It started on Oct. 22 when Jeff Koehn was shaving in the morning.
He felt a bump on his neck.
He didn’t know what it was, but he knew it was there.
He did the right thing. He didn’t avoid it, and he made an appointment right away with William Devine, M.D., his primary care provider at Sanford Health in Watertown, South Dakota.
“He looked at it, prescribed an antibiotic and a steroid and said, if it doesn’t go down, let me know,” said Koehn.
Days came and went, but the bump stayed. Koehn called his primary care provider once again.
“He saw me right away and was concerned about it. He sent me to Clear Lake to get a CT scan, and he said he didn’t like the results of that. He said it could be leukemia, it could be a few different things, but it was certainly something that was suspicious,” Koehn said.
Dr. Devine referred Koehn to the Sanford Ear, Nose and Throat Clinic in Sioux Falls, South Dakota.
“They called me and asked when I wanted to come in, and I said I’ll come in as soon as I can,” said Koehn.
They made an appointment for Nov. 1.
“I feel like they called me before they got the results because they called me like two hours later and they said they wanted to see me the next day at three o’clock. I said OK, I’ll see you tomorrow.
“Then, they called me back again and said we want to see you earlier than that. We want to see you tomorrow morning at 11,” recalled Koehn.
Surgery and treatment plan laid out
Koehn made the 100-mile trek down I-90 to Sioux Falls and met with Sundeep Alapati, D.O., at the ear, nose and throat clinic.
Dr. Alapati suspected Koehn had tonsil cancer that had spread to a lymph node, so he ordered two biopsies, one for the tonsil, and one for the lymph node, and preemptively made a surgery appointment for Koehn.
“He scheduled me for surgery before he even had the biopsy,” said Koehn.
The biopsies came back positive, just like Dr. Alapati expected.
“Three weeks later he does the surgery,” said Koehn.
What is the EVOLVE clinical trial?
Koehn stayed in the hospital for a few days to heal up. During that time, his providers told him about a clinical trial, EVOLVE, that he might be a good fit for.
Steven Powell, M.D., is a medical oncologist at Sanford Health in Sioux Falls.
Dr. Powell said EVOLVE looks to offer standard cancer treatments, but with fewer short- and long-term side effects.
“Throat cancer is probably the predominant cancer we’re seeing here now in terms of the head and neck region. We’ve learned that there’s subsets of these that have a very good prognosis.
“Unfortunately, we treat those patients the exact same way as we treat somebody that has a very aggressive form of cancer – so they get the full intensity of therapy,” he said. “What we’re starting to learn from our research is maybe those patients with less risky disease could get lower intensity treatments and do better.”
Dr. Powell said they’ve had this study open for roughly four years.
“It’s constantly, for a lack of a better term, evolving,” he said. “We’re adding different arms to it, hence the name. Anytime we see an impressive new approach that maybe could allow us to decrease the intensity of the treatment, we add it to the study.”
Cutting treatment time
The treatment protocol was developed by Sanford Health radiation oncologist Miran Blanchard, M.D., who practices out of Bemidji, Minnesota.
The way it was explained to Koehn was that a typical radiation treatment often consists of a once-a-day treatment, five days a week, for six weeks.
“30 shots,” said Koehn.
However, EVOLVE’s lower-dose radiation treatment was composed of 20 doses, but you do two a day. It cuts down the treatment time from six weeks to 10 days.
Decreasing the intensity allows for fewer side effects like trouble swallowing, eating issues, and dry mouth.
After Koehn’s initial surgery, he went home for a month to heal. He started EVOLVE on Dec. 18, and the treatment was completed by Dec. 30.
Three months later, at his check-up PET scan, he was cancer-free.
He still is today.
Lean on your team
Koehn’s take-home message: if you notice something, don’t avoid it, and trust your doctors.
“One thing that I did was I really trusted Dr. Alapati. You know how you can look up your doctors? You’re like, this is a surgical oncologist that specializes in cancers of the head and neck. This is the dude. This is the guy,” he said through a big, boisterous laugh.
Koehn puts his booming voice to good use. He’s an avid concert and festival goer. He went to two festivals in July – and Las Vegas for a concert. Before his cancer diagnosis, he and his family had planned a trip to Europe.
“When you talk about emotions (through diagnosis and treatment), I was thinking to myself I hope I can live to this trip. I hope that I’m not so sick that I can’t go on this trip,” he said.
He was healthy enough to go on the trip, and then some.
“When I was on the trip, I mean, nobody knew I had recently undergone cancer treatments or anything like that. It was just a normal trip, like anything else. So, it hasn’t really affected my lifestyle at all. I’m really glad I was in that trial,” said Koehn.
Small details make a big difference
One thing Koehn said he appreciated was his care team’s commitment to the small details: making someone feel at home through their journey.
“When you go to the radiation clinic, they call you by name. When you’re checking in, you don’t go up and give them your name. They say to you, ‘Hi Jeff, we’ve got you checked in.’
“When you’re sitting there, especially when you’re going twice a day and you have your dietitian appointments, regular doctor appointments, your oncology appointments, and your speech therapy appointments, it gets to be a little robotic and a little bit dehumanizing. So, it’s really nice to walk in twice a day and know someone knows your name. It made you feel really good.”
Learn more
- Early-phase cancer treatments available at Sanford Health
- NIH grants $6.2M for cancer studies at Sanford Research
- Clinical trials offer help, hope for patients in Bemidji
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Posted In Bemidji, Cancer, Cancer Screenings, Cancer Treatments, Research, Sioux Falls, Watertown
