Curtis Crump is serious about staying in shape. With his job, he has to be.
“I’m an airplane and helicopter pilot with the Harris County Sheriff’s Department,” he explains. “I conduct aerial surveillance that helps officers on the ground track down and catch criminals on the run. It’s demanding work, and physical fitness is a requirement.”
But Curtis wasn’t always so healthy. Four years ago, doctors found neuroendocrine tumors in his colon and liver.
A neuroendocrine tumor diagnosis
The first warning came late on a Sunday night. Curtis was driving home to Houston after visiting his then-girlfriend in San Antonio. Halfway home, he developed a stabbing pain in his right side.
“It was agonizing,” he says. “I thought I had appendicitis.”
He pulled into an urgent care center, where a CT scan detected a tumor the size of a tennis ball in his colon.
“After that,” he says, “everything happened quickly.”
An ambulance took Curtis to a nearby hospital, where a biopsy confirmed the tumor was cancerous. Scans showed cancer cells had crept outside the colon and spread to his liver.
“The doctor told me my liver was saturated with neuroendocrine tumors,” Curtis recalls. “When I asked, ‘How many tumors?’ he said, ‘Too many to count.’”
Curtis was given a stage IV neuroendocrine tumor diagnosis and six months to live.
Neuroendocrine tumors can form anywhere in the body
Neuroendocrine tumors grow inside specialized cells that make hormones – chemicals that control and coordinate nearly all the processes in the body, including growth and development, emotions, sexual function and even sleep.
When one of these hormone-producing cells mutates and begins rapidly multiplying, it develops into a neuroendocrine tumor.
Neuroendocrine tumors can form anywhere in the body, but about half start in the gastrointestinal tract, which includes the stomach, small and large bowel, pancreas and rectum.
Some neuroendocrine tumors can be aggressive, but most grow slowly and take years to develop.
“It’s not unusual for newly diagnosed patients to learn their cancer has already spread, because neuroendocrine tumors may not cause symptoms in the early stages,” says medical oncologist Craig Kovitz, M.D.
A second opinion offers hope
News of Curtis’ condition spread quickly. A friend who’s a nurse urged him to seek a second opinion at MD Anderson.
“She said MD Anderson has a track record of fixing what others can’t,” Curtis says. “That’s what I needed – a doctor who wouldn’t give up on me.”
At MD Anderson, Curtis met Kovitz, his new oncologist.
The doctor didn’t mince words.
“Once neuroendocrine cancers spread to the liver, they’re not considered curable,” he said. “We may be able to shrink the tumors and buy you some time, but a cure is unrealistic.”
“I knew there were no guarantees,” he says, “but we had to try.”
Dealing with depression after a neuroendocrine tumor diagnosis
Curtis began treatment in November 2017 with eight rounds of two chemotherapy drugs – carboplatin and etoposide.
“It was rough,” Curtis says, “not only because of the toll chemotherapy took on my body, but also because I was depressed. That can happen with a diagnosis like mine.”
For two weeks, he lay in bed. He stared at the ceiling, unable to sleep. He lost his appetite. His girlfriend left him.
Then, he suddenly snapped out of it.
“I jumped out of bed and told myself, ‘If I’m going down, it won’t be without a fight.’”
Curtis returned to the gym and worked out three hours every day – even on the days he received chemotherapy.
“I’ve always exercised regularly, but I went into overdrive,” he says. “I didn’t want cancer to make me look frail.”
He began attending weekly church services and got baptized.
And he went back to work.
“Dr. Kovitz advised me to stop flying until chemotherapy was over, so I handled desk duties instead,” he explains. “The tumor in my colon was still large enough to perforate my bowel. If that happened while I was in the air, well … I’d be in some serious trouble.”
Neuroendocrine tumor surgery and a cancer recurrence
By the time Curtis finished chemotherapy in March 2018, his tumors had stopped growing. Some had even shrunk or disappeared.
He was now stable enough to undergo surgery. Colon and rectal surgeon Craig Messik, M.D., removed the tumor in Curtis’ large intestine.
With the colon tumor gone and the liver tumors’ growth on hold, Curtis enjoyed a four-month respite from treatment.
Then, the liver tumors began to multiply.
“Neuroendocrine tumors often respond to chemotherapy at first,” Kovitz told him. “But they can become resistant to the chemotherapy drugs that initially seemed to help. So you try other drugs.”
An immunotherapy clinical trial for neuroendocrine tumors
Kovitz prescribed two different chemotherapy regimens over the next six months to shrink the tumors in Curtis’ liver. One worked briefly, and one not at all.
With the cancer spreading and his options dwindling, it was time for Curtis to try something different.
“When standard treatments stop working,” Kovitz explains, “the next step is a clinical trial.”
He referred Curtis to MD Anderson’s Clinical Center for Targeted Therapy, where researchers test experimental drugs and drug combinations so new that they are not yet approved by the Food and Drug Administration (FDA).
Unlike chemotherapy that directly destroys cancer cells, immunotherapy trains a patient’s own natural immune system to identify, target and eliminate cancer cells.
“Because these immunotherapy drugs had created prolonged clinical responses and improved overall survival in a number of different tumor types, we hypothesized that they might boost patients’ immune systems to eliminate neuroendocrine tumors as well,” explains Tsimberidou.
No signs of cancer after clinical trial
Three months after he joined the clinical trial, Curtis’ tumors had shrunk by 65%. In another three months, they’d shrunk by 80%.
“I was hoping the immunotherapy would slow down my cancer’s growth and buy me more time,” he says. “But I got much more than I’d hoped for.”
Nine months after Curtis joined the clinical trial, a CT scan detected no evidence of tumors, and a biopsy found no cancer cells in his liver.
“The doctors said I had a complete response,” Curtis says, “which means all signs of the disease had disappeared.”
Two years have passed since Curtis completed the trial. He still shows no signs or symptoms of cancer.
“Immunotherapy can provide long-term protection against cancer, because it trains the immune system to recognize and remember what cancer cells look like,” Tsimberidou explains. “This immune ‘memory’ can last for decades after treatment is completed.”
Life after neuroendocrine tumor treatment
Today, Curtis is back in the air and flying high. He’s been promoted from deputy to sergeant. He has a new girlfriend, a new house and a new offshore fishing boat. When he’s not working, he’s in the gym or at the beach. Life is good.
“I have a lot to be thankful for,” he says. “MD Anderson changed my prognosis from cancer patient to survivor.”
He offers this advice to others facing a challenging diagnosis: "Never give up, and don't accept the first prognosis you receive. I was given six months to live. Then I came to MD Anderson, and look at me now."