One morning in September 2023, Ed (who asked that we only use his first name) woke to find he couldn’t speak. Doctors quickly determined the 55-year-old former attorney had had a stroke in the night, but it was too late for emergency intervention.

He was airlifted from Port Angeles, Washington, to Seattle for surgery to remove the blood clot that caused his stroke — a risky procedure that proved unsuccessful.

The stroke left Ed with seizures and aphasia, a condition that makes finding and expressing words challenging. A CT scan revealed that the cause of the blood clot was a tumour in his lung. Because there was lymph node involvement, Ed’s cancer was classified as stage 3.

Blood clots are a common side effect of cancer, and though he didn’t know it at the time, Ed had already experienced one in his leg, leaving what looked like a bruise.

When a biopsy confirmed the diagnosis, Ed and his wife of 33 years, Joanna, decided the best course of action was to go to a dedicated cancer facility. Based on recommendations from friends, they chose Fred Hutch.

Ed still becomes emotional when he thinks about that choice.

Because Ed was otherwise healthy and his physicians at Fred Hutch determined surgery wasn’t appropriate, they suggested an aggressive two-dose chemotherapy regimen, followed by proton therapy and immunotherapy. Although it was risky to start chemotherapy right after a stroke, “I considered what was more important,” he said. “My head and learning to talk again, or my life. They chose the best possible course.”

Ed and Joanna had done some research and learned about the benefits of proton therapy, and Kang agreed that, despite insurance and financing hurdles, it was the right choice.

“The bulk of Ed’s tumour burden was in the mediastinum surrounded by soft tissue, which made his case particularly advantageous for proton therapy as there was less interplay between air and tissue,” said Kang.

Less interplay between air and tissue means less movement, and the ability to deliver a higher dose of radiation to the tumour while minimising the dose to surrounding tissue. Proton therapy would reduce the chance of negative side effects to Ed’s heart and healthy lungs, especially since he was still relatively young.

“Dr. Kang was incredible. He took as long as we needed to explain everything,” said Ed.

Following treatment, Ed suffered from shortness of breath, an intense rash and some trouble swallowing because the involved lymph nodes were in his neck. These conditions are improving with time, and Ed is now able to exercise and is feeling good. He will now focus on his speech and lingering aphasia, especially when dealing with numbers.

After a chest scan in February that showed no cancer, he and Joanna celebrated the end of treatment with a trip to Hawaii. They also recently bought an Airstream and have tested it out with a short trip to Port Townsend, Washington, with more travel plans on the way.

“Don’t give up,” Ed said to others going through a cancer diagnosis. “When I first had the stroke and was diagnosed with cancer, I thought it was the end. But seeing all the people who were trying to help me made me realise that there’s hope.”