The first cancer patient to undergo CAR T-cell therapy at Novant Health Forsyth Medical Center in Winston-Salem is itching to get back to work. And that 55-gallon aquarium he’s been too tired to set up? Now that Richard Smith is on the other side of Non-Hodgkin lymphoma, he hopes to fill it with water and fish in the next few weeks.

Dr. Kathleen Elliott
Dr. Kathleen Elliott, of Novant Health Cancer Institute - Forsyth (hematology) who performed the leading-edge procedure in May, doesn’t like to use the word “cured.” Rather, in Smith’s case, she said, “We anticipate the cancer will respond to treatment and disappear.”

For Smith, 55, of Linwood, North Carolina, that’s all the prognosis he needs to utter a cancer survivor’s sweetest words: “I’m looking forward to getting back to normal.” One more bit of sweetness. He got married June 19.

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What Is CAR T-cell therapy?

The procedure uses a person’s own cells to fight the cancer. White blood cells are removed from a patient’s body and engineered in a lab to find and kill cancer cells. They are also multiplied in the lab. Following chemotherapy, the modified CAR T-cells are returned to the body intravenously. The infusion through a vein in the arm takes about 30 minutes. Following the procedure, patients typically spend two weeks in the hospital being monitored and regaining their strength while the CAR T-cells go to work on the cancer.

Elliott says this therapy has shown promise in treating two types of lymphoma (cancer of the white blood cells) in adults.

That’s the simple explanation. By any description, Elliott said, “It’s actually pretty exciting.”

Advantages of immunotherapy

CAR T-cell therapy is part of a movement in cancer treatment – immunotherapy – that stimulates the immune system’s natural defense mechanisms to fight the disease. It differs from the more familiar forms of treatment such as chemotherapy, radiation and surgery.

Immunotherapy can lead to more targeted and longer-lasting responses, Elliott said. It can also lower the risk of some side effects associated with chemotherapy or radiation.

“By unlocking the power of the immune system,” she said, “immunotherapy represents a crucial step forward in the fight against cancer.”

Introducing Dr. Kathleen Elliott

Elliott, 45, is an oncologist and hematologist (blood system and related diseases) at Forsyth Medical Center.

A native of St. Croix, part of the U.S. Virgin Islands, she was 16 when she lost her sister, Clemencia, 25, to cancer. Moved by the care and compassion her sister received, Elliott became interested in medicine. She heard the call to treat cancer during her residency. It was the opportunity to build relationships with patients that touched her heart. She recalls one patient in particular, an ardent hiker in his late 60s who loved talking about visiting waterfalls in North Carolina. The morning after he died, his wife told Elliott how much those conversations meant to him.

“It was then I realized this is what I want to do,” Elliott said.

Meet the patient, Richard Smith

Smith has fought cancer twice. The first time he felt poorly, just before Christmas 2021, he thought it was kidney stones. But it turned out to be Non-Hodgkin lymphoma, which causes white blood cells to grow out of control and result in swollen lymph nodes and other growths. Chemotherapy seemed to do the job. A follow-up scan on Jan. 23, 2023, revealed that the cancer had come back.

Elliott said Smith was a prime candidate for CAR T-cell therapy: He was relatively young, otherwise healthy, had a good attitude and strong support system.

The CAR T-cell therapy was a success. Smith said the two weeks he spent recuperating at Forsyth Medical Center included a few rough days when his temperature climbed and he became disoriented. But those challenges passed. He is home now, getting stronger and hoping to return to work as a private security officer this spring or summer.

Doctor and patient, though, aren’t through with each other. Elliott says she typically sees her cancer patient for five years following treatment.

That works for the both of them.

“I think the world of her,” Smith said.

Said Elliott, “We make sure we get some laughs in.”


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