SBRT helps stage IV kidney cancer patient keep her treatment options open

Becky Van Curen’s family had no history of cancer. So, when she was diagnosed with kidney cancer in 2015, she was shocked and scared.

“My only symptoms were feeling tired a lot and a cough that wouldn’t go away,” she says. “I thought it was just a cold.”

Fortunately, Becky’s cancer was caught fairly early. So, surgery and three years of targeted therapy under Craig Kovitz, M.D., put her in remission for almost four years. Then, in early 2019, a scan showed that the cancer had returned. This time, it was in her hip bone — automatically making it stage IV.

“I was crushed,” Becky says. “I thought my life was over. I’d never known anyone with stage IV cancer who survived.”

Becky joined a clinical trial at MD Anderson involving a type of radiation therapy called stereotactic body radiation therapy (SBRT). And after only three treatments over the course of three days, she is again cancer-free, and has been for more than two years.

“I still have a little hip pain, but it’s getting better. And other than my hair turning white and my skin burning more easily, I’m mostly back to where I was before cancer,” she says. “I’m so thankful.”

Clinical trial puts off need for immunotherapy

The clinical trial Becky joined is being led by radiation oncologist Chad Tang, M.D. He’s focused on keeping options open for patients with minimally invasive kidney cancer and other genitourinary cancers, by using radiation therapy in an attempt to delay the need for systemic treatments such as chemotherapy and immunotherapy.

“Old data suggests that patients should not do radiation therapy for kidney cancer,” Tang explains. “But SBRT is actually a really good option for some patients with a limited number of metastases.”

One reason is that the particular immunotherapy combination normally recommended for someone like Becky (nivolumab and ipilimumab) is very toxic. About 40% of the patients who have received it developed a serious side effect.

“Cancers can also become resistant to immunotherapy eventually,” notes Tang. “So, our goal is to delay its use as much as possible. By using radiation therapy first, we can buy our patients some time. The immunotherapy will still be effective in a couple of years. And this way, we can put it in our back pocket for later.”

Cherishing every moment after successful SBRT

Becky only had one small spot of cancer on her hip bone, making her an ideal candidate for Tang’s clinical trial. And other than a little fatigue, she’s experienced no long-term side effects from the SBRT. She hasn’t needed any other cancer treatment since, and her scans continue to show no evidence of disease.

“I don’t take things for granted anymore,” she says. “I cherish every moment with my children and grandchildren.”

Becky appreciates that what Tang and other doctors are learning from her now could make future kidney cancer patients’ treatment less challenging.

“It’s pretty cool to be able to help,” she says. “Cancer is an ugly thing that needs to be destroyed.”

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