David Peterson was diagnosed with lung cancer in 2019 after he sought treatment for a cough that wouldn’t go away.
While he was a smoker, the softball-sized tumor growing in his lung was the result of a gene mutation 鈥� 鈥渢he luck if the draw鈥� is how he described it.
Surgeons removed the cancerous lobe but the cancer came back. He went through chemo and immunotherapy at MedStar Georgetown University Hospital. The cancer returned again, more aggressively.
By mid-2023, Peterson had a pulmonary embolism, was on home oxygen and, by his own account, had about two to three months to live. He was fooling himself, he said, but not the cancer.
鈥淚’m going to get through this, no matter what,鈥� Peterson said of his mindset at the time. 鈥淎nd I wasn’t. I was going downhill.”
He was also running out of options.
“I had gone through very end-of-the-line trials, just grasping at straws,” Peterson said.
In a last-ditch effort, he traveled to Chicago in 2023 to undergo a double lung transplant at Northwestern Medicine, the only hospital in the country that performs the procedure on patients like Peterson.
The program Peterson entered is called DREAM 鈥� which stands for Double Lung Transplant and Registry Applied for Lung Limited Malignancies.
Northwestern Medicine performed the first surgery in 2021.
“These patients were so hopeless at the time and they just dreamed for just some extra time,” said Dr. Ankit Bharat, the executive director of Northwestern Medicine鈥檚 Canning Thoracic Institute.
The concept grew out of Northwestern’s COVID-era work. The hospital was among the first in the country to perform lung transplants on patients whose lungs had been destroyed by the virus.
In those cases, surgeons had to remove severely infected lungs without spreading dangerous bacteria into the bloodstream. Bharat said the lessons learned translated directly to lung cancer cases.
“We thought that for at least a cohort of patients that have disease confined to the lungs, we can carefully take those cancer-ridden lungs out and put new lungs in,” Bharat said.
A puts hard numbers behind that approach. Among the 17 Stage 4 lung cancer patients who qualified for transplant and received one, survival at one year was 100%, Bharat said. Among the 81 patients who met the criteria but did not receive a transplant, the one-year survival rate was roughly 40%.
“There is really no treatment out there that can increase the one-year survival by 60 percentage points,” Bharat said. “There is literally nothing out there in the lung cancer space.”
The study also found transplant outcomes for lung cancer patients were comparable to outcomes for patients who received transplants for other reasons. Bharat said the results put to rest a long-standing concern about whether giving lungs to cancer patients was justified when donor organs are scarce.
Lung transplants聽are among the most complex surgeries performed anywhere, Bharat said, noting only about 3,500 of the operations were performed last year, compared to more than 50,000 kidney transplants.
Transplanted lungs also carry a higher rejection risk, partly because they are the only organs directly exposed to the outside environment courtesy of every breath we take.
Adding to the difficulty for cancer patients is the requirement that they stay in the Chicago area for a year after the surgery so they can be monitored. Insurance approval is also a hurdle.
Peterson got through it all and said it鈥檚 changed his life. He said for 15 years, he found it increasingly difficult to breathe, and assumed it was because he was a smoker.
Now, “I can breathe so incredibly well,” he said. “It sounds funny to say.”
鈥淲hen I inhale, I can inhale. For me, in my head, I’m like amazed how deeply I can inhale, and it feels terrific.鈥�
Since his surgery, Peterson said he has traveled to Australia, gone skiing in Utah, visited Budapest and attended his daughter’s college graduation.
And the advice he offers to others in the same bind as he once was: “Northwestern. Get there as fast as you can,” he said. “Don’t hang out and try to figure out alternatives when you’re so close to imminent death.”
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