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When the Lung Cancer Patient Climbs Mountains

Late stage cancer patients aim to climb peaks in the Himalayas.

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.

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.”

Read full article: When the Lung Cancer Patient Climbs Mountains – The New York Times

Read Full Article: When the Lung Cancer Patient Climbs Mountains – The New York Times

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