Colonel Jeffrey E. Smith is Changing the Face of Lung Cancer

I am Colonel Jeffrey E. Smith and I retired from the United States Air Force as the Commander, Defense Contract Management Agency of Chicago on 30 June 2006, after 26 years of distinguished military service. Upon my retirement I was given a clean bill of health and was looking forward to this new chapter of my life. I was thrilled with the prospect of spending more time with my wife and three sons. My wife and I had planned the places we intended to visit, the time we would spend with our sons and grandchildren and opening up the next chapter of our lives. We eagerly anticipated the change after I had spent so much of my time away from my family throughout my career.

Then without any warning and just one year after I had left the military, things went horribly wrong. Of course, at first I had no idea of the signs I was being given. I had developed a cough that would not go away. Finally, I decided to seek medical attention. This still did not reveal anything which caused worry. The doctor prescribed antibiotics and we both thought that would be the end of it. Of course, the antibiotics did not work and I returned to the doctor’s office. My primary care physician then told me that sometime a stronger antibiotic was required. I was not alarmed and proceed to fill and take the new medication. After the second set of antibiotics did not work, the doctor sent me for an x-ray. This showed an abnormality and I was referred to a specialist. The specialist ordered a full set of tests. My evaluation included CT scan, PET scan, MRI, and end bronchial examination of my airways. After a month of test and biopsies, I was told I had lung cancer. How could this be, I had NEVER smoked in my entire life and I constantly counseled others to stop smoking. I exercised regularly and took pride in the fact that I beat many of the younger airmen on the base during the 1.5 mile run. I was conscientious to eat a healthy diet and get a physical when required. How, could I be facing a diagnosis of lung cancer?

At the age of 50, with the support of my family, I began chemotherapy for the treatment of stage IV lung cancer. Stage IV, the highest stage, has a prognosis of 8 to 10 months. At the time, I did not know this and was informed by the doctor that I could only expect to live another 2 to 3 pursing treatment. I was told the chemotherapy would be as bad as or worse than the disease. At best, it would only to help ease my symptoms and at worst it would make me feel even worse with no benefit. In short, I was told there was no hope and I needed to get my affairs in order.

My desire for life, my love for my family and my faith would not allow me to accept this prognosis. I decided to pursue chemotherapy. The chemotherapy consisted of carboplatin, paclitaxel and bevacizumab. The drugs left me exhausted, nauseated and stole my energy. After six weeks I had my first CT scan, and the results showed that the cancer was responding. Responding in such a manner that the doctor said only occurred with about 10% of patients. I began to feel encouraged and started to believe I might be able to beat this. This fight lasted for only a short 6 months. I grew more fatigued and my toes turned black and my fingernails begin to slough off. I was told the chemotherapy was no longer working and there were no standard drugs the doctor could prescribe. The doctor recommended that I explore a clinical trial and suggested I should seek treatment at Walter Reed. This advice was one of the many blessings I have enjoyed over the course of my treatment.

While this first door had closed, my family and my faith helped to sustain me. After my evaluation at Walter Reed, I knew I was with the right medical team. They began to discuss further testing of my tumor and that they would manage my disease in collaboration with the National Cancer Institute at the National Institute of Health. The team is at the forefront of cancer research. More importantly, in my mind, they know that the patient requires more than care of the disease. The doctors, nurses and administrative staff provide a level of care that lets you know they care about you as an individual. Care for your spirit is every bit as important as care for your body!

A key change occurred about a year into my treatment. My tumor underwent molecular testing. Now, my treatment could be tailored to my particular disease. I was no longer given chemo that indiscriminately just attacked any cell. My chemo was now carefully selected based on the characteristics of the cancer Jeff Smith is battling. This testing showed that my tumor was overexpressing a protein, HER2/neu. This protein was first discovered in breast cancer and the discoveries in breast cancer have allowed my physicians to continue to target this protein in the treatment of my cancer. I have been on several chemotherapies over the years and remain on chemotherapy today, but my therapy is always targeted. I have been treated at both Walter Reed and the NIH participating in clinical trials and in just getting what Walter Reed calls the standard of care, although I am aware that there is nothing standard about this care. Today, we celebrate surviving lung cancer. I am a veteran and a 5-year survivor of metastatic lung cancer.

Team Draft was kind enough to send me to see my hometown team, the Washington Redskins. I was able to celebrate this day with my oncologist from Walter Reed, Dr. Corey A. Carter. We had a wonderful day and I hope my story can bring hope to others.