Forging Ahead

A dire cancer diagnosis during a national pandemic sparks a blacksmith’s journey to City of Hope
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Steve McGrew’s move from Spokane, Washington, to a neighborhood near City of Hope’s Duarte campus is a story that’s part good fortune, part dogged determination. 

McGrew moved here temporarily to take part in a potentially life-changing clinical trial to treat his Stage 3 mesothelioma. He might never have come to City of Hope if not for one of his students, who wanted to learn how to make knives.

McGrew is the “village blacksmith,” pounding metal into knives, works of art and more. And he teaches his craft to a lucky few who spend time in his workshop.

Yuman Fong, M.D., made knives with Steve McGrew before he became his physician.

One of those was Yuman Fong, M.D., chair of City of Hope’s Department of Surgery. Fong is a self-described “dabbler” who seeks out master teachers to instruct him in new disciplines. Their relationship yielded some new handcrafted knives for Fong. It would give McGrew much more.

He’s not sure how or when exposure to asbestos — the primary cause of mesothelioma — ultimately made him ill. As a child, McGrew and his friends crawled through an attic with asbestos insulation. He remembers odd jobs: cutting asbestos boards; demolishing an old Army barracks. It could have been any of the above; mesothelioma has a latency period as long as 50 years.

He was 74 when his chest began to feel strange and he started losing weight. A few months later, he became short of breath and couldn’t eat. A CT scan and biopsy revealed so many mesothelioma tumors in his lung’s lining that his doctor nearly gave up on McGrew right then and there.

Enter Yuman Fong. Again.

City of Hope has instituted stringent preventive measures to protect patients, caregivers and staff as the COVID-19 situation evolves, including a strict visitor policy.

Fong knew what McGrew’s doctors in Spokane didn’t: A clinical trial at City of Hope was combining immunotherapy with chemotherapy, followed by surgery, then more immunotherapy afterward. The new approach was improving outcomes and extending life expectancy.

Fong urged McGrew to come to California. “We’ll get you into that trial,” he promised.

But by now it was March 2020 and the coronavirus pandemic was changing everything. 

Quarantines and delays left McGrew with little time to reach City of Hope before the trial’s enrollment window closed. COVID-19, meanwhile, was wreaking havoc with air travel. 

He had just one option.

“We drove,” he said. “Myself, my wife and the dog. Twelve hundred miles in three days. We signed up for the trial 30 minutes before the deadline,” he said.

McGrew’s clinical trial consists of four cycles of the checkpoint inhibitor atezolizumab (Tecentriq) plus the chemotherapy drugs pemetrexed and cisplatin. The goal is to shrink his tumors and make surgery more effective. 

And it’s working.

“I’ve improved even more than they expected,” said McGrew. “The tumors have shrunk. And I feel great. Almost normal!”

Monica Arevalos, ambulatory care assistant, works in a drive-through patient screening facility. City of Hope tests all patients for COVID-19 prior to procedures, hospital admittance and enrollment in clinical trials.

None of this is a cure, and McGrew knows it. This blacksmith researched his disease and City of Hope’s track record as carefully as any project he’s ever undertaken. He liked what he saw. And he likes his chances.

“I’m ready for the best- and worst-case scenarios,” he said. “Could be five years. Could be one year. And then we’ll try something new!” And yes, he fully expects to see that “something new,” because at City of Hope he’s surrounded by “doctors and researchers who always know what’s coming.”

“There’s no better place in the country. I’m in the best possible hands.”

City of Hope is a National Cancer Institute-designated comprehensive cancer center and a global leader in the advancement of research and treatment protocols. To learn more, visit CityofHope.org.