Mark James, age 59, is a distance runner. One of his favorite races is the Blue Ridge Relay through the Blue Ridge Mountains of North Carolina, his home state. James grew up in rural eastern North Carolina and is an administrator at East Carolina University Brody School of Medicine. He is also part of a national men’s workout organization called F3, which he credits with keeping him fit and healthy.
In November 2023, however, James ran into issues. He started experiencing hearing and ear drainage issues and ended up having a nasoscope done by his local ear, nose and throat specialist.
An abnormal mass in his left sinus mandated a biopsy, and two days later he was diagnosed with squamous cell carcinoma of the nasopharynx. The diagnosis was unusual because it is a very rare cancer in white men. It had also spread to four lymph nodes in his neck and the base of his skull.
“I was scared,” said James, “but I am a very positive person. I had just signed up for a marathon and thought it would affect my training. I didn’t think I wouldn’t be able to do it until I learned more about this cancer. Then I figured I had to get in the best possible shape to deal with treatment.”
His local cancer team wanted to begin an aggressive treatment regimen of eight to 10 chemotherapy infusions and seven to nine weeks of radiation, plus gamma knife radiosurgery. Every person on his care team told him that they don’t see this cancer very often since it is more common in Asian people.
Knowing this, James reached out to his brother, a family medicine physician, who was the Chair of Family Medicine at the University of Washington School of Medicine, to seek his advice. His brother talked to a colleague whorecommended James come to Seattle and meet with Fred Hutch head and neck expert, Jay Liao, MD.
“They have a much larger Asian population [in Seattle] and see this type of cancer frequently,” James said.
James met with Liao and the radiation oncologist provided details and context about his cancer, as well as the efficacy of proton therapy in relation to his diagnosis. Then he went back to speak to his ENT and colleagues at East Carolina University; they all encouraged him to receive treatment at Fred Hutch Cancer Center – Proton Therapy.
He began treatment in Seattle that December and was able to work remotely during his treatment, which involved seven weeks of proton therapy and three chemotherapy sessions.
“Cancer of the nasopharynx is challenging to treat due to the location of these tumors close to and often invading the skull base close to the brain, as in Mr. James’ case,” Liao said. “Proton therapy is especially well-suited to treating nasopharynx cancer since it allows us to better target tumors in very close proximity to the brain and vision structures, while minimizing the risk of radiation damage to these areas and reducing exposure to other normal tissues in the head and neck, which may improve recovery of swallowing, saliva, taste and other important factors that affect quality of life of our patients after treatment.”
His physicians, including Cristina Rodriguez, MD, explained everything in detail, he said, and told him exactly what he could expect, and when. This included the need for a temporary feeding tube for nutrition support during treatment, which is not uncommon for patients being treated for head and neck cancer.
“Proton therapy was the best decision I ever made in my life,” said James. “I felt cared for the entire time.”
The treatment wasn’t without challenges. James is claustrophobic and had to wear a mask during treatment. He was prescribed medications to help remain calm, but he credits his care team for getting him through it.
“I was strapped to the table for 40 minutes each day because they treated me from four different angles,” he said. “The team was so supportive when I felt alone. They knew what to do, to talk to me. I took it one day at a time and they gave me the confidence to do it.”
James developed radiation burns and lymphedema in his neck. He also had fatigue and couldn’t swallow without pain after several weeks of proton therapy. He developed two common side effects with head and neck chemotherapy and radiation treatment, tinnitus and dry mouth, which typically resolves on their own.
When he finished treatment in early February, he was so fatigued he could barely get out of bed to walk, but he pushed himself because he wanted to run in the Blue Ridge Relay again in September. By June, he could run at intervals and in September, he fulfilled his goal of participating in the relay even though it meant walking much of it.
James advises patients to lean into the support provided by friends and family. He benefited greatly from his son’s visit to Seattle, his daughter’s daily calls and the support of his partner, Michelle. He said he can’t thank his brother and sister-in-law enough, who took care of him during treatment.
“They kept me mentally positive through some very difficult times,” he said.
Additionally, he credits the emotional support from his F3 team.
“Before I left for Seattle, about a hundred guys got together wearing special T-shirts with my nickname [Silverback] on them, to pray over me, give me positive vibes, run with me and raise money for a cancer organization called Daughters for Dads,” he said. “They also sent me gifts and cards while I was in Seattle.”
With the help of F3 and his family and friends, James keeps getting fitter. Today, he’s looking forward to returning to running longer distances and to surfing. He sees his local physicians and returns to Fred Hutch every three to six months for scans. James is confident about his recovery as his last scan in September showed zero cancer.
Subscribe to our monthly proton therapy newsletter
Get once-a-month updates about proton therapy, including science and medicine news, survivor stories, staff profiles and more.
