Stomach Cancer - Stage IV: James Tran

I am a 48-year-old male, who after a weekend of sharp abdominal pain and a visit to the emergency room, was diagnosed with widely metastatic Stage 4 stomach cancer.

The first oncologist I met was in the Emergency Room. He prescribed 5-FU chemotherapy claiming that he would try to control the spread but that basically there was no hope. With such negativity, my wife and I wanted to say goodbye and FU-5 times to this doctor.

We then got a second opinion from a university-based oncologist. He prescribed either a treatment with 5-FU or a clinical trial from which I would have to sign-up and randomly get selected to the test group. The control group would receive irinotecan and docetaxel, while the test group would be treated with a combination of two test drugs. Intuition tells me multiple drug combinations are the better way to go and I wanted to be on the test group without randomization.

For the clinical trial however, personal choice is not possible and it was a 50-50 chance to be in the test group. Still, the clinical trial would be a test “using my body” if I got selected. This second doctor was more general in that he disclosed average statistics, but acknowledged that I was not an average Stage 4 stomach cancer patient given my age and health.

In between the consultations, we heard about Dr. Robert Nagourney through a former patient of his. Upon further online research, it was very clear that we needed to consult with Dr. Nagourney. We brought up the topic of functional profiling to our second consulting physician.

He was surprised that we knew about this and pushed the approach aside citing statistical significance, etc. He’d further explained that we should only look into this approach if a standard protocol did not work. My wife and I could not believe what we heard: Basically, the university-based oncologist wanted to use my body for trial-and-error, and he knew about but never disclosed chemosensitivity testing and functional profiling techniques.

We then decided to seek a third (and final) opinion.

During our first appointment with Dr. Nagourney, we could clearly sense his passion and conviction in treating cancer patients. He reviewed my case and explained that while the opinion of the university investigator was valid, it might underestimate the patient’s individual chance of response.

He explained that gastric cancer statistics, like all medical statistics, are population based. That is, a 20 percent response rate does not mean that every patient gets 20 percent better, but instead, that two out of every 10 respond, while eight do not. He stated that his job was to find out to which group I belonged. And his objective was clear: kill the cancer cells, not control the spread.

I underwent a surgical biopsy and submitted tissue to Rational Therapeutics for their functional profiling analysis. The results were strikingly favorable with several drug combinations revealing both activity and synergy. After careful comparison, Dr. Nagourney recommended the combination of Cisplatin, Taxotere and 5FU.

On March 12th, I began treatment on an every-other week schedule. Dr. Nagourney repeated the PET/CT after just two cycles. Much to all of our delight, I had achieved a complete remission with resolution of all measurable disease, including the bulky abdominal masses and numerous lymph nodes.

Please see my story in Dr. Nagourney’s May 20th, 2014 blog article on metastatic gastric cancer.

We knew I was in, not just good, but perfect hands! The rest is history and now I continue to complete the full treatment while in complete remission.

Thank you Dr. Nagourney for your dedication to treating the ill, your passion and compassion, and your brilliant approach.

People say there is no cure for cancer. This must be the belief for the masses and the average. But if anything, each patient is an individual and the closest cure to an individual with cancer may just be within reach through Dr. Nagourney.

We wish all cancer patients to be informed about Dr. Nagourney and Rational Therapeutics. This is crucial information to have if patients are fighting for their lives.

James T., informed 48-yr old Stage 4 stomach cancer patient and survivor, reinsurance risk manager/underwriter/actuary, loving husband and father.

How We Test Your Cancer Infographic

Currently, hundreds of drugs, drug combinations and targeted agents are used to treat cancer patients. With so many choices, how does your oncologist decide which ones are right for you?