Karen DiRienzo realized there was something wrong with her husband, Marino, at their son’s wedding.

In retrospect, she and other family members had already noticed uncharacteristic behaviors. Staining a fence a few weeks earlier outside their home in Ottawa, Canada, Marino had asked Karen the same question three or four times. He’d also mentioned episodes of double vision. And, at separate family dinners, his mom and cousin noticed he was less jovial and energetic than usual.

But the real concerns emerged the day Andrew and Adriana got married. Marino was there, but his jovial self was not. Further, when Marino’s band played a set, the seasoned accordion player and singer kept messing up. Was this Long COVID, following his bout of the coronavirus a few months earlier? Or something worse?

Marino’s double vision worsened, and he started to suffer from bad headaches. He first made an appointment with his optometrist, and after a thorough examination, the optometrist told Karen to take Marino to the emergency room. There, a CT scan revealed a large brain tumor. He was soon diagnosed with glioblastoma (GBM).

“Of course, my first instinct was, “What the heck is this? I have to Google it,’” Karen recalled. “I did, and I just about threw up.”

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Marino and Karen met in high school. One night, a group outing was cut short, and neither were ready to go home. They wound up talking in his car until the early hours of the morning. She’s the one, Marino told himself. The next morning, he surprised her by telephoning the bank where she worked and asking her out on a date.

Karen was soon drawn into the world of Marino’s tight-knit Italian-Canadian family, which both treasured its traditions and also seemed to gather spontaneously. Mr. DiRienzo would emerge from the cellar cold room with homemade wine, Marino would get out his accordion, and the next thing she knew, a packed house was listening to a few uncles tell stories about the Old Country.

“Those were some really good times,” Karen said.

She fell in love with his ebullient personality and steadying presence during both easy and hard days. When they initially struggled to get pregnant, he knew exactly what to say – and how to say it – to alleviate her stress and renew her hope. Four years into marriage, they had twin boys, Andrew and Anthony.

Marino and Karen have now been together for more than 40 years, and they have cultivated their own good times by maintaining old traditions and starting new ones. On Remembrance Day, everyone goes to Marino’s parents to eat homemade gnocchi and try this year’s vintage. A few weeks later, they head to the same tree farm, cut down a balsam fir for Christmas and take a family photo. These days, it includes daughters-in-law and grandchildren.

Karen was working on wedding invitations with Andrew’s fiancée a few years ago when Marino, as he always does before leaving to run an errand, walked over and gave Karen a kiss. Adriana, the bride-to-be, turned to Andrew and said, “So that’s where you get it from.”

“He’s been an affectionate husband and an amazing father,” Karen said. “It’s just in the way he does things day to day that you don’t even realize the kids are picking up on. And now you see our boys showing that same respect to their partners.”

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"It’s all about what you make of the situation. I’ve accepted that I have cancer. So, now what? How you respond, how you spend whatever time you have left, that’s up to you."

Marino DiRienzo, living with glioblastoma

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‘He has the most amazing attitude,’ Karen says of Marino. ‘From the get-go, his mindset has been, ‘OK, just help me figure out how we’re going to tackle this. Let’s go.’

A week after the cancer was discovered, Marino underwent a craniotomy. Surgeons successfully removed the tumor and relieved his symptoms; Karen got back the husband she knew. Marino left the hospital two days later, and he resolved to keep living just as he had been.

With that goal in mind and with Karen’s help, Marino did carefully consider his next steps for treating the cancer. He decided to try Tumor Treating Fields (TTFields) therapy for GBM.

TTFields therapy is delivered through adhesive patches, or transducer arrays, placed on a patient’s shaved head. Depending on how quickly a patient’s hair grows, he or she replaces the arrays every few days. For Marino, it’s an every-third-day routine, and one that’s become an exercise in teamwork. Karen places the arrays on his head once he has carefully cut pieces of tape and laid everything out on a table in an organized fashion. They can now complete the routine three times faster than they initially could.

“We’ve gotten that down to an art,” he said. “We are a good team.”

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'I still get up in the morning,’ Marino says. ‘I brush my teeth, I shave, I’ll go to work until I retire, I spend time with my grandkids, my family and my friends. It really is very much the same routine. Life goes on.’

Marino is grateful for his good health outside his GBM, and while using TTFields therapy he’s prioritized staying about as active as he was prior to his diagnosis. He’s continued to join Anthony and Andrew on a father-son baseball team, and he still golfs with a group of 20 or so longtime friends. Sure, he bats lower in the lineup than he used to, and he runs a little slower. On the links, he might not break 90 as often as he used to. That’s OK — he’s happy to be out there, enjoying the exercise and camaraderie.

“It’s all about what you make of the situation,” he said. “I’ve accepted that I have cancer. So, now what? How you respond, how you spend whatever time you have left, that’s up to you.

“I still get up in the morning. I brush my teeth, I shave, I’ll go to work until I retire, I spend time with my grandkids, my family and my friends. It really is very much the same routine. Life goes on.”

Marino is close with relatives living in southern Italy, and he and Karen have made many visits over the years. A few months after Marino started TTFields therapy, they once again traveled there, this time for three weeks with a few Ottawa neighbors. They visited Colle d’Anchise, the small village where his parents grew up. His Italian family, who’d wondered if they would see him again, was overjoyed.

Marino and Karen both retired this spring. Their sons’ families live nearby, and they are excited to spend more time with their grandchildren. Anthony and Jenna have three, and Andrew and Adriana are expecting their first.

Oakley, Marino and Karen’s first granddaughter, was born in late November, just in time to join the annual outing to the Christmas tree farm. Jenna, Anthony’s wife, insisted on her and the baby being there. “It’s tradition.”

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Marino and Karen recently retired and look forward to spending time with their twin sons’ families. They recently welcomed a granddaughter, Oakley, and are expecting a fourth grandchild soon.

Since Marino’s diagnosis, his best qualities have stood out more than ever, Karen says.

“He has the most amazing attitude,” she said. “From the get-go, his mindset has been, ‘OK, just help me figure out how we’re going to tackle this. Let’s go.’”

The health status of patients featured reflects their condition at the time the story was written and photographs were taken and may have changed over time.

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