It’s 5:30 in the morning in Athens, GA. Kirk Smith dons his sneakers and goes for a 6-mile run just before heading to the office. Signing off his e-mails with “LIVE,” Kirk’s message to himself and others is simple: continue doing what you love. It’s hard to believe that this active 54-year-old owner of an advertising company, a triathlete, and a runner for the past 15 years or so, has lung cancer.
Kirk was diagnosed with lung cancer in December 2013. He started having pain in the left side of his chest, which only happened after going for a run. He thought he might have pulled a muscle, but it kept coming back when he breathed really deep after a run. So he finally drove himself to the emergency department. Several chest scans and a bronchoscopy later he was told he had stage IIIB lung cancer.
“The pain that I was having was the tumors; I have 2 tumors in my left lung. That pain was that blood supply finally getting choked off until it died. I call it a ‘lung attack,’” Kirk said in an interview.
An active person who has never smoked, a diagnosis of lung cancer was most unexpected, and coming to terms with it was not easy. “It wasn’t that I thought I was immune to cancer. I live a pretty healthy life. I’ve always been very active. I eat well. I had never been on prescription medications. There’s a little bit of disbelief that it’s lung cancer.”
Because he didn’t smoke, his doctors, Cynthia Shepherd, MD, of Athens, GA, and Suresh S. Ramalingam, MD, of Winship Cancer Institute, Atlanta, GA, wanted to find out what caused Kirk’s lung cancer; they thought that a genetic mutation (alteration) could be the reason. They tested some lymph nodes around his lungs, which revealed that indeed his cancer was associated with a genetic mutation called “ALK mutation,” which is associated with lung cancer.
Because his disease was already at an advanced stage, surgery was not an option, and Kirk started taking the targeted drug Xalkori (crizotinib). At that time (2013), Xalkori was the only drug specifically approved for patients with lung cancer and ALK mutation.
Lung Cancer with ALK Mutation
“Xalkori was a targeted therapy drug that worked great and started shrinking tumors right away,” Kirk said. But after a while, Xalkori increased his liver enzymes to dangerously high levels, so he switched to a new targeted drug, Zykadia (ceritinib), which was approved in April 2014 for ALK mutation–positive lung cancer.
It’s now been more than 2 years, and Kirk continues to take Zykadia, with impressive results. His side effects are mild, and the tumors are responding well to the drug. However, Kirk is realistic about the possibility that the drug will eventually not work for him, and he’ll need to switch to yet another targeted drug. At the end of last year, another drug, Alecensa (alectinib) was approved for people who have lung cancer associated with ALK mutation.
“Zykadia could work for me for another 10 years, who knows? So far, the big challenge with targeted therapy drugs has been that they work, and then they don’t. Lung cancer figures out a way to become resistant, and start growing. Now, there’s been a third drug, Alecensa, which has recently been approved. If my drug stops working, I would probably start using Alecensa,” Kirk explained.
Support for Cancer Research Is Crucial
Kirk is a passionate supporter of cancer research: he says that his active lifestyle is a testament to the progress made through research. Without lung cancer research, targeted drugs like Xalkori, Zykadia, and Alecensa would not be available, Kirk says, and he would not be able to continue his active lifestyle today.
“I’ve been a triathlete or a road runner for the past 14 or 15 years. The targeted therapy drugs have allowed me to still do what I do. I have stage IIIB lung cancer. There’s no way that would have happened even 6 years ago.”
The rates of survival for lung cancer are not encouraging; less than 5% of patients with stage III (advanced) lung cancer live more than 5 years. But cancer research can change these numbers for the better, Kirk says.
Free to Breathe
In October 2016, Kirk participated in the PPD IRONMAN North Carolina, presented by New Hanover Regional Medical Center Team Free to Breathe (www.freetobreathe.org). Free to Breathe is a lung cancer research and advocacy organization dedicated to doubling lung cancer survival by 2022 through funding the research that shows the greatest potential to save lives.
“Working with Free to Breathe is helping to bring it a little more to the forefront, so that people understand how important funding is for research. We can see that it makes a difference,” Kirk said.
“This is not about raising awareness—we’re all aware of cancer,” he said in a press release. “This is about educating people that research makes a huge difference. Research saves lives and allows cancer patients like me to live an active life.”
Participating in the PPD IRONMAN with Team Free to Breathe will signify the continuity of life for Kirk: he continues to do the same things he enjoyed doing before his diagnosis. “With this race, it’s proof that I’m still living, and that there’s hope for others out there,” he said.
“The reality is, if I’m able to finish the race, if I do what I hope to do, I still have cancer. The next day I’m going to wake up and I’m still dealing with this, so it’s not truly a finish line. From my standpoint, it’s a way to tell the story, get it out there, get people to pay attention, and get people to see that the things that are happening are really making a difference. Personally for me, it’s part of a journey,” Kirk said.
Education Is Power
Kirk stresses the importance of educating oneself about cancer.
“Educate yourself as much as you can, not only when you’re first diagnosed, but continue to educate yourself. Be patient, give it time for the process to work, and find out what you do have, what your treatment opportunities are, and learn as much as you can about that. You have to keep yourself informed, and become a part of the process, and not just a lemming that goes wherever someone tells it to go,” he emphasized.
You can support Kirk’s Ironman fundraising challenge by visiting his fundraising page, http://bit.ly/29DMxwU.