Paying It Forward
When Tsuruoka was diagnosed with stomach cancer in late
2013, Aki and Tom were in the process of closing a business
they had started together. As Tom moved on to another startup
company, they decided that Aki would take a break from
working so she could care for Tsuruoka.
But as Tsuruoka’s health improved, Smith began to think
about how she wanted to spend her time going forward. In early
2014, she had started blogging about her dad’s treatment to
give updates to friends and family (
Through blogging and social media, she had connected with other
stomach cancer patients and caregivers. “I made the decision that
if my dad survived this, I would pay it forward and help other
people,” she says. In January 2016, she founded the nonprofit
organization Hope for Stomach Cancer (
Smith’s goals are to promote stomach cancer prevention and
early detection and to point patients and caregivers to resources
on treatment, precision medicine, life after gastrectomy and
other topics relevant to day-to-day life. “Aki has served as a one-
person patient navigator for a cohort of patients,” says Samuel J.
Klempner, a gastrointestinal medical oncologist at the Angeles
Clinic and Research Institute and Cedars-Sinai Medical Center
in Los Angeles who advises Smith on her nonprofit. Smith also
attends conferences to stay informed about stomach cancer
research. She has gone to several American Society of Clinical
Oncology gatherings and attended the American Association for
Cancer Research (AACR) Annual Meeting 2017 as part of the
Scientist Survivor Program. (The AACR publishes Cancer Today.)
Tsuruoka has also been involved in patient advocacy. In
March 2015, he traveled with Smith to Washington, D.C., to
push for funding for stomach cancer research through the
Debbie’s Dream Foundation, a nonprofit organization that advocates for stomach cancer awareness and funding. In the early
days after his treatment, he also started corresponding with
fellow stomach cancer patients. A photo he took of a hummingbird hovering near a flower was included in the 2017 calendar
put out by the Conquer Cancer Foundation.
Tsuruoka is quick to say, “My story is not so important,”
despite his willingness to share it if it helps others. But Smith
says that the hours she has spent with her dad in the car and
at medical appointments have deepened her appreciation of
him. “As hard as what he went through [was], he had so much
courage and strength,” she says. “Even if he didn’t make it, I’d
still be so proud. He wants to live, and he took a lot of risks
without a guarantee.”
KATE YANDELL is the digital editor of Cancer Today.
Aki Smith holds her son, Kai Tomasz Smith, while new grandfather
Shigeo Tsuruoka looks on. Kai was born in October 2017.
A NEW TREATMENT OPTION
In 1975, just 14 percent of people in the U.S. diagnosed with stomach
cancer lived five years or longer. Today, the proportion who live five years or
longer is twice as high. This improvement is likely due to “the combination
of better chemotherapies, better targeted therapies, certainly better
supportive care and better surgical outcomes,” says Zev Wainberg, a
gastrointestinal oncologist at the University of California, Los Angeles.
Immunotherapy could further increase survival, Wainberg says. In May 2017,
the U.S. Food and Drug Administration (FDA) approved the immunotherapy
drug Keytruda (pembrolizumab) for patients with any metastatic tumor type
whose tumors show high microsatellite instability, a pattern of genetic
changes. In September 2017, the FDA approved Keytruda for certain patients
with metastatic stomach cancer who had undergone substantial treatment
already, following results of a trial that Wainberg helped lead.
Other trials will determine if a wider group of patients with stomach cancer
can be helped by immunotherapy drugs, whether used alone, in combination
with other immunotherapy drugs, or combined with chemotherapy.