- Diagnosed with renal cell carcinoma, stage III, at age 52
- Treated with surgery at UW Medical Center followed by chemotherapy
- Recurrence of cancer, stage IV, successfully treated with immunotherapy
Jeff Cline embraces life and enjoys an active lifestyle. He's ridden his bicycle in the 200-mile Seattle to Portland Bicycle Classic, an example of his endurance. He runs white-water rapids in a raft, an example of his bravery. And in the winter, he takes his family skiing down the most challenging runs the resorts have to offer, double black diamonds, an example of his perseverance. In October 2010, Jeff used all three of these important traits to attack an unwelcome intruder into his domain, renal cell carcinoma.
“I’m a senior engineer at Boeing,” Jeff said. “I’ve been married since 1980. And I have three happy, successful adult children. I’m a healthy guy, not a slacker.” So it came as quite a shock to realize one winter morning in 2010, after skiing those double black diamonds, that Jeff had blood in his urine.
“I immediately called my primary care doctor, Robert Thompson, MD, at Cascade Primary Care, [which is part of the UW Medicine system],” Jeff said. “He got me in for a computed tomography (CT) scan.” Then Jeff had a CT scan with contrast, a special agent that helped his doctors see the details of his kidneys more clearly. After that, Jeff got the news that he had kidney cancer. “I had no symptoms that often come with kidney cancer, like back pain,” Jeff said, “just blood in my urine.”
Jeff's doctor referred him to John L. Gore, MD, assistant professor in the Department of Urology at University of Washington (UW) School of Medicine. Dr. Gore ran lots of tests, did more imaging, and learned that Jeff's cancer had also moved into Jeff's inferior vena cava, “like a plug,” Jeff said. The inferior vena cava is the central, wide vein that carries deoxygenated blood from the lower body to the heart. “That was not good news,” Jeff said.
Scheduled for surgery right away, Jeff had his right kidney removed along with the tumor from his vena cava. “I have a built-in Halloween costume now: a great scar across my torso,” he said. After surgery, there was no longer any sign of cancer in Jeff’s body.
“People ask me what my odds are or how long I have to live,” Jeff said. “My response is, ‘Really? You’re asking me that?’ I’ve never once listened to what my odds are. I don’t even want to know what the stage of my cancer was. I just prefer not to know the details.”
After surgery, Jeff saw Scott S. Tykodi, MD, assistant professor of medical oncology at UW School of Medicine, who specializes in treating kidney cancer at Seattle Cancer Care Alliance (SCCA).
Even after a successful surgery, microscopic cancer cells may have still been in Jeff’s body and may have even spread, undetected. After reviewing his options with Dr. Tykodi, Jeff opted for a clinical study of adjuvant therapy, additional treatment given after the primary treatment to keep cancer from coming back. “But six months later, my cancer returned [as stage IV disease], and Dr. Tykodi decided to treat my cancer with interleukin-2,” Jeff said.
Interleukin is a form of immunotherapy, a treatment that uses the immune system to fight cancer. Interleukin-2 (IL-2) is a potent growth factor for immune cells called T-lymphocytes (T-cells). In some kidney cancer patients, IL-2 stimulates T-cells to attack cancer cells. However, IL-2 is difficult to receive. The treatment is intensive, and it's often associated with severe side effects. Fortunately, for Jeff it has been very effective. “But it was a very un-fun treatment,” he said.
To receive IL-2, Jeff was admitted to the intensive care unit at UW Medical Center. He received the treatment intravenously every eight hours for one week. Then he had a week off at home before coming back the next week to do it all again.
“I had a wonderfully caring staff for a horrible treatment,” said Jeff, who experienced every side effect that was likely and not so likely to occur, from uncontrollable shaking that was managed with Demerol to extreme water-weight gain and full-body skin dryness and shedding that were dramatic.
John A. Thompson, MD, professor of medical oncology at UW School of Medicine, is part of the melanoma and renal cell carcinoma care teams at SCCA. He saw Jeff on a day that Dr. Tykodi wasn’t in the clinic during Jeff’s IL-2 treatment and referred to Jeff’s side effects as the “shake and bake,” Jeff said. It was awful, but it only lasted a month. “I made it through the entire regimen with the help of the wonderful, caring institution that is SCCA and UW Medical Center,” Jeff said.
Life After Immunotherapy
“The nicest thing an oncologist can say to a patient is that it’s time to develop a 20-year plan for living,” Jeff said. “That’s what Dr. Tykodi told me after my IL-2 treatments. It’s an awesome thing.”
It took Jeff three years to get back to his pre-surgery workouts. He doubts he’ll ever be fully back to where he was, but he tries to stay active. As a member of the White Water Rafting Club at Boeing, he plans to be out on the water as much as possible. And he plans to ride his new Honda Gold Wing motorcycle as much as possible, too.
“I try hard not to dwell on the negative,” Jeff said. “I’m a ‘glass-half-full’ guy. I’m getting my life back, and I always look for ways to be positive.”
Talking about his illness and his experience is Jeff’s form of support and therapy. The more people he talks to, the larger his support network grows.
“My mom died of breast cancer at age 71,” Jeff said. “But my dad is still fit and active. There’s no science to say why I got this. My care system worked perfectly, and it’s just a memory now. I have chosen to live my life, and I don’t want to know my odds for survival. I am massively optimistic about this adventure I’m on.”