A clinical trial saved his life: LOWVELO performer cancer-free 15 years after terminal diagnosis

He didn’t feel sick at all.

Nathan Calhoun was young, he was fit, he was in a brand-new relationship, he had just started a band: And then he heard the words, “You have cancer.”

“I couldn’t believe the diagnosis,” Nathan said. “At 28 years old, working in a gym and playing music and enjoying life – It seemed impossible. It almost felt like a misdiagnosis.”

But unfortunately, that wasn’t the case. After noticing a spot on his neck, Nathan visited a dermatologist who gave him the news he never expected to hear – it was stage 3 melanoma. He was admitted to MUSC Hollings Cancer Center for a wide local excision. This is a surgical procedure to remove the cancerous lesion and the surrounding tissue, with the goal of eliminating the cancer and minimizing the risk of it returning.

After the surgery, the news got worse.

“It had metastasized to stage 4,” said Nathan. “And there were tumors in the lungs and there was no treatment available.”

He was given four to six months to live. He still didn’t feel sick. And there was another reason this frightening news was even harder to take. Her name was Elizabeth – Nathan’s girlfriend of just six or seven months.

“She was 23 at the time,” said Nathan. “And I can remember having conversations where I was almost implying that she not go down this journey with me because it was a lot to ask of anyone.”

That journey didn’t scare Elizabeth off, though. Nathan said she demanded to stay by his side, a dedication he now can’t imagine living without.

 

“I think I was a little naïve,” Elizabeth said with a chuckle. “At the time I was like ‘All right, let’s go. What’s our next step?’ And we dove in and tried to go at it as a team.”

Without any treatments available and his tumors growing 2 to 4 millimeters a week, there was only one option for Nathan – a clinical trial. His doctors at Hollings immediately started contacting people to find a spot for him.

“I was lucky enough to get into the National Institutes of Health,” said Nathan. “The way it works is you kind of go and audition. You have a stress test, and they do bloodwork and check everything and then they let you know if you’re eligible for the trial.”

He was eligible. Nathan was accepted to a trial for tumor-infiltrating lymphocyte (TIL) therapy. TIL therapy is a kind of immunotherapy that uses a patient’s own immune cells to fight the cancer. All humans produce TIL cells naturally, but there are usually not enough of them to fight cancer. So, in this therapy, a small sample of the patient’s tumor is surgically removed, the TILs are isolated and grown in a lab to multiply and then they can be reinfused back into the body to fight the cancer.

“That wouldn’t have been done without Hollings,” said Nathan. “I had never heard of the National Institutes of Health. I don’t know what direction I would have gone in without the help of the staff, the oncologist and my surgeon.”

Nathan and Elizabeth uprooted their life in Charleston so he could be at the NIH in Bethesda, Maryland, for the trial. In between treatments, they stayed with his parents in Louisville, Kentucky.

“It was going to be a long road ahead and so they let us stay with them,” said Nathan. “That was so important to that support system. We moved everything to Louisville – not that we were pessimistic, but we were trying to be realistic. We didn’t know when or if I would get to move back to Charleston.”

Nathan had a thoracotomy to access his lung so that his TIL cells could be isolated and multiplied in a lab. While that was happening, he was started on an immunotherapy called high dose interleukin-2, which required a stay in an intensive care unit. Every 12 hours, Nathan would receive an infusion designed to stimulate his immune system. Though not the same as chemotherapy, it can have some similar effects on the body – shortness of breath, nausea, diarrhea, pain. At the time, interleukin-2 had a 4% partial response rate.

 

Nathan had a complete response.

“At the end of about a six- or seven-week period of interleukin-2, they reported that even the scars from the tumors had disappeared,” Nathan remembered. “It was a very challenging treatment, to say the least – but a small price to pay.”

It was around this time that Nathan picked up a new nickname.

“The doctor called to tell me on the phone that is was a full response,” remembered Elizabeth. “I think they were all very excited as well. But you know, Wolverine started going around a lot.”

“I definitely didn’t feel like Wolverine,” Nathan added with a laugh.

After spending about a year with his parents in Louisville and being told he had no evidence of disease, Nathan and Elizabeth started getting back to their normal life. They moved back to Charleston. He started playing with his band, Calhoun’s Calling, again. Life was good – until he got some heartbreaking news.

“It was probably 14 or 15 months after I had the news that I was cancer-free that my scans showed that it had returned to the lung,” said Nathan. “So that was devastating, but during the treatment with interleukin-2, they were putting together my trial, growing the TIL cells, and in the event that this were to happen again, everything would be ready for me.”

Nathan had been the only one in his trial to have a complete response, and with his multiplied TIL cells waiting for him in the lab, the NIH brought him back in to have them infused back into his body to fight the recurrence.

There was only one thing standing in his way – the threat of the 2013 government shutdown, which would mean that no one would be admitted to the NIH.

“I remember that feeling of ‘Wow, how devastating that could be,’” said Nathan. “Lives are lost during a government shutdown and so that was scary.”

Luck was on his side again. The NIH was able to fly Nathan in and admit him earlier while they prepped to avoid a potentially life-threatening situation when the shutdown eventually took place.

In this new round of treatment, Nathan was given a strong chemotherapy. This broke down his immune defenses so that the TIL cells could be reinfused and fight off the cancer. Although the actual procedure of putting the TIL cells back in his body was a generally easy one, the effects took a toll on Nathan’s body.

“I had a bit of what they call a cytokine response and an infection in the lung where the TIL cells were attacking the body instead of just the cancer,” he said. “So, even though infusing the cells wasn’t difficult, I was pretty sick right after, and we weren’t exactly sure what the outcome was going to be.”

"I know the medical profession is reluctant to use the word ‘cure.' But they did deem that if the cancer were to come back, it would be completely independent of the melanoma that I had."

Nathan Calhoun

But the Wolverine was back.

Two weeks after the treatment, Nathan’s scans showed once again the there was no evidence of disease. Fifteen years later, those results remain true. In 2019, even his routine scans became unnecessary.

“I know the medical profession is reluctant to use the word ‘cure,’” said Nathan. “But they did deem that if the cancer were to come back, it would be completely independent of the melanoma that I had."

Besides Elizabeth and his parents, another constant in Nathan’s recovery has been his music and playing with Calhoun’s Calling. After riding one year in LOWVELO, the band was invited to perform at the 2024 Finish Festival.

“In the last 16 or 17 years that we’ve had the band, we’ve had some amazing opportunities,” said Nathan. “And playing in LOWVELO is one of the best musical experiences. I could have stayed up there all day long.”

Elizabeth, now his wife of more than 10 years, agreed.

“I think it’s just an overwhelming moment just seeing him being able to do what he loves,” she said, as she choked back tears. “You can’t be on that field and you can’t be around that stage without feeling that love and support and excitement.”

Nathan said a big reason he took part in that clinical trial more than 15 years ago was to be part of something that was bigger than himself. TIL therapy is now approved as a treatment for advanced melanoma and is undergoing more clinical trials to expand its use to solid tumors. Even if his story had ended differently, he knew that taking part in a clinical trial could potentially help someone else facing a similar diagnosis. And that, to him, is what LOWVELO is all about.

“I think I’m just very sensitive and intuitive to this kind of support group and community,” said Nathan with a smile. “And it could be a sixth sense but the energy and support and community for cancer research – I just felt like I was home.”

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