Mike Tilley was in bed scrolling through his phone one night last July when he saw an email from a Gmail address he didn’t recognize.
The attached note said it was from Trey Mancini, the Baltimore Orioles first baseman/designated hitter who, two weeks before, had finished second in the 2021 MLB Home Run Derby contest.
Tilley, director of construction for an architectural company in Central Pennsylvania, is a New York Yankees fan. But his twin brother loves the Orioles. They’ve gone to a ton of games together at Camden Yards over the years.
Tilley knew Mancini’s story well — and connected with it more than most.
It was a year ago Friday — three days after Mancini’s return from colon cancer surgery was widely celebrated during the nationally televised Home Run Derby — that Tilley was diagnosed with the same type of cancer. Anticipating the diagnosis, Tilley, then 30, paid particular attention that night to Mancini, then 29.
“Seeing someone doing what Trey was doing on the other side of colon cancer was inspiring,” Tilley said. “I just remember sitting on my couch, watching that, and my head was going in 100 different directions.”
Days later, Tilley stared at an odd email. It simply asked if he wanted to talk.
“I showed my wife,” Tilley said. “And I was like, ‘Do you think this is real?’”
Mike Tilley was born Dec. 25, 1990, four minutes after his identical twin, Ryan.
Call him a Christmas miracle, because Mike was a surprise until his brother was born. Ryan exited and then the doctor said incredulously, ‘There’s another one in there.’
Previous ultrasounds during his mother’s pregnancy discovered only one heartbeat. In retrospect, it’s believed the boys’ hearts were completely in sync each time.
It’s been that way for 31-plus years.
“Mike has been my best friend since, yeah, literal birth,” Ryan Tilley said. “Mike and I’ve gone through every life obstacle together. We played on the same sports teams. We shared a room until we went for college. Whenever he had some sort of girlfriend trouble or anything trouble, I’d be the one that he would call. And vice versa.”
On July 15, 2021, Ryan Tilley was stunned. What could he possibly say to or do for his twin? He didn’t know anyone who had been diagnosed with colon cancer. There was no family history of it. No friends had ever had it.
The only colon cancer survivor he knew about was Mancini, the inspirational leader of his favorite baseball team.
So Ryan Tilley, an attorney, took a shot. He sent an email to someone he thought could get word to Mancini. All he wanted was a “hang in there” from the ballplayer for his twin brother, maybe a video message or something brief but personal for Mike.
Mancini almost immediately emailed Ryan looking for his brother’s contact information. Then Mancini emailed Mike, asking if he wanted to talk.
An extraordinarily swift effort from a public figure in the midst of his busiest time of year.
“It’s incredible this guy, who is now a figurehead in colon cancer (circles) was the very first person we met that had colon cancer,” said Mike Tilley’s wife, Sarah. “I was very impressed that this was a topic that somebody felt so moved by to reach out to just some random — I mean, he’s my husband — but he’s just some random person to Trey Mancini.”
In March 2020, a few days before his 28th birthday, Mancini underwent surgery to remove a Stage 3 cancerous tumor from his colon. He had to pause his successful baseball career in his prime to undergo 12 chemotherapy treatments that year. In September, he received a clean slate of scans and was proclaimed cancer-free.
Mancini made it back to the big leagues the following April and won the 2021 AL Comeback Player of the Year Award after appearing in 147 of the Orioles’ 162 games. He also created the Trey Mancini Foundation last year to support those facing life-changing illnesses and hardships.
Mancini doesn’t have to do more. He’s inspiration enough.
However, Mancini, the middle child and only son from an Italian Catholic family, has always believed that everything is part of a greater plan. He tried to remember that when he had on-field struggles at the University of Notre Dame or in the minor leagues. And he focused on that tenet as he engaged in his cancer treatments. In Mancini’s opinion, the support and advice he received from surviving cancer patients was paramount to his recovery.
“Everybody can prep you, but only those who have gone through it really know what it’s like,” Mancini said. “I also made a vow when I was going through it that if I came out OK then I would help others that followed me.”
Trey Mancini and Mike Tilley have plenty in common. They’re roughly a year apart in age, both from close-knit families and both diagnosed much younger than the average colon-cancer patient with tumors nearly the same size. Mike and his wife, Sarah, have been married a year. Mancini and his fiancée, Sara, will marry this December.
“I just had a feeling when I heard his story,” Mancini said of Tilley. “I just felt like I should call rather than send a text and say, ‘I hope you’re doing well.’ I thought I’d call and kind of prepare him for what chemo is like, what this surgery is like and everything like that. I felt like that was just something I should do.”
Once Tilley realized this was the real Trey Mancini, and that Ryan had set it up and everything was legit, Tilley and Mancini arranged for a time when they could chat.
Oh, did they chat. For more than an hour.
“I remember I had a while before the game that day,” Mancini said. “So, I talked to him for a long time and prepped him just about the surgery and we went through his options.”
Sarah Tilley sat nearby, taking copious notes.
“He never paused. It was like he had this energy toward this topic, and you could tell he felt very moved to help other people,” she said. “Some of the best advice we have gotten in this journey.”
The communication hasn’t stopped. If Mancini hasn’t received a text from Tilley in a couple of weeks, he’ll check up on him.
“It means the world to me,” Tilley said. “It’s a lot of pep talk stuff. I’ve gotten more bad news than good news, and he’s always like, ‘Keep your head up. You got this. This is nothing.’ It’s different when that’s coming from someone who also went through it.”
Mike Tilley’s cancer story — besides the sports celebrity cameo — is sadly a common one, from the unexpected onset to the struggles to acquire adequate treatment.
A former high school athlete who briefly played rugby internationally, Tilley still considered himself active and fit as he approached 30. At 5-foot-11, 200 pounds, he worked out regularly. He had to look good for the upcoming wedding photos.
In March 2021, he began having pains on the left side of his abdomen. With his wedding approaching in June, Tilley needed the situation resolved, so he went to the doctor for an exam. He was told it was diet-related and was given heartburn medication.
“I even asked the doctor at that appointment like, ‘Is there a chance that this could be colon cancer?’ Because I was just reading stuff online,” Tilley said. “And the doctor practically laughed at me and told me, ‘No.’ I was too way too young. So, I went home and started these heartburn pills.”
Two weeks passed and the symptoms worsened. Blood in his stool. He had lost 10 pounds. Again, his doctor was adamant it was diet-related. So, the former high school running back performed his first end-around of this complicated saga. In May, he made his own appointment with a gastroenterologist. The result? He was told his issues were likely diet and stress-related — his wedding was a month away, after all.
In June, the stomach pains were unbearable, he had constant fatigue and his body temperature soared to 104 degrees.
Sarah Tilley, a merchandise planner by day and now a prolific amateur medical researcher at night, scanned the internet for hints as to what was happening with her husband: Colon cancer or a type of colitis. Neither was particularly comforting.
Ten days before their wedding, Sarah and Mike went to an emergency room in Philadelphia, near where they were living at the time. The couple was there all night. And when they left the next morning, they thought they had answers. It appeared Mike had Crohn’s disease, a type of inflammatory bowel condition.
“We left that morning thinking, ‘All right, new diet plan for the next week,’” Sarah Tilley said. “So, let’s get down to business, because we wanted to make sure he could walk down the aisle.”
The next morning a voicemail was left on Mike’s phone. It was from the hospital. His CT scan was re-reviewed. He better call back immediately. He might have colon cancer.
“We were both like, ‘What the hell?’” Sarah Tilley said.
Imagine preparing for the most important event of your life with a potential cancer diagnosis hanging over your head.
That’s what the Tilleys did for their wedding and honeymoon last year.
The good news was that the results of the CT scan expedited the scheduling of a colonoscopy, so he’d be getting the procedure shortly after he arrived home from the couple’s honeymoon in Jekyll Island, Ga.
The bad news was he had to keep his mind calm during the honeymoon while continuing a strict diet in case he had Crohn’s. His honeymoon food options were limited because everything’s fried in Georgia. He also had to stay away from alcohol, so there’d be no cocktails with dinner.
“It just sucked seeing all these other people with their delicious meals and he’s sitting there with his melon or whatever it was,” Sarah Tilley said. “I felt so bad.”
It was almost a strange relief when, a year ago Friday, the colonoscopy discovered the tumor and Tilley woke up to hear that he had cancer. At least he knew what was causing his pain.
Two weeks later, on July 27, 2021, the tumor, 16 inches of Tilley’s colon and his appendix were removed at a New Jersey hospital.
Thanks to Mancini, the Tilleys had an idea about what the road ahead would look like. But another curve was thrown their way.
Mancini has been extremely candid throughout his cancer experience.
One thing he’s repeated multiple times in the last two years is how fortunate he was to be a professional athlete at the beginning of his cancer discovery. Disconcerting bloodwork results from a routine physical led the Orioles’ head athletic trainer to order more tests, which led to the colonoscopy, an uncommon procedure for someone in their 20s.
Once Mancini was diagnosed, he chose to have his treatment at Johns Hopkins Kimmel Cancer Center in Baltimore, one of the best facilities in the country. He felt from the beginning that his care, from the Orioles to Johns Hopkins, was both exceptional and proactive. And he knows that’s not always the case for typical cancer patients.
One of the tools used by Mancini’s oncologist at Hopkins was a Circulating Tumor DNA test, a newer technology that compares current blood samples with tissues of the cancerous tumor. It’s not standard procedure yet, but Mancini is a big believer in it; the test calmed his fears when another potential cancer indicator was elevated last June.
Whenever he talks to new cancer patients, he tells them to push for the usage of a CT DNA test at surgery. That was one of the Tilleys’ major takeaways from their initial conversation with Mancini.
They immediately ran into roadblocks. The cancer surgeon said it was a test that should be ordered by Tilley’s oncologist. And, the first time Tilley met with his oncologist, she dismissed the test as unnecessary. The Tilleys went back to the original surgeon and pleaded. He ordered the test for Tilley, which showed extremely elevated levels, indicating that the cancer had spread.
They took that information to the oncologist, who ordered a new CT scan, which showed that Tilley’s liver was, in his words “essentially just covered in tumors.” It also showed spots on his lungs that are currently being monitored but may not be cancer.
Six weeks had gone by. After that scan in October, he officially became a Stage 4 cancer patient.
Tilley is now midway through a radiation procedure on his liver tumors and is also receiving chemotherapy every two weeks. After “shopping around” for new doctors, Tilley chose an oncologist based out of the world-renowned Memorial Sloan Kettering Cancer Center in New York City.
The chances of a Stage 4 colon cancer patient living for five years is only 15 percent. Tilley knows that. He’s already blown through the basic standards of treatment for colon cancer and is circling back to one in which he’s had some success. He’s rail thin now, down to 140 pounds.
When you’re in that situation, you think about the end.
Tilley has, and he’s shared those thoughts with his twin brother.
“He talks to me about death, and I know he just wants to talk about it,” Ryan Tilley said. “And I sit there and listen to him, and it’s horrible to hear someone that you love so much discuss that.”
It’s an excruciating time for the Tilley family. Yet there’s still baseball to watch. For Mike Tilley, that’s not a cliché. It’s not some movie quote. It’s his reality.
“It gives him a distraction, for sure. And it gives him somebody else to root for besides himself. I think so much of this is Mike-focused. ‘Fight Like Mike.’ Everybody is like, ‘How are you doing, Mike?’” Sarah Tilley said. “So, I think when it comes to baseball, it’s about everyone on the field; it’s not about anyone in the stands.”
The Tilley twins had tickets for Opening Day this April at Camden Yards. That morning, Mike called Ryan and said he couldn’t go, that he wasn’t feeling well. Ryan told him if they arrived at the stadium and he couldn’t push through, they’d turn back around. Or they could leave early. No worries.
“We got down to the game and his complete complexion changed,” Ryan Tilley said. “We stayed for the whole thing. We stayed afterward to meet up with Trey. Mike was a completely different person from 12 hours earlier.”
Sarah Tilley has seen the transformation, too.
“Baseball is such a wonderful escape for Mike, especially going to a ballpark. The atmosphere and the fans and the smells. It’s nostalgic. It’s something that’s familiar, that’s comfortable,” Sarah Tilley said. “It’s just an easy, feel-good lever that he can pull.”
They are trying to pull that lever as often as possible. They went to Pittsburgh earlier this year for a baseball road trip. And when Tilley is in New York for chemo treatments, he’ll go to Yankee Stadium, where he’s worn a Yankee hat/Mancini shirt combination. He also said he went to one recent chemo treatment in Manhattan wearing an Orioles cap.
“I caught shit from every Yankees fan, my nurses included,” Tilley said. “So, I’m a Trey fan first, Yankees fan second.”
Mancini has made it easier for Tilley to scratch his baseball itch. When they caught up after the Opening Day game, Mancini told the Tilleys that if they ever wanted to attend a game again, he would get them tickets. They’ve used the connection several times this season, although it’s more about the sentiment than the actual tickets.
“For a long time, I was sitting at home, not doing anything and it was just cancer, cancer, cancer all the time,” Tilley said. “Now, to be able to run down to Camden Yards for a few hours every few days. I just can’t say enough about how awesome Trey is.”
Mancini’s not particularly forthright on how many cancer patients he’s forged relationships with in the last year, only smiling, shrugging and saying, “Some.”
A further probe reveals he’s kept a running dialogue with about 10 to 15 people who are currently dealing with cancer. He didn’t know any of them previously, but was introduced through baseball or personal connections. There are others he’s reached out to at least once to provide encouragement.
As for providing tickets, that’s only been for the Tilleys, primarily because they’re the only ones near Baltimore and able to make the trip.
“I love telling my friends, ‘Yeah, I’m going to a game. Trey Mancini is giving me tickets,’” Tilley laughed. “It’s a nice flex.”
There’s still so much heartache here. Another face-slapping example of life not being fair.
Mancini’s a free agent at year’s end. It seems almost certain he’ll be traded to a contender by the Aug. 2 trade deadline. Mancini, though, has no plans of skipping out on Tilley.
“I know he’s gonna keep fighting and I’m always in his corner,” Mancini said.
There is a part of Tilley that dreams of Mancini being a Yankee — or at least rejoining former Orioles manager Buck Showalter with the New York Mets. That would give Tilley a reason to go to Citi Field when he’s getting another chemo treatment in New York.
Even if this ends with cancer taking Tilley too soon, he feels like his story has value. Because he has made sure his friends and family have received early colon cancer screenings.
“I really don’t know if I will physically ever beat this cancer,” he said. “But how I will beat this cancer is making sure that none of my friends and my family are diagnosed with colon cancer. And that’s the thing that’s most important to me.”
Sarah Tilley, his wife, is banking on that baby boy who no one expected to be born to conjure another magic trick. She’s set on a honeymoon re-do, maybe to Greece one day. And she believes people who hear her husband’s tale may be inspired to advocate for their own health issues, which would be a great comfort to the family.
“I think I had a completely different projection (about the future) a year ago, but I kind of have to take things as they come. I am a realist, but I’m also definitely an optimist,” she said. “I’m gonna see the glass half-full. I look at odds as, ‘We’re gonna beat them.’”
Maybe that’s the one takeaway here: That, even in rough times, the unexpected can bring you, your friends and complete strangers to their feet. Rooting together.
“Cancer is one of the worst things that could ever happen to someone, someone in your family. But it brings out this side of humanity that you can’t get exposed to unless you go through this with someone,” Ryan Tilley said. “Trey symbolizes that. He’s been such a blessing through this whole awful experience for Mike.
“People think everything is so bad in the world today. But, if you take a closer look, there are amazing people out there.”
(Top photo of Trey Mancini and Mike Tilley courtesy of the Tilley family)