strict reputation that accompanied his time at West.
“I know I had a reputation of being a hard-ass to a degree, but I had my expectations,” McClanahan said. “I liked having control over my basketball court.”
One former player of McClanahan’s, current West junior Gavin Gillikin, was on the receiving end of those expectations but was grateful for it and expressed that with a visit to McClanahan’s home.
“I told him that he meant the world to me,” Gillikin said. “I realize the reason why he pushed me so hard. It was to make me better. Even though some see him as mean or a hard-hearted person, he’s really not. He is a great person if you get to know him. I will always miss him coaching me. If I could have one former coach back out there with us, it’d be him.”
In addition to his 21 years as West’s boys varsity basketball coach, he spent 17 coaching boys and girls tennis and 15 as the school’s athletic director. His final season at West was as a watershed year with the program winning its first conference championship in 33 years and finishing 19-6 overall.
He became just the second coach at the school to win a conference title, joining Billy Widgeon, who also coached 21 years with the program. McClanahan, the 3A Coastal Conference’s Coach of the Year in 2006-2007, led the Patriots to winning records in five of his last six seasons. The team went a combined 47-24 (.661) over the last three.
McClanahan hung up his whistle officially in July when the school year ended, with plans to take up golf for the first time and whisk away on vacations with his wife.
“Our normal changed,” Jacqueline said. “I don’t care about getting to go to faraway places or once-in-a-lifetime vacations anymore. I just want a sense of normalcy again, the small stuff. I want to see him back out there on his mower, doing what he loves. Sometimes those little things represent what’s important to you, the little daily activities that tell you things are normal.”
McClanahan echoed those sentiments, “You have a better appreciation of waking up every day and seeing the sun shine. There was a point early on where I wondered if I’d ever get another chance to go to the Cape in our boat.”
McClanahan got to branch out away from his new normal routine recently with a weeklong trip to Black Mountain. It was his first weeklong period without a thoracentesis appointment, but the trip went well and represents the first of many opportunities he plans to jump on.
“Your bucket list gets a little more refined,” he said. “And when you get the opportunity to go do something, you do it, because you don’t know when this is going to creep back up. I don’t know how much time I’ve got. They don’t give you any kind of timetable, and they shouldn’t. I can only hope I’ll be so lucky to get into remission and stay there for multiple years. So, I have to live my life right now. The next day could be my last, which is the case anyway. But a healthy mind doesn’t think that way.”