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Targeted Therapy Brings Back Active Lifestyle

  • November 01 2014

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    Targeted Therapy Brings Back Active Lifestyle
    Kirk Smith, a survivor in Athens, GA, shares his story about receiving a lung cancer diagnosis to participating in the Athens Free to Breathe 5K this year. Watch for more feature blog posts in our Lung Cancer Awareness Month series all month long.

    I was diagnosed with lung cancer the day after Christmas, 2013. I have stage 3B lung cancer caused by the ALK gene mutation. I never smoked, rarely drink and have always been very active. Some would say overly active, competing in running races, cycling events, triathlons, and duathlons of every distance. 

    After finishing my run one evening, I had sharp pain on the left side of my chest. I finally had to stop and walk back to my office. I then drove myself to the ER knowing something was not right. After multiple tests, they saw something on one of the scans but wanted a pulmonologist to take a look. He saw two dark areas in my left lung that concerned him, so I was scheduled for a bronchoscopy in order to get pathology. My wife and I met with him the day after Christmas for the results, and he confirmed that it was indeed lung cancer.  

    My next step was a mediastenoscopy at Emory's Winship Cancer Center to determine the staging, get more specifics on the type and cause of the cancer, and to see if surgery was an option. That procedure showed the cancer was stage 3B. I had two tumors on my left lung and some cancer in the lymph nodes of my sternum. Surgery was not an option. They also determined the cancer was the ALK gene mutation, which meant targeted therapy could be part of my treatment

    I began on crizotinib (Xalkori®)Xalkori. It worked well for the most part, but it also sent my liver enzymes thru the roof. I was in the 3,000s, a level classified as life threatening. I had to back off the Xalkori for a period until my enzymes normalized, and then resumed at a lower dosage. This happened three times, but each time it was less of a spike, as if my body was becoming more tolerant.

    On April 30th, the FDA approved a new drug, ceritinib (Zykadia®), after it had been fast-tracked through clinical trials. I was able to start taking it near the end of May. After just two months on Zykadia, I had a CT scan that showed one tumor had reduced 50% and the other had essentially disappeared.

    I think I may be the only patient in Athens, GA currently on this medication, and my doctor has referred to me as a "clinical trial of one" because my profile is so radically different from most lung cancer patients.

    I am still on Zykadia, and may very well be for the rest of my life, or at least until the cancer becomes resistant – something that often happens with targeted therapy drugs. At that point in time, we’ll decide what the next step will be.

    Meanwhile, I am living life! I recently raced a sprint triathlon finishing 2nd in my category and in the top 4% overall. I will also race the Athens Free to Breathe 5K in November. I am certainly not at my peak racing speed. But looking at where I’ve come from since February, when taking a breathing test almost made me cry from the pain, to now being able to race somewhat competitively, is a HUGE sign of progress. Although I would like to pat myself on the back and say it’s all because of my healthy lifestyle, the truth is that the research and progress in this area, and the development of targeted drugs, may be the only reason I am still alive and able to enjoy this very active lifestyle at all.

    I am a walking testimony to the benefits of funding research to fight this disease.

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