TREMONTON, Box Elder County — Jim Abel smoked for 35 years, but that was more than two decades ago.
He's given that up, is active in his church and is now an unlikely cancer survivor.
"I tell everyone who smokes, 'Don't take the chance. You're gambling, and the odds aren't good,'" Abel said.
Turns out, there was a time that luck almost ran out for him.
New research at the Huntsman Cancer Institute at the University of Utah shows different types of lung cancer tumors should be treated differently, giving hope to anyone facing the bleak prognosis and limited treatment options that come with a lung cancer diagnosis.
And while small cell lung cancer is typically only found in smokers, treatment for any type of lung cancer can result in small cell, as tumors mutate during therapy and can reappear at any time.
"Tumors are notorious for changing in response to therapy, and as they develop a resistance to therapy," said Trudy Oliver, a Huntsman researcher and professor of oncological sciences at the U. She said the new findings are relevant to anyone with lung cancer, "because you never really know how your tumor will evolve."
In 2012, Abel was given two to six months to live after doctors discovered he was in the advanced stages of small cell lung cancer, a very deadly form of the disease. Without insurance other than Medicare and because he believed chemotherapy would only make him feel worse leading to an inevitable death, Abel decided he wasn't going to do anything about it.
"It was not worth it for the small chance that treatment would do anything for me," he said. "The chances weren't very good."
His sentiments are apparently not too uncommon for patients with small cell lung cancer, Oliver said. She said that for decades, small cell has been treated the same as any other lung cancer, when it really behaves very differently in the body.
And previous treatment models haven't resulted in good outcomes for patients, as those with small cell lung cancer typically live just 10 months after diagnosis.
The study, which was published in the journal Cancer Cell, found that all patients with small cell lung cancer should be genetically tested to determine whether they have specific mutations that need to be treated differently, with different types of drugs that may have better success rates and lead to longer lives.
Abel ended up getting a second opinion from a Huntsman Cancer Institute doctor, who was confident Abel would survive with help from a drug being used in a clinical trial. The cost of the treatment, including travel to and from the Salt Lake facility, was fortunately all covered by the drug company.
"At that point, what did I have to lose?" Abel said. "It ended up being the smartest thing I've ever done."
Treatment was different than he expected. He didn't get too sick and only lost some of his grey hair, and it grew back curly, which he had hoped. And while he'll never be the same as he was before being diagnosed, Abel, 75, has a new lease on life.
"I don't have bad days," he said. "I have good and better days."
The near-death experience led Abel and his wife to discuss financial matters and square them away for any possibility, which, he said, is a huge relief. And business at J.C.'s Country Diner, which he owns and manages in Elwood, Box Elder County, is good — better than ever, actually.
The hardest part so far, Abel said, is that he has seen so many of his friends and others die of the cancers they have and it doesn't seem fair. But his doctor told him he must have been left on Earth for a reason "and that's to give hope to others."
"I've been really lucky," he said. "I should've been gone. I can't ask for more than what I've got."
While the drug used to treat Abel is different from the one used in Oliver's study, researchers learned much about his type of cancer through the course of his treatment and can hopefully benefit the lives of other patients facing similarly grim outcomes.
Small cell lung cancer kills about 30,000 people in the United States each year, including smokers and non-smokers who develop small cell tumors during their initial treatment.
"We have very few cures for lung cancer, especially those diagnosed at more advanced stages," Oliver said. When surgery isn't successful at removing tumors early, doctors turn to chemotherapy, yet, oftentimes, that fails and, as a last resort, patients enlist in clinical trials for experimental treatments.
"It becomes more and more difficult to treat," Oliver said, adding that advances have been made in treating adenocarcinoma and squamous cell lung cancers.
"Small cell lung cancer has the worst prognosis," she said.
But the results of her study, as well as the mouse models created from it, will continue to drive the research toward positive outcomes for patients with lung cancer and, perhaps, other cancers.
"It's promising for these people who are given a death sentence," Oliver said.