Andy Lindsay, a lung cancer patient, was among the climbers and porters heading up Mera Glacier in Nepal to Mera High Camp on a three-week trek this fall.CreditMargaret Fahey
On Oct. 15 at 8 a.m., Andy Lindsay stood atop 21,247-foot Mera Peak in Nepal, a wildly improbable place for him to be both athletically and medically.
Andy, a veteran climber and a friend of mine, had been living with Stage IV lung cancer for three years. “To live one year was statistically unlikely, and two years looked like a miracle,” he said.
He was able to make the climb thanks to the success of a cutting-edge targeted therapy clinical trial. It targeted his specific lung cancer mutation, shutting off the fuel to his tumor’s growth and shrinking the tumor. He wasn’t cured, but his scans were strikingly improved and he was almost symptom-free.
The trip illustrates a shifting landscape both for oncologists and cancer patients exploring a return to active lifestyles. Dr. Tomas Neilan, the director of the cardio-oncology program at Massachusetts General Hospital in Boston, and part of Andy’s medical team, said the recent success of these targeted therapy treatments alters the way specialists like him view and treat advanced cancer patients.
“They’re taking Stage IV cancer and turning it into a chronic disease no different than high blood pressure,” he said.
Andy, 61, of Ipswich, Mass., had a window of good health, a honeymoon of indeterminate time during which he could resume the activities he loved. He played in his coffeehouse band, traveled and took long bike rides up the coast. He also accepted a friend’s invitation to climb in Nepal.
Jan and Andy Lindsay take a tea break in the Hinku Valley on the third week of their trek.CreditSandy Walker
Over three strenuous weeks he and his wife, Jan, who is a registered nurse and an experienced outdoorswoman, trekked alongside eight other climbers and several guides, most of whom they’d traveled with in the past.
In announcing the trip on his Caring Bridge page to ask for donations to fund lung cancer research, Andy had said there was a slim chance he’d summit.
At the altitude he reached, there’s 70 percent less air pressure than at sea level to push air into the lungs. Breathing is hard for the fittest climbers. There was no data on what the high altitude would do to an advanced lung cancer patient: None were found to have tried.
“It’s a remarkable achievement,” Dr. Neilan said. “My colleagues are flabbergasted.”
He gave Andy the O.K. to go to Nepal not as a dying man attempting his last climb but as a person with a deep experience in the mountains who exhibited solid cardiovascular function and health. In the previous months Andy had climbed high peaks in Maine and New Hampshire. Years earlier he’d traveled to Nepal for a trekking trip without incident.
Dr. Neilan, a climber himself, said he found no data around altitude sickness — the most dangerous and common health risk for climbing in high mountains — and Andy’s conditions. But Dr. Neilan knew that at lower altitude even healthy younger climbers tended to have a greater likelihood of pulmonary edema and cerebral edema.
They reviewed a series of warning signs of altitude-related health problems ranging from coughing up blood to severe, unshakable headache. He gave his blessing but acknowledged: “If you polled physicians you might have gotten a lot of different advice.”
Jan and Andy Lindsay climbing in October.CreditSandy Walker
Another of Andy’s doctors, Dr. Zofia Piotrowska, a medical oncologist at Massachusetts General, said her team wanted to help him go where he wanted to go, knowing the trip’s meaning to him. However, if she thought the trip was a “medically very unsafe thing to do,” she’d have asked him not to go, she said.
Dr. Piotrowska focuses on the type of lung cancer Andy has, which has a mutation in the gene called epidermal growth factor receptor, or EGFR. The EGFR subgroup represents about 15 percent of all non-small-cell lung cancers and is relatively common in “never smokers” like Andy.
When he was given his diagnosis in 2014, he was treated with a first-generation EGFR inhibitor, an oral pill that turned off the mutant protein on the surface of the cancer cell. His response was swift, but the remission lasted less than a year.
In 2016 he enrolled in his current trial after a biopsy showed his cancer had developed a specific mutation to resist the original drug he’d been on.
A newly developed drug known as EGF816 targeted his acquired resistance.
Within days of being treated, Andy noticed he was breathing better. He resumed his outdoor activities and adventures in the months to follow, doing more as his fitness improved.
Dr. Piotrowska said that before clearing him for the climb, she thought his lung function was pretty close to normal. The question nobody could answer was how lungs that were once filled with cancer would tolerate altitude. Also unanswerable was how he’d respond to the exertion and stress of the expedition, which included waking in darkness in subzero temperatures and a 16-hour climb on summit day.
At the summit of Mera Peak — altitude 21,247 feet — Andy Lindsay pays tribute to his cancer team at Massachusetts General Hospital, where gene therapy for his Stage IV lung cancer enabled him to make the climb.CreditSandy Walker
Andy admitted that he was pleasantly surprised that his doctors signed off.
His most recent scan had confirmed two small, slow-growing nodules, one on each lung. There were no immediate symptoms.
“It’s not like we were told to expect these spots to blossom forth while he was gone,” his wife said. “If we had, it would’ve been an absolute no go.”
A longtime ski mountaineering friend, Brian Lambert, invited Andy to join the trip. They felt he’d be in good hands: the lead guides were Jim Gudjonson, a longtime alpine guide on several of Andy’s previous trips, and Deryl Kelly, an Everest veteran and the head of Parks Canada rescue service who, as an E.M.T., would oversee the clients’ health on the mountain, along with a team physician.
The trip itself was a test. Though Andy went at his own pace the opening week, staying mostly to the rear of the rest of the party as he combined walking steps with periodic “rest steps,” he struggled.
He said he was within a day of letting the others advance on the summit without him when his stamina markedly improved. As they crossed the Mera glacier above 17,000 feet he found himself alongside the group’s faster members. Although it is poorly understood who acclimatizes well and who doesn’t, Andy said he found that he did better at higher altitudes. He likely also benefited from his superb technical skills in using crampons and ice tools on the high glacier.
And he joked that he might have another useful mutation: “I seem to love a sufferfest.”
In ascending on the final day — the climbers were tethered to one another with rope — Andy described the despair of a too-fast pace in the darkness melting in the uplift of a spectacular daybreak. The “beautiful crimson” lit up all the neighboring high peaks, including Everest.
Late last year, he was among several Stage IV cancer patients invited to a small gathering in Boston of top Massachusetts General researchers who outlined their thinking on future therapies. The researchers were clearly energized by the presence of the pioneering patients.
“This is an example,” Dr. Piotrowska said, “of something that none of us ever thought would be possible a few years ago.”
Correction: January 8, 2018
An earlier version of this article mistakenly referred to the therapy Andy Lindsay had as gene therapy. It is targeted therapy, which targets and inhibits the EGFR mutation, but does not alter the patient’s DNA.
Anneka Baldwin, Niamh's mother, said her child's hair style should not decide whether she can be in class.
"I am so upset that the school has made her feel so low," she said, branding the decision a form of "discrimination".
Niamh Baldwin before her charity head shave
After being put in isolation on Thursday, Niamh did not attend school on Friday due to being upset at the prospect of being put in isolation again, her mother said.
On Monday her hair was judged to have grown enough for her to be put back into normal classes.
'So proud'
"Although Niamh is back to classes I still feel like the positive and amazing deed she did has been dampened and not praised as it should have been," Mrs Baldwin said.
She added she was "so proud" of her daughter, and disagreed with the school's rules on hair length.
Mounts Bay Academy vice principal Les Hall said Niamh was removed "for a short time" as her appearance was "upsetting and confusing to a number of students and staff", but was not excluded.
He added the school had not been made aware about the charity head shave, and the reasons behind the hair cut "were unclear at the time".
"Niamh was soon after returned to her normal lessons where she is currently studying successfully," Mr Hall said.
A NINE-year-old who battled terminal cancer long enough so he could name his baby sister told his parents shortly before he died: ‘You can only cry for twenty minutes’.
Brave Bailey Cooper battled the disease for 15 months and was determined to keep fighting until his new sibling arrived.
Mum Rachel, 28, gave birth in November and Bailey named her Millie.
Tragically, Bailey lost his fight with the disease on Christmas Eve and his proud mum and dad Lee said he smiled all the way through his treatment.
Rachel said: ‘We didn’t think he would last that long, but he was determined to meet Millie.
New arrival: Bailey gets to meet his new sister – and named her Millie
‘It got to the end of November, and Millie was born. He hugged her and did everything an older brother would do — change her, wash her, sing to her.’
Bailey’s dad Lee, 30, added: ‘Doctors said he was going to go before Millie was born.
‘He didn’t. He fought, and on the way to hospital, he said we should call her Millie.
‘But the moment after he met her, he began to taper off quickly. He was slipping away.’
The family knew Bailey was unlikely to survive to celebrate Christmas but encouraged him to write a list of gifts he would like.
But the unselfish youngster drew up a list of presents for his younger brother, Riley, six, knowing he wouldn’t get the chance to play with them himself.
All together: Bailey Cooper pictured in hospital with brother Riley, sister Millie and parents Lee and Rachel
When his grandmother said she wished he could take his place, Bailey told her: ‘That is really selfish Nan. You have grandchildren to take care of.’
And in their last family get-together the youngster told his parents: ‘You’re only allowed to cry for 20 minutes. You have to take care of Riley and Millie.’
Bailey first became ill in the summer of 2016, and after a series of tests was diagnosed with Non-Hodgkin Lymphoma, which develops in the network of vessels and glands in the body.
By the time it was discovered, it was already in Stage Three.
Brotherly love: Bailey Cooper in hospital with his younger brother Riley
Doctors treated the cancer with chemotherapy and steroid medication and were optimistic the youngster would recover.
But, after a period of remission, Lee and Rachel were handed the devastated blow their son had gone into relapse and no more could be done.
After being taken to a hospice on December 22, Bailey’s family gathered by his bedside and read him stories to keep him company.
‘By 11.45am on Christmas Eve, we were by his bedside, mum Rachel said.
‘We knew it was not going to be long. We told him “It’s time to go Bailey. Stop.”‘
‘The moment we said “stop”, he took his last breath and had just the one tear come out of his eye. It was peaceful.’
由醫療研究局(the Medical Research Council)贊助是項研究，還得到國際衛生研究所(National Institute for Health Research, NIHR)的劍橋生物醫學研究中心(Cambridge Biomedical Research Centre)和實驗癌症醫療中心( the Experimental Cancer Medicine Centre)支持劍橋人民研究組織銀行(the Cambridge Human Research Tissue Bank) 提供這研究的基礎設施支援。
本網站與英國癌症研究(Cancer Research UK)合作, 獲授權翻譯和轉載中文版內容。「她」聯合英國過百個慈善機構、許多醫護界和科學專家等集中癌症範疇研究，內容涉及先進醫療科技、資訊、癌症新趨向與標靶藥物等，期望找出腫瘤病源和醫治方法，除了能及早醫治外，還有助增加癌症病人存活率。 https://www.cancerresearchuk.org/
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