Worth the Distance: Advanced Cancer Treatment Helps Alaska Man After Just One Infusion

**By Hagen F. Kennecke, MD, MHA, FRCPC

The day after Christmas in 2016 brought unwelcome news for Wasilla, AK resident Josh McCool.

McCool, then 26, was diagnosed with a rare tumor of his adrenal gland, called a pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh). But after surgery to remove the tumor, a type that can cause serious complications but is rarely cancerous, McCool’s symptoms returned and got much worse.

“My resting heart rate was very elevated,” remembers McCool. “I was super weak, unable to play with my kids, and spending 16 to 18 hours a day in bed. On top of that, I lost more than 100 pounds over six months. I would be out of breath just walking from our couch to the kitchen.”

A Rare Cancer 

McCool’s pheochromocytoma was a type of malignant tumor known as a neuroendocrine tumor, or NET. There are many types of NETs, some which make abnormally high amounts of hormones that cause many different symptoms. After traveling to the Seattle Cancer Care Alliance and undergoing extensive evaluation, McCool was referred to the Neuroendocrine Tumor program at Virginia Mason Medical Center.

That’s when I first met McCool, who had become very weak and sometimes needed a wheelchair. He was in significant pain and his cancer was secreting adrenaline, which was causing even more symptoms. To help target his treatment we used a specialized PET-CT scan, called NETSPOT®, which identifies hormone receptors on cancer cells.

With the cell receptors identified, McCool became a candidate for an advanced treatment known as Peptide Receptor Radionuclide Therapy (PRRT) with a treatment called Lutathera®. In PRRT, a cell-targeting protein, or peptide, is combined with a small amount of radioactive material. When injected in the blood stream, this new substance, called a radiopeptide, binds to NET cells, delivering a high dose of targeted radiation.

Josh Before and After Treatment

Immediate Results

Amazingly, just one week after his first treatment, McCool noticed his symptoms were improving. A better appetite was followed by markedly more energy, increased activity and a significant decrease in his back pain. The targeted nature of PRRT — binding to a protein only on the cancer cells — greatly minimized side effects.

A total of four treatments were needed, once every two months. Since PRRT is not available in Alaska, McCool arranged travel to Virginia Mason. After only his second infusion, McCool was completely off pain medications, had gained weight and was able to play with his two young sons.

A New Beginning

Josh-McCool_Shannon-and-sonsDespite all the challenges of therapy, McCool feels very lucky. “Getting the green light to move ahead with the treatment was like winning the lottery,” says McCool. “It has definitely been a character building experience and one I couldn’t have gotten through without the amazing support system of family and friends that I’ve been blessed with all along the way.”

McCool finished his treatment this month and is planning a trip to Disneyland with his family next year.

All of us on the Neuroendocrine Tumor Program team who took care of Josh McCool take great inspiration from the remarkable improvement in his health. While PRRT is not a cure, the treatment has the potential for adding years to an active and fulfilling life.


Hagen F. Kennecke, MD, MHA, FRCPC
Hagen F. Kennecke, MD, MHA, FRCPC, has advanced training in oncology and specializes in neuroendocrine tumors and colorectal cancers. He is director of the Cancer Institute at Virginia Mason. Dr. Kennecke practices at Virginia Mason Hospital and Seattle Medical Center.

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