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Jack: Lung Cancer Survivor

Each time Jack White starts a new entry in the notebook he uses for work and personal reminders, he writes a series of numbers in the corner of the page. The left number never changes: It’s always six. It stands for the six sessions of immunotherapy he had on a clinical trial at Smilow Cancer Hospital to treat his non-small cell lung cancer. The right number changes every day. It marks the amount of time that has passed since his final immunotherapy session. On August 31, 2021, he wrote “8,” to celebrate a remarkable eight years of his cancer being in remission. “It’s a reminder of how far out I am from treatment and how far I’ve come,” he says.

Mr. White’s medical journey began in February 2011. He was preparing to leave his Stafford Springs home for a lumber industry convention when he coughed up blood in his bathroom sink. Mr. White, a former smoker, was alarmed. He quickly consulted with his primary care physician, who referred him to a pulmonologist.

Scans showed a tumor in his right lung; a biopsy determined it was non-small cell lung cancer. In April, a surgeon removed the lower lobe of his right lung and discovered the cancer had already spread to surrounding lymph nodes.

He completed a round of chemo over the summer. Scans in early 2012 showed the lung cancer was still present, so Mr. White started a combination regimen of a different chemotherapy medicine plus radiation. “Scans afterward showed the radiation didn’t even touch it,” he said. “I was told I didn’t have more than two years to survive.” He sought a second opinion and got the same two-year prognosis. “That wasn’t a good enough answer for me,” he said.

Mr. White came to Smilow Cancer Hospital for a consult with Anne Chiang, MD, PhD, Associate Professor of Medicine in the Section of Medical Oncology and a specialist in thoracic oncology. “I was struck by Jack’s confidence,” Dr. Chiang said. “He came into my office and said, ‘I am not going to settle for anything but the best outcome.’”

Mr. White was equally impressed with Dr. Chiang. “She was so confident about the treatment options she had,” he said. “As I was listening to her, I relaxed for the first time in three years. I knew I was in the right place.”

Dr. Chiang enrolled him in a clinical trial that combined two immunotherapy drugs: nivolumab, an anti-PD-L1 blocker, and ipilimumab, an anti CTLA4 inhibitor. “Cancer cells are really sneaky. They’ve figured out ways to put your immune system to sleep,” Dr. Chiang explained. “These antibodies disrupt these pathways from working and wake up your immune system to recognize the cancer cells.”

After three sessions, Mr. White developed a cough, which he shrugged off but which Marianne Davies, ARPN, who works with Dr. Chiang, recognized as a potential warning sign of something more serious. She instructed him to report to Smilow as soon as possible. Her instinct was right: Mr. White had developed pneumonitis, an inflammation of the lungs that’s a potential side effect of immunotherapy. Once prednisone reduced the inflammation, Mr. White completed three more sessions, the last one on August 31, 2013.

In the eight years since, Mr. White has remained cancer free. He and his wife, Susan, have celebrated many family milestones, including the birth of four grandchildren. He is set to retire this month. He plans to take guitar lessons from his son-in-law Rick. He relishes watching the birds, foxes and other wildlife that inhabit his 13-acre property, in the company of his Chihuahua, Jimmy, who joined the family around the time that Mr. White finished his last treatment. “Getting Jimmy was a way of me saying, ‘I am not going anywhere,’ and I didn’t,” he said.

The treatment he received isn’t going anywhere either. In March 2020, the FDA approved the combination of nivolumab and ipilimumab as a first-line treatment for certain patients with metastatic non-small cell lung cancer. “Jack not only has enjoyed a great benefit personally from these drugs, but he helped other patients through his participation in this successful clinical trial,” said Dr. Chiang.

Both Mr. White and Dr. Chiang enjoy catching up at their once-a-year checkups. “I get chills when I talk about Jack to other patients,” said Dr. Chiang. “Ten years ago, patients with metastatic lung cancer had a poor prognosis and maybe a year or two at most to live. But Jack shows how the paradigm has changed. Here was a gentleman whose disease had recurred despite the use of the best tools at the time. But because of clinical trials and scientists being able to translate these advances for our patients, Jack is alive and well.”

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