With Months to Live, Immunotherapy Gives Patient with Esophageal Cancer More Time

For John Joslyn, a patient with stage 4 esophageal cancer, traditional treatment methods weren’t working. With standard chemotherapy, it was estimated he may have had six months to live and he needed a miracle. Science delivered him one.

His story starts with fatigue, a symptom he brushed aside, attributing it to just getting older. In addition, he ran a small contracting business and was working 60 to 70 hours per week, so being tired wasn’t unexpected.  

He also noticed his indigestion had started to worsen, but still, he didn’t feel concerned.

Then it came time for Thanksgiving, his favorite meal of the year.

John Joslyn with his fiancee, Jenn

“I was sitting there with three-quarters of a plate of food and couldn’t get it down,” he says. “Something is wrong here. I wasn’t able to swallow right.”

He went for an endoscopy and the doctor who did the procedure felt pretty confident it was cancer before the biopsy results even came back. And unfortunately, he was right.

John came to Wilmot Cancer Institute for treatment and was beginning to prepare for surgery. It wasn’t until a PET scan showed that the cancer was everywhere, that he realized surgery wouldn’t be an option.

After a year of difficult chemotherapy treatments, John knew that it hadn’t worked. His treatment options were running low, and John still faced potentially only months left to live.

His team didn’t give up. 

“I feel exceptionally lucky for the staff there,” he says. “They had a proactive approach and did not just say ‘this is what we can do for you’ but they really went after it.”  

His medical oncologist, Richard Dunne, M.D., recommended a Foundation 1 test, which provided detailed genetic information about John’s tumor. And the results showed good news: the characteristics of John’s tumor meant he was eligible to start an immunotherapy treatment called pembrolizumab (Keytruda).

That was more than two years ago. Now, after an extensive evaluation, his doctors haven’t been able to identify any active cancer and have told him he is in remission. He recognizes that he is part of a very small number of esophageal cancer patients with a type of esophageal cancer that responds well to immunotherapy. Researchers are still trying to understand why it only works for a small group and how it can help more people.

But in the meantime, John and his team will take the miracle they’ve received.

“I’ve gone from going to be dead twice in six months, to, I’m three years down the road and I have a distinct opportunity to continue on,” John says. “I’m amazed. They’re amazed. We can’t believe this either. We thought we were in a real tough spot.”

Today, he feels pretty good. He deals with some side effects like neuropathy in his feet that he jokes makes him feel like Charlie Chaplin. He has retired from his contracting business but he's able to continue watching sports, including his beloved Buffalo Bills, and spending time with his seven grandchildren. 

“I feel grateful for that fact that I’m even still here to do that,” he says.