ATLANTA - Kirk Smith is powering down a road he never thought he'd be on.
He’s 54, training 3 or 4 hours a day, living with advanced lung cancer.
"Some of it is an attitude approach,” Smith says. “I have never been one, and neither has my wife, we've never been ones for drama."
Cancer is just part of their lives now.
"Once we find out what we had,” Smith says, “It's, ‘Alright, let's deal with it. Let's move forward.’ We can't go back."
Diagnosed the day after Christmas of 2013, Smith came to see Dr. Cynthia Shepherd, a medical hematologist and oncologist with University Cancer and Blood Center in Athens, for tests to stage his cancer.
"And he had a PET scan that showed the main tumor as well as some other nodules as well as lymph nodes,” Dr. Shepherd says.
Smith was diagnosed with stage 3B non-small cell lung cancer.
Only about 5% of patients at this stage of the disease survive beyond the first year.
Smith he was a veteran triathlete, who'd never smoked. So, why lung cancer?
A blood test showed Smith has a genetic abnormality known as an ALK mutation fueling his cancer.
"So his particular mutation was found and is typically found in young, males who are non-smokers, and who have adenocarcinoma, which is a particular type of non-small cell lung cancer," Dr. Shepherd says.
Smith braced for chemotherapy, and all the side effects that can come with it.
Typical chemo attacks and destroys fast-growing cells in the body, but it can also impact healthy tissue, causing problems like fatigue, nausea and vomiting, and hair loss.
"I'm a naturally already a thin person, so I was worried about losing weight,” Smith says. “I was worried about losing strength."
But, because he was ALK+, Smith was placed on a newer, much more targeted cancer drug -- designed to zero in on -- and shut down -- his specific gene mutation.
It’s called ceritinib, and it's working.
Smith takes 4 pills a day, and in 2 and a half years, his tumors have gotten smaller, and the cancer has disappeared from his lymph nodes. The cancer is still there, but the medication is holding it at bay.
And, Smith back to training, and competing, though a little more carefully.
"I have to be very aware of what I'm doing,” Smith says. “And I have to incrementally increase my training load. And then if I see a sign I've overdone it, then I scale back."
Later this month, Smith will compete in the PPD IRONMAN® North Carolina triathlon, racing with "Free to Breathe," an organization raising awareness and money for lung cancer research to create the next generation of drugs like the one Smith believes is keeping him alive.
"And what I have is a terminal disease,” he say. “So, despite these targeted therapies, what I have will probably take my life at some point, unless these medications continue to improve."
"But it is extraordinary, with stage 3b lung cancer, to be doing as well as he's doing,” says Dr. Shepherd.”
Smith will compete in a half-Ironman: swimming 1.2 miles, biking 56 miles and then running 13.2 miles.
It’s not a big deal to him.
So, for now, Kirk Smith he will stay the course, not just living -- but thriving – with lung cancer..