Lung cancer patient, Steve, chose protons after getting a second opinion

Steve smiles for a photo with a suspension footbridge and rolling hills covered in fall foliage behind him.

The first thing Steve wants to share when talking about his lung cancer diagnosis and treatment is how wonderful the staff at Fred Hutchinson Cancer Center – Proton Therapy have been. “The people are just phenomenal,” he says. “The radiation therapists were so warm, kind and friendly, they made you feel like you are part of the family. I can’t say enough about how grateful I am.”

Earlier this year, Steve was diagnosed with stage III non-small cell lung cancer (NSCLC) after asking to be screened because he was a smoker. Although his tumor was small, it was close to his esophagus and heart, and several lymph nodes were also affected. Because the spot that showed up on his low-dose CT scan was so tiny, Steve was surprised that his diagnosis was stage III.

Although lung cancer diagnoses among younger non-smokers are becoming more common, Steve couldn’t help but feel that his cancer was the result of his decision to smoke, so he quit immediately.

After the diagnosis, Steve and Lisa, his wife of 17 years, felt scared and sad. Would Steve die? Lisa’s father had died of cancer, and his last years had been torture, partly from the chemotherapy. She didn’t want Steve to have to go through that. But Lisa also felt that whatever decision he made was his to make, for himself alone.

Steve decided to fight.

When he spoke to his doctors about treatment plans, they recommended surgery, radiation and chemotherapy. Although he’d been seeing his doctors for many years and trusted them, Steve thought it would be prudent to get a second opinion, especially because a world-class cancer center was within driving distance of his home on Mason Lake near Shelton, WA. So, he went to see Dr. Rafael Santana-Davila at Fred Hutch.

Dr. Santana-Davila encouraged Steve to take a different tack: chemotherapy coupled with proton therapy. Steve hadn’t heard about proton therapy before, but what he learned made sense. Standard X-ray therapy would have radiated most of his chest area, but proton therapy could better target the tumor and lymph nodes. Because the tumor was so close to his esophagus and heart, proton therapy could also help spare those organs from an excess radiation dose.

His proton therapy radiation oncologist was Dr. John Kang, who specializes in lung cancer. “Steve was an excellent candidate for proton therapy given the location of his cancer near the center of his chest,” says Dr. Kang. “Compared to standard photon (X-ray) treatment, proton therapy was able to significantly decrease the cumulative dose to his lungs and heart, which we are learning can be sensitive to even low doses of radiation. He received six weeks of treatment, and I could see on our interval quality assurance scans that his tumor was shrinking about half-way through. That let us adjust the plan to be even more focused on the cancer and further spare his nearby organs.”

Steve was treated from two positions in the gantry, with the beam entering from his left and right back. For most of his treatment, Steve had no side effects from proton therapy. But he did develop esophagitis during his final week, which was painful and made swallowing difficult. He says he also had a tough first week on chemotherapy. “But the staff at Fred Hutch were there for me 24/7, and they helped me feel better quickly. Now, a month out, I’m feeling great,” he says.

Steve has lots of advice for other patients diagnosed with cancer. “Be positive,” he says. “When you are first diagnosed, it’s a life-changer. But you’re not dying today. Make it worth it.”

Following his own advice, Steve now lives life to the fullest. He’s currently in Nashville and heading to a log cabin in the Great Smoky Mountains. Next month, he and Lisa are cruising the Panama Canal, and in January, they are taking their entire family of four children, spouses and 10 grandchildren on a cruise in the Bahamas. “When Lisa said, ‘Let’s do this, let’s do that,’ I just said yes.”

Two  weatherworn buildings sit in a grassy lawn covered in fall leaves in the  Great Smokey Mountains National Park.
Steve and Lisa just visited Great Smokey Mountains National Park.

Steve encourages everyone to get a second opinion, even when you trust your current provider. He believes it saved him from more pain. By choosing proton therapy at Fred Hutch, he avoided having a port placed or going through surgery. He highly recommends seeing someone at Fred Hutch, which is the only NCI-designated hospital in the region.

Finally, Steve is adamant about not smoking. Like so many smokers, he quit before and relapsed, and he understands how hard it is to quit. In the past, he’s used patches, gum and hypnosis. This time, it was pure willpower. “I’m sure it helped my recovery to not be smoking,” he says. “I understand the struggle. But keep trying.”

At the end of his proton therapy, Dr. Kang reviewed his latest CT scan and was very pleased: The tumor was nowhere to be seen. He immediately called Dr. Santana-Davila with the good news. Following protocol, Steve will have a follow-up PET scan in November to make sure there’s no regrowth of the tumor.

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