Despite this progress, he is bothered by a lack of overall attention paid to lung cancer by media, funding agencies and the public compared to some other forms of cancer.
Otterson attributes these problems to a lingering stigma against the disease. He notes that many consider it a “self-inflicted” illness caused by tobacco use, even though some 20 percent of patients have never used tobacco. He said other factors that contribute to the lack of attention include a more elderly patient population, late-stage diagnosis, lower survival rates and a lack of compelling spokespersons for lung cancer awareness.
To assuage his frustrations, Otterson hits the road each year for Pelotonia, working to help change the lung cancer landscape for his patients and their families. Since the first Pelotonia cycling event in 2009, he has ridden every year but one, when a schedule conflict forced him to be a virtual rider instead.
“The purpose of Pelotonia is to end cancer by raising money for research,” says Otterson, a professor in the Division of Medical Oncology at Ohio State and member of the Translational Therapeutics Program at the OSUCCC – James. “Everyone who’s been doing research of any duration recognizes that there’s been a shrinkage of federal monies, so getting finances to support research in whatever ways we can is important.
“On a personal level,” he adds, “I ride to honor my patients and families for all they have to go through.”
He thinks of them often during his usual 100-mile ride from Columbus to Gambier, especially in the second 50 miles, when every pedal stroke is hard. “The first year, I thought, ‘Oh, I can do a 100-mile ride, lots of people can do that,” he recalls. “I’ve discovered over the past 10 years that it’s actually pretty tough. But so is going through treatment for cancer, so I draw inspiration from my patients.”
Otterson is captain of the Team Lung peloton (riding group), which is part of the Team Buckeye superpeloton representing Ohio State. His team has some 15 members, including several of his colleagues, at least one of his patients and a few family members of patients—not to mention his wife, Mary Ann Murphy, who’s ridden with him every year that he’s ridden in the event.
But not mile for mile. “She usually beats me,” Otterson says. “She’s a much better athlete and has a lot more endurance. She’ll stick with me for the first 50 miles, and then she takes off.”
Despite his frustration over impediments to progress against lung cancer, he is encouraged by dramatic improvements in caring for these patients over the past decade.
“One advance has been the advent of immunotherapy (enhancing the body’s natural ability to combat cancer) through new agents,” he says. “The real question now is, ‘What can we do when patients either don’t respond to immunotherapy or when their cancer progresses again after immunotherapy?’ There’s a new generation of clinical trials looking at next steps for patients, and that’s one of the biggest areas of our research.”
Also transforming cancer care over the past 10-15 years, he says, has been the rise of targeted therapies. “Some of these are amazingly effective—we used to call them ‘Lazarus drugs’—but they’re not ‘forever drugs,’” Otterson says. “Many patients develop resistance, so finding the next targeted therapy is a compelling need.”
Which is another reason he rode again in 2018, although somewhat apprehensively because his training was slowed by an inclement early spring. But he stepped it up and completed his ride, fueled by patients, families, funding needs and the cheering multitudes he saw along the way.
He notes that, in Pelotonia 17, he was pleased to ride awhile with Clara D. Bloomfield, MD, a Distinguished University Professor who also serves as cancer scholar and senior adviser to the OSUCCC – James. At 76, she still rides 25 miles each year.
“She was on a tandem bike with one of her postdoctoral fellows,” Otterson says, “and that was inspiring. She helps ignite the fire in my belly, anyway. I see her out there and think, ‘All right, I can do this.'"