Four Years and Counting – New Cancer Drug Extends Ohio Man’s Life

While growing up in Akron, Ohio, in the 1950s, Eric Bray survived polio and its aftermath. “I had severe damage across my chest and shoulders. At one point, I was so stiff that I couldn’t touch my chin to my chest,” he says. “The muscles on the inside of my legs also were damaged.”

Eric regained his strength and coordination with the help of a library book, Track and Field for Boys. By sixth grade, he was the fastest runner in his class. This sparked a lifelong passion that included completing 42 marathons.

Eric faced another major challenge in his late 20s — while running, he was struck by a pickup truck, which severed his right quadricep above the knee. Surgery and rehabilitation set him back on track, and he was running again within a year.

So it was that in 2019, he was shocked to be diagnosed with Stage 4 urothelial cancer, but resolved to prevail once more. “I had beaten the odds a few times,” he says. “I would not let cancer define me.”

He and his wife, Betsy, were living in Seattle when he was diagnosed with urothelial cancer of his kidney with metastasis to his lung and lymph nodes. This type of cancer starts from the cells of the tissue lining the bladder, kidney, renal pelvis and ureter. “In my second meeting with the oncologist, I asked about my prognosis,” he says. “She looked at me and said, ‘If there’s something you want to do or see, go do it now.’ My prognosis was for less than a year.”

The Brays decided to move back to Northeast Ohio to be near family. Their children found them a house, which they moved into on Memorial Day weekend. The location allowed for easy travel to Cleveland Clinic’s main campus, where Eric began seeing oncologist Timothy Gilligan, MD, an expert in testicle, prostate, bladder and kidney cancer. His goal at the time was to make it through one more Christmas with his family.

“I met with Dr. Gilligan the first week of June and then completed the chemotherapy treatment I had started in Seattle,” Eric says. “I got a break so my body could recover, and at the end of that period, my scans showed mixed results. Some tumors were stable, and some had shrunk. Others grew, and they also found a few new spots. In the fall, we tried immunotherapy, which failed.

“The first week of January 2020, I met with Dr. Gilligan to see what they could try next. He presented a brand-new drug, just approved on Dec. 20 for a very narrow window of uses. He asked whether I wanted to try it, and my reaction was, ‘Sure! If it works, it works. If it doesn’t, then we’ve learned something for the next person.’ My next question was, ‘How long will I be on this?’ Previous treatments were for weeks or months. He said, ‘For the rest of your life.’ I said, ‘Let’s go for it.’”

Today, over four years later, Eric is still on the new treatment. His most recent scans showed no signs of cancer.

“Urothelial cancer is one of the five most common cancers in men,” Dr. Gilligan says. “There are several new classes of treatment now. We’ve seen major advances in outcomes for some patients who were expected to live a year or two and, instead, are living in stable condition for much longer. It’s not clear what the endpoint is. Will they at some point become resistant to treatment, or will they stay in a stable condition forever? We don’t know yet.”

After his treatments with the new drug began, scans revealed that while the lung and lymph node metastases seemed to be shrinking and going away, the original tumor in Eric’s left kidney did not. Christopher Weight, MD, a urologic oncology surgeon, presented Eric’s case to the multidisciplinary tumor board, and they determined that the kidney should be removed. He performed successful surgery in November 2022.

Dr. Weight will climb a mountain for Eric — literally. Through a nonprofit that he founded called Climb 4 Kidney Cancer (climb4kc.org), Dr. Weight and other climbers take the photos of consenting patients to the summits of mountains on five continents. Dr. Weight plans to carry Eric's picture to the summit of Grand Teton.

“In cases like Eric’s, we almost never do surgery because usually, the risk of dying from the cancer is so high that surgery is not thought to be of value,” Dr. Weight says. “But Eric had such a good response to treatment, and the lesions seemed to be going away elsewhere, though not in his kidney. We removed Eric’s left kidney and also nearby lymph nodes.”

For a brief window of time, Eric and his team at Cleveland Clinic thought the cancer was gone. But soon thereafter, the same kind of urothelial tumor found in Eric’s kidney also implanted in his bladder, and Dr. Weight continues to follow him. “We take a multidisciplinary approach — utilizing surgery, IV chemotherapy and bladder immunotherapy washes,” he says. “We removed all visible tumors surgically with an endoscopic instrument — in his case, using pulsed electricity — to remove tumors from the inside. Then we prevent recurrences by washing the bladder once a week for six weeks with immunotherapy. The last time we checked Eric’s bladder, we saw no visible disease.”

Eric was amazed. “After five years and 29 days of being scanned and scoped, I heard words I never thought I’d hear when Dr. Weight said, ‘there’s nothing there.’ Until the day I heard that, I had had six surgeries, 179 IV infusions, and I don’t know how many scans and scopings and support appointments, including cardiology, nutrition, and physical and occupational therapy. Over that period, with a combination of my age and the drugs, I had eroded physically. Now, my journey is to see how much of that erosion I can reverse.”

Although the new drugs are much better tolerated than chemotherapy, they do have side effects, Dr. Gilligan says. “The main one I’ve seen is neuropathy, which is a loss of sensation in the hands and feet. That can be a real problem for balance, as your ability to walk steadily is dependent on your brain receiving signals from your feet.”

Neuropathy has kept Eric from running, but not from living. He and Betsy enjoy spending time with their children and grandchildren.

“If a patient is stable for a few years, we don’t know whether it’s safe to stop,” Dr. Gilligan says. “But I think it’s a good problem to have. I think the main message is that we’ve made real strides. We have some patients who now live for many years with metastatic bladder cancer, and that almost never happened 10 or 20 years ago. It doesn’t work on everyone, which is disappointing, but it’s amazing that we have this significant minority of patients who get this durable response to treatment where they not only live for many years without the cancer growing, but can go about their normal lives.”

Eric agrees, expressing gratitude to both his wife and his medical team.

“I want to give well-deserved credit to the sacrifices, care and support of my wife of 51-plus years, who has put her life on hold for this journey,” he says. “She has dealt with the ups, downs and stresses of the unknown future. Her faith in my medical team is equal to mine, and is the reason my positive mental attitude is possible. I will never sail with Magellan or cross the plains with Lewis and Clark. My journey with Dr. Gilligan, Dr. Weight and all the other members of this exploration team through unchartered waters is exciting. I’ve been very lucky with respect to the people I’ve traveled with.”

The self-described “stubborn Irish kid” also is the proud owner of his own copy of Track and Field for Boys. “I found it in a used-book store,” he says.