A Tulsan's Rectal Cancer Journey and the Life-Saving Role of Clinical Trials

For Gregory Fowler of Tulsa, a higher-than-normal instance of constipation seemed like a mere annoyance at first. As a father, musician and entrepreneur, Gregory led an active and busy life, but when over-the-counter remedies failed to provide relief, he knew something was seriously wrong.

“I was at work, and I started feeling really bad, like I was trying to throw up. I got really dizzy and nauseous, and next thing I know, I'm passed out,” Gregory said. “My stomach hurt really, really bad, and I was in a lot of pain. They took me to a local hospital, and the doctors told me that it sounded like I was constipated. I was like, ‘Nah, bro, I'm trying to tell you this is not constipation.’”

The otherwise healthy 44 year old never imagined a silent killer was lurking in his body. A colonoscopy revealed a fist-sized mass in Gregory's rectum. Doctors classified it as Stage 3 colorectal cancer and aggressively treated the cancer with radiation and chemotherapy in hopes of shrinking the tumor before surgery. The intense treatment seemed to work initially.

"It shrank to the size of the tip of my tongue," said Gregory. But the victory was short-lived – a follow-up scan showed seven new lesions on his liver, advancing his diagnosis to Stage 4.

"I was devastated. Everyone in the hospital was telling me it's not over, that we were going figure it out,” he said. “But those words sounded like ‘we're going to try to make things as comfortable as possible.’ According to doctor Google, I was supposed to die within a year."

But Gregory wasn't ready to abandon hope. His Tulsa physician referred him to hematologist/oncologist and Director of the Oklahoma TSET Phase I Cancer Clinical Trials Program Dr. Susanna Ulahannan, M.D., MMeD, associate professor in the Section of Hematology/Oncology at the University of Oklahoma College of Medicine to see if he qualified to enroll in any active clinical trials.

Cancer clinical trials are medical research studies that test new ways to diagnose, treat and manage cancer. They involve volunteers, including people with cancer and healthy people, to test new treatments or new ways of using existing treatments. Stephenson Cancer Center is the only cancer center in Oklahoma to offer Phase I clinical trials. Gregory agreed, especially when facing the reality that he might not have much time left.

"Anything is worth fighting for as long as I get to live,” he said.

Beating the Odds with Clinical Trials

Dr. Ulahannan became something of a “medical guardian angel” to Gregory, and he said he found new purpose and strengthened his resolve after being admitted into a Phase I clinical trial.

"Dr. Ulahannan’s staff is outstanding. They all support her and make sure that she never misses a beat," he said. "She's a healer, and she has a natural love for her patients."

However, even she was worried when he arrived for his first visit.

“When he first came, he was not looking great,” she said. “Greg was in such bad shape that I barely could put him on a clinical trial and I honestly didn't know if the clinical trial would even help. It was kind of a Hail Mary, but he truly had nothing to lose by trying.”

Despite his dire condition, Gregory’s body responded positively to the treatment. That “death sentence” he feared began to fade away.

“He had a really good response to therapy and is clinically doing so well. He’s now one and a half years out from starting on this trial, and he’s a completely different person,” said Dr. Ulahannan. “I think there’s really that balance of being a realist and being hopeful.”

That balance between realism and optimism in the face of a grim prognosis highlights how clinical trials offer a chance to defy the odds. For Gregory, the treatment not only saved his life, he said, but gave him the energy to keep healing.

Although the clinical trial offered the best hope, the dosing protocols and lab work required Gregory to commute the two-hour distance from Tulsa to Oklahoma City every week, often for 12-hour stints. He would start his journey before sunrise and drive home well after dark. He frequently had to stay overnight in Oklahoma City when he was too depleted following his treatments to drive after chemotherapy and the drug infusions.

New Hope with the Stephenson Cancer Center in Tulsa

The May 2024 announcement of Stephenson Cancer Center’s expansion into Tulsa and the announcement of the collaboration with Hillcrest HealthCare System in June 2024 are beacons of hope for Gregory and many others.

The expansion into Tulsa marks a significant milestone in providing access to research-driven cancer care to northeastern Oklahoma residents. As the state’s sole National Cancer Institute (NCI)-Designated Cancer Center, the new state-of-the-art facility will offer local patients unparalleled access to advanced treatments and innovative clinical trials.

This expansion is crucial, as northeast and eastern Oklahoma have some of the highest cancer mortality rates in the state, and the need for outpatient cancer care is expected to increase by 13% over the next 10 years.

The multidisciplinary approach to cancer care at Stephenson Cancer Center places patients at the forefront, offering a wide range of resources and support services. With this expansion, patients like Greg will have the opportunity to receive top-tier cancer care while maintaining their daily lives.

The care patients receive at NCI-Designated Cancer Centers when participating in a clinical trial is different from standard care. Patients work with their own research nurse, have additional visits to track the success of the trial treatment and receive quality of life checkups.

“It’s not just about the experimental drug, but also about the enhanced level of care and monitoring,” Dr. Ulahannan said.

"To be able to have this facility here, and the treatment center here in Tulsa will allow me to be able to go and get my son after school and be close to home," said Gregory, who says he’s missed important family milestones and quality time with loved ones due to the commute needed to receive treatment in Oklahoma City. While the clinical trial represents his best hope, the travel itself is "pretty much a 12-hour day" of sheer endurance each cycle.

"Having the cancer center here in Tulsa gives you opportunity to live your life normally," Gregory said.

The clinical trial drug has been remarkably effective for Gregory, and the results represent a stunning reversal from his initial grim prognosis. Under Dr. Ulahannan's guidance, Gregory's cancer is well controlled.

"Stephenson Cancer Center pretty much saved my life” Gregory said. "If it wasn’t for the center and the study I was allowed to go on, I wouldn't be able to still fight."

Gregory's prognosis today is miles away from the devastating "make him comfortable" conversation from not long ago.

"Don't stop, keep believing," he said. "You've got to have faith in something bigger than you, bigger than the doctors. Because what you believe is going to also help those doctors find the care that you need."

For Gregory, that unwavering belief, coupled with Dr. Ulahannan's clinical expertise and the last-resort clinical trial aided by the Stephenson Cancer Center's research capabilities, quite literally saved his life. The journey has been grueling, but Gregory now sees light at the end of a long, dark tunnel thanks to the innovative work at Stephenson Cancer Center.

Learn more about resources and cancer treatments at OU Health Stephenson Cancer Center, or to schedule an appointment or second opinion, call (405) 750-2273. In addition, visit the Oklahoma TSET Phase I Cancer Clinical Trials Center for more information on Phase I clinical trials.