A former Ironman triathlete was stunned to learn that his vision problems were actually the first sign of stage 4 lung cancer.
Dave Nitsche, 57, was initially given just 12 to 24 months to live – but an experimental drug has helped him surpass that timeframe by several years.
“In 2019, I noticed that I was having trouble seeing with my left eye,” the Canadian man shared during an interview with Fox News Digital. “I went to the optometrist, and they said it was probably a detached retina.”
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After scans revealed fluid buildup and rising pressure, doctors determined that Nitsche had lost vision in the eye — and ultimately removed it. A biopsy of the fluid revealed that it was cancerous.
Next, Nitsche saw more specialists, who extracted fluid from his lungs for more testing. “The next day, the oncologist told me that I had stage 4 lung cancer,” he said.
Nitsche said his doctors were “very shocked” to find that his initial eye issues had stemmed from lung cancer – particularly because he had never been a smoker.
Azam J. Farooqui, M.D., a hematology and oncology physician at Ironwood Cancer & Research Centers in Chandler, Arizona, agreed that Nitsche’s case was “very surprising.”
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“Cancer can find its way to some very odd locations, but the eye is a very, very rare one,” Farooqui, who did not treat Nitsche, told Fox News Digital. “Usually cancer will get there via a nerve channel or blood vessel, but it’s very uncommon.”
Nitsche, an ex-triathlete who has done multiple Ironman races, hadn’t experienced any other symptoms other than the eye issues. “I was running quite a bit at the time,” he shared. “I had a little bit of back pain here and there, but lung cancer definitely wasn’t on my radar.”
His first treatment was a targeted therapy called afatinib, which lasted about three months. When doctors found that the cancer had spread to Nitsche’s brain, he began taking another medication called Tagrisso (osimertinib), which crosses the blood-brain barrier.
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After six years, when those drugs stopped working, Nitsche started taking a chemo drug called Rybrevant (amivantamab), which he receives via IV infusion every three weeks in a supervised medical setting. After a year on the drug, which is manufactured by Janssen Biotech Inc. in Pennsylvania, his scans are looking “very, very good,” he said.
“Science is catching up to me perfectly with all these drugs that I’m on,” Nitsche said. “Now, we’ll just wait for the next thing to come along, and we’ll jump onto that. But for now, the Rybrevant is working perfectly.”
Nitsche has experienced a few side effects, primarily skin irritation and fingernail infections, but said for the most part, the drug is “very tolerable.”
Compared to the full-dose chemo and other lung cancer treatments, Farooqui agreed that Rybrevant is “very manageable.”
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Other common side effects can include infusion reactions, muscle and joint pain, mouth sores, swelling, fatigue, nausea, bowel changes, vomiting, cough, shortness of breath and low appetite, according to FDA prescribing information.
In rare cases, serious effects can include lung inflammation, blood clots, severe skin reactions and eye problems. Pregnant women should not take the drug due to fetal risks.
“If somebody is having too many side effects, or if it is feeling too aggressive, we can do dose reductions,” Farooqui noted. “In my experience, we’ve had patients do really well on it, and we’ve been able to manage their side effects without any major concerns.”
Rybrevant has now been approved to treat certain types of non-small cell lung cancer in the U.S. and Canada, and Nitsche said a few of his friends are also taking the drug.
“Doctors gave me a year to two years – they told me to get my affairs in order. And it’s been seven years now,” he said. “I’ll take it.”
Nitsche is now preparing for a 600-mile biking expedition in June to raise awareness for lung cancer. He credits his endurance training and high fitness level with helping to extend his survival.
“There are days that you feel strong and there are days that you’re a little weaker, but you just adjust accordingly,” he said.
Embracing his role as an advocate, Nitsche now speaks openly about his experience and what others should know.
“If you have lungs, you can get lung cancer – but at this point, for almost any type of cancer, a diagnosis is not a death sentence,” he said. “They’re doing so much research on it, especially with lung cancer… I’ve known people who have lasted 12 to 18 years, so for me, seven years is great. So I’ll just keep going.”
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Farooqui echoed the importance of patients “advocating for themselves and getting the most up-to-date therapy there is.”
