Man outlives rare myelofibrosis prognosis by recycling and science
Jack Vexler's journey with myelofibrosis.
By all appearances, Jack Vexler, 79, is the picture of healthy aging. He’s active in life and in his family business, Monterrey Iron & Metal, a San Antonio-based scrap-metal recycler, where he is the owner/CEO and self-described “chief problem solver.” A husband, father, and grandfather, Vexler keeps an impressive calendar. He works five-and-a-half days a week, spends weekends in the Texas countryside with his wife Bette, goes to the gym five days a week, and still jogs a good 20 minutes outside in heat that can top 100 degrees.
Vexler has a quintessential Texas twang and a personality to match. He’s stoic, a straight-shooter, courageous in the face of daunting obstacles, and right now, he’s taking on an obstacle that has no cure: a disease called post-polycythemia vera myelofibrosis, or PPV-MF.
Jack resides in San Antonio, Texas with his wife.
Vexler first developed symptoms of polycythemia vera (PV), a chronic and progressive blood cancer in which a person’s bone marrow produces too many red blood cells, about 10 years ago. PV is rare — about 100,000 Americans are living with the condition, according to the advocacy group Voices of MPN — and it starts with a genetic mutation, typically in a gene called JAK2. Although PV is genetic, it’s rare for it to be passed from one generation to the next.
In about 10% of cases, PV — which is incurable but treatable, with a median survival of 20+ years — transforms into PPV-MF, which is characterized by scar tissue (“fibrosis”) forming in the bone marrow. This fibrosis eventually prevents blood cells in the marrow from developing correctly, and as that happens, blood cell production shifts to the liver and spleen. Because these organs aren’t as efficient in producing blood cells, those with PPV-MF, or MF for short, often develop an array of symptoms that most commonly include anemia and an enlarged spleen.
Jack resides in San Antonio, Texas with his wife.
Vexler was one of the unlucky fraction of a fraction of people to develop MF about 10 years after his initial diagnosis of PV. With PV, patients like Vexler may experience symptoms like bone pain, unintentional weight loss, brain fog, abdominal pain, and an early feeling of fullness. As time passed, Vexler’s doctors noticed more scarring in his bone marrow, an uptick in his white blood cell count, an enlarged spleen, and Vexler reported experiencing additional symptoms like night sweats and fatigue — all symptoms of MF.
“My family doctor told me years ago, ‘Your blood’s irregular,’” says Vexler. But he didn’t initially realize his doctor was talking about cancer. “I never said anything to anybody, including my wife,” he says. However, when Vexler’s medications became ineffective in treating his PV, his doctors wanted him to start interferon injections. “And I knew at that point my wife had to get in the game,” he says. On learning about the extent of her husband’s “irregular blood,” and doing some research on healthcare resources, Bette pushed her husband to seek treatment at the Mays Cancer Center at UT Health San Antonio MD Anderson.
Jack resides in San Antonio, Texas with his wife.
Vexler comes by his inner strength and business acumen honestly. The family business was started by his grandfather, who fled Romania when he was 16 and made his way to Canada, where he founded Monterrey Iron & Metal in 1895. He eventually relocated to San Antonio in 1916. In 1945, Vexler’s father Harold stepped up to run the family business, and in 1969, Vexler himself gave up a future as a lawyer and took over, steering Monterrey Iron & Metal through many triumphs and challenges.
Scrap recycling of the kind Vexler’s family business performs is characterized by taking waste material and processing it so it can be used to make new metal products — finding precious value in what would otherwise be discarded. Similarly, Vexler isn’t throwing away a single second of his life, MF diagnosis or not. He’s living — and he’s living proof of the value of tenacity, and of scientific progress.
Vexler draws hope from close sources. Over the years, there were at least three occasions where his father was near death, according to his doctors. Instead, he lived to age 100. About 15 years ago, one of Vexler’s younger brothers received a diagnosis for a different type of blood cancer called multiple myeloma. “He was given, at that point, a 20% chance to live seven years… He’s 75 today, and they say he’s got about 15 more years,” says Vexler. “I have great confidence in science and doctors. I’ve watched my brother’s treatment get better and better and I think, you know, we’re capable of doing those things,” he says.
Jack resides in San Antonio, Texas with his wife.
Vexler himself has hopeful news to share. With the advice of his specialist at Mays Cancer Center, Vexler was enrolled in a clinical trial looking at treatment for MF. It’s a double-blind trial, neither Vexler nor his doctors know if he’s receiving an actual medicine or a placebo, but so far, things look promising. Vexler’s enlarged spleen seems to have stopped growing, and he’s added about 15 pounds to his wiry frame. “Which, you know, everyone, including my wife, said I needed to do,” Vexler says with a chuckle. “So I think I’m in pretty optimal range.”
Vexler once described living with MF as living under a black cloud, where just the thought of having cancer could dampen a good moment. These days, the condition still scares him, but with many thanks to his doctors, he is optimistic. "They think they could keep this under control for a very long time." And that’s good news for Vexler — and his family business. Like his father Harold who worked at Monterrey Iron & Metal well into his older years, Vexler remains dedicated to his work. “I want to do my job,” he says. “And I have no desire whatsoever to retire.”
