Persistent hip pain troubled Laird &ldquo;Smitty&rdquo; Smith for many years, eventually sending him to the doctor in September 2018. Doctors did numerous tests, including extensive imaging, which led to a surprising diagnosis of stage 3 lung cancer. Smitty is tough &mdash; a ground-pounding medic in the jungle and then a helicopter dust-off medic in Vietnam, he has a realistic sense of &ldquo;hard&rdquo; &mdash; and says nothing will ever be as difficult as his tour in Vietnam. It was there that Smitty was exposed to Agent Orange, a chemical agent that is now a known carcinogen. The cancer had spread to surrounding lymph nodes and his esophagus. Smitty was referred to Carolyn Presley, MD MHS, a thoracic medical oncologist at The Ohio State University Comprehensive Cancer Center &ndash; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC &ndash; James), to find the best treatment plan. He enrolled in the FITNESS study, which was designed to address the unique needs of older adults with cancer. It pairs aging research with subspecialty evaluation with geriatric principles and collects blood and stool specimens to discover novel aging and disease response biomarkers. Throughout his five months of chemotherapy and radiation treatment, that fierce sense of determination kept him moving forward. He didn&rsquo;t miss a single day of work, and he continued to walk every single day, often clocking up to nine miles. As part of his treatment, he is participating in a study to assess patients' overall measure of fitness &mdash; both physical and mental &mdash; and how that influences clinical outcomes. The study, funded by a Pelotonia junior investigator grant led by Presley, is informing which types of lung cancer treatment result in worsening disability and functional decline and to identify tests that can predict which older adults will develop these symptoms. &ldquo;Lung cancer is a disease of older adults; but we do not know how to identify which older adults with lung cancer will become disabled or lose the ability to care for themselves during treatment,&rdquo; says Presley. &ldquo;This knowledge could help patients make informed choices about treatment options. It could also help us design interventions to prevent or delay functional decline in our patients, preserving their quality of life.&rdquo; Smitty says he is doing well. He comes to the OSUCCC &ndash; James every two weeks for chemotherapy treatments and stays active in his job as a building manager, traveling frequently across the United States and internationally. To learn more about lung cancer treatment at the OSUCCC &ndash; James, call 1-800-293-8066 or visit cancer.osu.edu/lungcancer. Information about Pelotonia-funded research is available here.