San Diego philanthropist and local investment company co-founder Fred Applegate needs his right hand to talk. So much so, in fact, that if he's carrying two drinks at a social function -- one for him and one for his wife, Laura -- or shaking someone's hand, he can only smile amiably until his hand is freed.
"It's a little awkward," said Applegate, 63, sitting by the pool of his Del Mar home one afternoon. "Most people who know us know the deal."
He presses his right hand against the gauze covering the opening in his neck, forcing air into a valve that then vibrates and allows him to speak -- one of the only outward signs that Applegate recently battled one of the most rare forms of cancer in the world.
Applegate first noticed something was wrong in October 2007, as wildfires scorched the county and displaced thousands of residents. His voice had taken on a scratchy quality, which he attributed to the ash in the air. He remembers having to cancel a party the day before he and Laura were evacuated, due to the layer of ash in his backyard and the ever-darkening sky.
By Thanksgiving, however, the rasp hadn't disappeared. A visit to the doctor and a subsequent camera down the throat, MRI, and CT scan eventually revealed a tumor the size of a golf ball pressing against his larynx, paralyzing half of his voice box. A biopsy in mid-January confirmed it was malignant.
There are several types of thyroid cancer. Applegate had one known as "primary squamous," or a skin cancer that originates within the thyroid -- as opposed to the slightly more common "secondary squamous," which originates outside of the thyroid but then grows inward.
"The way this kills you is it closes the voice box and then it suffocates you," said Applegate, who began doing extensive research as soon as he was diagnosed.
Only between 100 and 200 cases of primary squamous have ever been reported, said Robert Weisman, director of Head & Neck Oncology at the Moores UCSD Cancer Center.
"Primary squamous is probably the most unusual," Weisman said in a recent phone interview. "The cells that give rise to squamous cell cancer are usually surface lining cells, and the thyroid doesn't have any skin or mucous membrane in it."
Research has shown that the squamous cell cancer in the thyroid comes from the same cells that cause the other types of thyroid cancer but that those cells somehow changed, Weisman added.
Applegate, with Laura sitting nearby, speaks in a matter-of-fact tone about his diagnosis and the months that followed, punctuating his narrative with jokes and sarcastic asides.
He admits that he was initially very depressed but eventually decided to approach the situation with a positive and pragmatic attitude.
"When you go through this process, you see people in much worse shape," Applegate said. "What the hell should I complain about? I've had a great life."
Applegate grew up in Milford, Ohio, with aspirations of building a resume strong enough to get him out of Milford and eventually out to California. He went to the Miami University on a scholarship and plowed through the school's accelerated MBA program. He then did a four-year stint with the Air Force, during which he worked his way up to the rank of captain.
His subsequent investment career took him to Chicago, San Francisco, Centre City and eventually San Diego, where he co-founded Nicholas-Applegate Capital Management in 1984.
The firm started with five employees and $300 million in assets under management. In five years, the sum had grown to $1.5 billion and totaled $50 billion at the firm's peak. The firm was eventually sold to German insurance giant Allianz for $980 million in 2001.
"I'm just a fighter," said Applegate, who retired in 1992 at 46 but stayed on at Nicholas-Applegate as a director for a time. "When push goes to shove, I'm going to push forward and deal with what I have to deal with."
Local portfolio manager John Wylie, who worked for Nicholas-Applegate Capital Management while Applegate was there, recalls one time when fog trapped team members at the San Diego International Airport on their way to Los Angeles to meet an important potential client.
Applegate simply hopped in a car, drove out to Brown Field and hired a private plane. He and the team got to the meeting with five minutes to spare, Wylie said.
"That's just how Fred is," said Wylie, who also served alongside Applegate on San Diego Foundation's investment committee and said he counts Applegate among his mentors. "Whether it's a business challenge (or) a personal challenge, he's not going to take 'no' for an answer, and that's how he approached his cancer."
Applegate went through three surgeries in the first few months of 2008: a biopsy in mid-January, the removal of his thyroid at the end of January, and finally, when his doctor realized that the cancer had spread, the loss of his voice box in mid-March.
Without his voice box, Applegate was locked in silence for six weeks as he recovered -- no easy task for a man who thrives on social interaction. To communicate, he scribbled notes that Laura and others sometimes struggled to read.
Applegate received a speaking valve in mid-May, which allowed him to finally speak, albeit with a more guttural voice.
"Our home telephone number -- the recording is my original voice, and I never want to erase it because that's what my voice was," Applegate said.
Still, he was thrilled to be able to talk, which entails completely covering the opening, or stoma, to force air into the valve. (Applegate said he has to use his right hand because his left hand doesn't cover the stoma as well.)
At the beginning, Applegate could only whisper, but his voice soon grew stronger.
"He always bounced back so fast," Laura said, recalling how her husband began eating solid food when many still expected him to be using a feeding tube. "People never realize how close to dying he was."
The following weeks involved a gauntlet of maximum radiation and chemotherapy to ensure the cancer was gone. For 33 consecutive weekdays, doctors would bolt Applegate's head to a table using a plastic mask to ensure radiation would be as precise as possible.
Throughout it, Laura was by his side, which Applegate says was key in helping him stay positive.
"She stayed in the hospital, she went to every radiation session and sat outside," Applegate said of Laura, who he married earlier this year. "She sat with me during my chemo, which lasted six hours."
Today, a year and a half later, Applegate is back to his busy self: He wakes up at 5 a.m. every day, watches CNBC and sports, and reads four newspapers daily on top of his social calendar, which inevitably includes good food and wine. He and Laura travel regularly and recently embarked on a National Geographic private jet tour around the world.
He still actively manages his own stock portfolio, looking for strong company value. He dotes on his three Chihuahuas: F.C., Chloe and L.T., after the Chargers football player.
Applegate's plan is to "just enjoy every day. And for me, enjoyment is managing my stock portfolio, being with Laura, being with our friends. Who knows what's going to come out of life?"
Still, his schedule contains some traces of his ordeal.
He goes to the hospital every three months for a CT scan to make sure the cancer is still gone. Laura, who used to be a nurse, helps him keep the valve clean and ensures he takes an antacid regularly.
The American Cancer Society will be honoring Applegate at its annual Discovery Gala next month at the Paradise Point Resort & Spa, a local festivity that seeks to raise funds for cancer research -- a cause that is naturally close to Applegate's heart.
"For me, it was a huge no-brainer," said Ann Haddad, Discovery Gala co-chair, referring to Applegate's involvement with local nonprofits including the San Diego Foundation, the International Sports Council, the Air & Space Museum and San Diego Nice Guys, where he met Laura.
"He's been such a marvelous contributor to the community. ... He's really lent his heart and soul to a lot of wonderful causes."
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