Nine years ago, John White was told that aggressive prostate cancer would take his life. The 59-year-old from North Attleborough, MA, had been diagnosed with stage 4 locally advanced and metastatic high-grade differentiation prostate cancer in 2014. Despite a family history of prostate cancer, the grim prognosis came as a surprise to the medical biotechnology engineer. “I’d just had a physical 11 months before my diagnosis,” he said. “I felt healthy – how could I be terminal?”
Advised to get his affairs in order, John instead put his positive attitude and over 3 decades of expertise in the biotech industry to use. Because of his career, John was familiar with many of the cancer programs in Boston, including Tufts Medical Center and renowned genitourinary oncologist Dr. Paul Mathew, MD.
“I knew about Tufts Medical Center from my work and they stood out right away. They’re known for taking on challenging and aggressive cases, and Dr. Mathew had the research background with clinical expertise, so that’s where I wanted to be.”
John began a grueling course of hormonal therapy and chemotherapy with his family and the Tufts Medical Center team by his side. “Everyone showed me compassion and care. They took my calls any day of the week and evenings to answer my questions—they even brought coffee to my bedside when I was in the hospital.” Despite the support and care, 2 years after his initial diagnosis, John’s prospects were worsening. Despite the removal of the prostate and lymph nodes and additional chemotherapy, the disease had progressed to other lymph nodes and the bladder. The tumor demonstrated an even more aggressive behavior with high-grade neuroendocrine features under the microscope.
That’s when Dr. Mathew proposed sending the prostate tumor for testing at a Cambridge, MA-based biotech and genomic testing firm. The results revealed John’s cancer was fueled by an exceedingly rare genetic mutation, and it also revealed another option for treatment.
“Genomic testing can sometimes give us the information we need to target and treat disease in a precise and effective way,” says Dr. Mathew. “In John’s case, we were able to identify a strategy with immune checkpoint inhibitors for his tumor, which had a very high number of DNA mutations. His tumor lacked a proofreading enzyme that functions like a copyeditor to review DNA replication errors. This deficient copyeditor led to the accumulation of multiple DNA mutations, which can make the tumor more sensitive to recognition by the immune system. With this information, we were able to secure permission for the use of the immune checkpoint inhibitor pembrolizumab from the manufacturer, as it was not yet FDA-approved for the indication and his insurance company would not cover it. Pembrolizumab boosts the immune system of a patient, helping it to fight tumors.”
Within a few months of beginning infusions, John’s prostate-specific antigen (PSA), the protein which serves as an indicator of the disease, was regressing and repeat CT scans showed that he was making excellent progress. “When I started, I told Dr. Mathew I wanted to walk my daughter down the aisle on her wedding day and he told me I would make it. Four years after my diagnosis, I was there and so were Dr. Mathew and my oncology nurses, Maura McMahon and Jen Dagesse. "I’ll never forget that day and their attendance. It made it all that more special to me and my family," said John.
Now, 8 years after beginning immunotherapy, John’s scans show no signs of disease. He has been off all treatment for almost 2 years. And while he retired from his long career during treatment, he hasn’t slowed down. He’s started a home repair and remodeling business and continues to ski, golf and play hockey in his spare time. But perhaps most importantly, John has become a deeply committed advocate for several leading cancer institutions, supporting patients and their families, serving as a mentor in the YMCA’s Livestrong program, travelling abroad to speak with cancer experts, and sharing a powerful message, “My case is exceedingly rare, but I tell anyone living with cancer to keep hope alive and hold on for the next big research discovery to come along. The landscape of cancer treatments is changing with the advent of targeted and precision therapies.”
