When Glasgow, Ky., resident Debra Kantosky got a diagnosis of lung cancer in December of 2023, she was told that if she quit smoking, she鈥檇 have a better chance of a good outcome.
鈥淏ut when you鈥檝e smoked for 52 years, you really have to wrestle with yourself whether it鈥檚 something you want to do and can do,鈥 Kantosky said.
When patients and clinical trials connect
Then Kantosky was offered the opportunity to participate in a clinical trial at 鈥 a member of the 鈥 to determine if allowing patients to choose their own tobacco cessation treatment and level of coaching helps them quit.
鈥淭his was a completely personal, mental battle,鈥 Kantosky said. 鈥淚 had tried nicotine patches years ago and they didn鈥檛 do it for me. This time, I was able to chew nicotine gum, and I discovered that the nicotine pouches that you put in your mouth and then remove quickly helped.鈥
She also found that keeping her hands busy 鈥 doing puzzles, coloring, gathering and cracking pecans and chopping vegetables 鈥 lessened the temptation to grab a cigarette.
The former pack-a-day smoker was able to quit, thanks to trial and her own determination.
鈥淚t is a big deal that Debra stopped smoking,鈥 said Diego Cabrera, MD, Kantosky鈥檚 medical oncologist at The Medical Center at Bowling Green. 鈥淩esearch shows that patients do worse if they continue to smoke while they are receiving treatment for cancer. It鈥檚 clear that if they continue to smoke after treatment, they have a greater chance of cancer relapse and death than nonsmokers.鈥
The Medical Center at Bowling Green became a member of the UK Markey Cancer Center Affiliate Network (MCCAN) in 2016 and the Markey Cancer Center Research Network (MCCRN) in 2021. The networks connect community hospitals across Kentucky and beyond with the comprehensive resources and expertise at Markey. Like many of Kentucky鈥檚 hospitals with growing cancer programs, The Medical Center at Bowling Green didn鈥檛 offer clinical trials at the time. But with MCCRN鈥檚 guidance, its first clinical study was up and running in October of 2022.
鈥淐linical trials provide access to cutting edge care," said Cheri Tolle, administrative director of MCCAN. 鈥淧articipation in trials is a best practice and while patients do travel to Lexington from across the state and even outside of Kentucky to take part in trials, there are many barriers, from socioeconomic to health complications, that make it too difficult for many to make the trip.鈥
Cabrera agrees.
鈥淭he Wall Street Journal labeled it the 鈥榗ancer commute,鈥欌 he said. 鈥淧roviding care closer to home is pivotal.鈥
In addition to the TTOP trial, Kantosky is also part of UK鈥檚 study. The TTOP and PRiMAL trials were developed and are led by Markey clinician investigators Joseph Valentino, MD, and Timothy Mullett, MD.
鈥淲e test the DNA of a patient鈥檚 cancer and look for particular mutations that can drive that cancer,鈥 Cabrera said. 鈥淪ome of those mutations have treatment indications.鈥
惭补谤办别测鈥檚 , a forum of UK experts, reviews any abnormalities and provides guidance on patient-specific targeted therapies. Cabrera hopes that the study will help identify which types of patients might benefit most from the review.
鈥淭he support from MCCRN has really been wonderful and has been a huge part of our success,鈥 said Tina Berger, oncologic clinical research coordinator for Bowling Green. 鈥淲e are happy that we can offer trials right here in our patients鈥 backyards. Your heart just goes out to them, and when we see someone like Debra quit smoking, we are elated.鈥
Kantosky was a bit apprehensive before beginning chemotherapy and radiation therapy because she watched two of her sisters, who had other types of cancer, suffer from the side effects before they died from their disease. She feels fortunate that she had few problems. Last May, she began immunotherapy and she continues with a monthly infusion for maintenance.
鈥淚 feel pretty well and the tumors have shrunk. One they can鈥檛 even see anymore and another is much smaller,鈥 she said.
The news is welcome because Kantosky and her husband have plans. Every July 4th since 1992, they鈥檝e hosted as many as 36 family members for a reunion, and now everyone chips in to plan the event. She also creates hand-made Christmas stockings for her relatives, this past year adding two more to the collection 鈥 one for her new daughter-in-law and another for her third great-grandchild.
鈥淚鈥檓 73, and I expect to do the same things as when I was 43,鈥 Kantosky said. 鈥淏ut I just absolutely eat my great-grandchildren up and love doing all kinds of activities with them.鈥