In the fall of 2016, Stephen Aldrich began feeling winded and fatigued. He was sweating profusely and experiencing pain in his chest and back.
By the following February, Aldrich’s symptoms had progressed to the point that he fainted at a birthday party. Tests subsequently revealed a diagnosis of stage IV adenocarcinoma of the esophagus, which has no known cure. Fewer than 5% of patients survive for more than five years beyond diagnosis.
After taking a few days to recover from the shock, Aldrich said he realized, “Nobody knows how I’m going to die. I guess that means I have to take responsibility … solve my own problem. … I have to find a cure for cancer.”
Today, the 64-year-old Stockbridge, Vt., resident is confronting the uncertainty and challenges of cancer head-on, trying to find personalized cures for himself and others.
Aldrich has a bachelor’s degree in evolutionary biology from Harvard University and founded a Cambridge, Mass.-based consulting company, Bio Economic Research Associates. Known as bio-era, the company focused on the overlap between biology and economics, and among other things advised companies in how to prepare for pandemics. He retired in 2009.
Before his diagnosis, Aldrich served as chairman of the board of the South Royalton-based Building A Local Economy, led the White River Investment Club and served on the board of the Randolph-based nonprofit Stagecoach Transportation Services.
To stave off death and get more time with his wife, Deborah, and two adult children, Aldrich applied his knowledge of biology and problem-solving to his cancer. He put together an advisory board including medical providers, biotechnology researchers, cancer survivors and alternative healers to help him navigate the process.
Aldrich initially underwent a chemotherapy treatment called FOLFOX at Dana-Farber Cancer Institute in Boston, but ultimately he rejected the typical treatment for his cancer, which was palliative, not curative.
“I pledged to myself and my family I would not leave any stone unturned,” he said.
Aldrich learned earlier this month that the tumor in his esophagus has grown, after a roughly three-year stint where it had not progressed. But through his work, he now has several treatment options to choose from as he moves forward.
“The first time around I was panic-stricken,” he said, noting that he experienced a lot of anxiety. “I don’t have any of that.”
From the outset, Aldrich knew he wanted to create a personalized vaccine to harness his own immune system to attack his cancer. While the technology to develop such vaccines exists, they are not readily accessible.
Though cancer centers genetically sequence patients’ cancer cells obtained through biopsies, they don’t typically make that information available to patients, Aldrich said. In order to get that information, which he needed in order to have a personalized anti-neoantigen vaccine developed, Aldrich turned to connections he had developed during his time leading bio-era.
To buy himself time to develop the vaccine, Aldrich joined a Connecticut-based clinical trial in the summer of 2017. The trial evaluated the efficacy of two immunotherapy drugs, pembrolizumab and epacadostat, intended to trigger an immune response against cancer. While Aldrich saw some benefit from the drugs, they can harm healthy cells in addition to the cancer, he said. In contrast, the personalized vaccine trains the immune system to recognize certain molecules present on the outside of cancer cells and then to attack the cancer cells.
Aldrich eventually found a German company to design the vaccine and another in the Netherlands to manufacture it. In order to get it in the winter of 2019, he enrolled in a clinical trial in San Diego. It took three inoculations spaced three weeks apart, he said.
In all, it took Aldrich two years and $200,000 to get the vaccine, he said.
Such vaccines have, in clinical trials, shown promise in eliciting a cancer-fighting response in the body’s immune system, with few side effects, wrote Jasreet Hundal, project manager of the personalized vaccines project at Washington University School of Medicine in St. Louis, and Elaine Mardis, co-executive director at the Institute for Genomic Medicine in Columbus, Ohio, in an article in The Scientist last summer.
But there are obstacles to “the scalability” of the development and production of the vaccines, which because they are personalized are difficult to mass-produce, Hundal and Mardis wrote.
Though not involved in Aldrich’s care, Dr. Jason Faris, director of Dartmouth-Hitchcock Norris Cotton Cancer Center’s Early-Phase Trials Program, said in an email that such vaccines “are an exciting experimental therapeutic … and some have shown promising early data.”
But because they are not yet approved by the FDA, they can only be accessed through clinical trials. Norris Cotton has run such trials in the past, but is not running any currently, Faris said. The Lebanon-based cancer center is conducting trials for other immunotherapy approaches for late-stage cancer patients, he said.
In hopes of bringing the price down and making these vaccines accessible to more cancer patients, Aldrich started a new company called MyCancerDB last year. The company aims to offer patients a secure place to store information about the genetics of their cancer, to allow them to share the database with their clinicians and use it to navigate the process of obtaining a personalized vaccine.
The company intends to help patients get their vaccines within four months, for $50,000, a quarter of what Aldrich paid, he said. The company now has six patients participating and hopes to get FDA approval to expand to 100 patients, he said.
Brad Power, one of MyCancerDB’s founding members, said that like Aldrich he hopes to give patients more control over their own treatment. Power, a 66-year-old resident of Maine and Cambridge, Mass., was diagnosed with lymphoma in July 2018. With the help of chemotherapy, Power said, he is currently healthy.
But, he said, “I think of myself as having cancer just lurking in the shadows.”
Power is an investor in the company and also a “guinea pig.” Eventually, he said, he hopes to upload information about his cancer to MyCancerDB and use the database to develop his own personalized vaccine.
Power compared a cancer diagnosis to the COVID-19 pandemic.
“It’s how we react that kind of defines us,” Power said.
People with cancer are generally immunocompromised and therefore at a greater risk of serious symptoms of COVID-19. Power said he plans to hide out in his Maine home until a vaccine is available.
But Aldrich, whose consulting work involved advising companies on how to prepare for pandemics, isn’t too worried. He said he already acknowledged his own mortality when he was first diagnosed with cancer.
“I’m going to die, and I had to deal with that,” he said.
There are some practical burdens, however, to receiving care during the pandemic. He had to get administrative approval from Copley Hospital in Morrisville, Vt., to have his recent endoscopy, which found the tumor growth. Upon arrival, he had to be screened for COVID-19 at the door.
“Getting things done is a slower process because of COVID,” he said.
Though he’s uncertain what delays he might face, he said he plans to develop another vaccine for himself.
“No one knows in any individual case how long the immunity (or) beneficial effect of one of these personalized vaccines will last,” he said. “One obvious antidote of that uncertainty is to imagine that you’re going to be doing this every once in a while if you still have cancer.”
In addition to high-tech treatment, Aldrich has also made lifestyle changes. Early on in his healing process, a friend sent him a copy of Radical Remission: Surviving Cancer Against All Odds by Kelly Turner and it “became sort of a bible” for him, he said.
The book, which was first published in 2014, stems from Turner’s study of more than 1,000 cases of remission in terminal cancer patients. In it, she describes nine factors that can lead to a spontaneous remission, including diet changes, taking control of one’s health, using prescribed herbs and supplements, increasing positive emotions, and having a strong reason for living. More recently, she has added exercise to the list. She has a new book, Radical Hope, that came out last month.
Turner, in a voice message, said that researchers have found that these 10 things “significantly enhance your immune system.”
An English major at Harvard who went on to earn a doctorate in oncology social work at University of California, Berkeley, Turner said she jokingly refers to these efforts as “old-school immunotherapy.”
She became familiar with Aldrich’s story when he shared it through her website and is supportive of his efforts to make personalized vaccines more widely available. Ideally, cancer patients would have access both to these vaccines and to support in making “old-school” lifestyle changes, both to address cancer once it’s present and to prevent it, she said.
Aldrich has reduced his consumption of animal products and increased his intake of plant-based foods. He avoids red meat and dairy, but eats some fish and chicken. The shift was difficult at first but has gotten easier with time, he said.
He also has utilized alternative medicine, he said. One day, he said, he woke up and felt “as if every bone in my body had been broken. … It was an emergency.”
He had an appointment with Dr. Christopher Hollis, a naturopathic doctor who has an office in Randolph. It was the first time Aldrich had acupuncture and he said he had his doubts.
But, he said, “it was like a bloody miracle.” The pain was significantly reduced and Aldrich said the experience opened his mind to other alternative treatments.
Aldrich also has deepened his meditation practice and embraced his love of blues and jazz. By “listening to music that you love, your immune system gets a boost,” he said.
A member of the Christ Episcopal Church in Bethel, Aldrich continues to attend services via Zoom during the pandemic. His experience with cancer has deepened his faith, he said.
“I’m on a mission from God (to) help people who are dying of cancer,” Aldrich said. “I’m a miracle. I don’t feel like I’m responsible for it.”
In addition to trying to help others through MyCancerDB, Aldrich has reached out to cancer patients in the Upper Valley. He taught a class this winter at Bethel University, a free pop-up university offered during the month of March. This year’s classes were cut short by COVID-19, but two people attended the first (and as it turned out only) class, and Aldrich remains in touch with them, he said.
Aldrich and Power both said that their cancer diagnoses have brought opportunities they wouldn’t have had otherwise.
“The last three years for me have been unbelievably rewarding,” Aldrich said.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
Correction
Stockbridge, Vt., residents Mike Pfiel and Stephen Aldrich made maple syrup in early March at Aldrich’ s sugar house. An earlier photo caption with this story misidentified Pfiel.
