On June 10, her 42nd birthday, Amanda Wilk of Minnesota had more than just the day to celebrate. After battling colorectal cancer since 2017, Wilk rang the bell at Northwestern Medicine in Chicago to declare that she was officially cancer-free.
She was the first known patient to undergo a double lung transplant while diagnosed with Stage 4 colorectal cancer in the US.
According to the CDC, colorectal cancer is the fourth most common cancer linked to cancer-related deaths in both men and women in the US—with nearly 142,000 people newly diagnosed in 2022—and it’s becoming more widespread among patients under 50. If malignant cells enter the bloodstream, the cancer most often metastasizes first in the liver, followed by the lungs, bones, brain, or spinal cord, according to the nonprofit cancer research center City of Hope One study found that about 20% of patients are already experiencing metastases when they are diagnosed.
While the first successful double lung transplant was in 1986, Northwestern surgeons have pioneered a new surgical technique for cancer patients who have exhausted all other options. The goal? To prevent the cancer from spreading during the actual transplant surgery.
Discovering transplantation. The bilateral transplant surgery, which took place on June 3, was Wilk’s second major transplant. She previously had had a liver transplant after her brother donated 60% of his liver in 2020, she said during a press conference on Wednesday.
Wilk’s treatment prior to the liver transplant included a colon resection, chemotherapy, liver ablations, and radiation beads on the liver, according to a press release.
But the cancer returned in her lungs six months after she received the liver, and her doctor told her she likely had just two and half years to live, she said, adding that there didn’t seem to be any other viable treatment option available.
Wilk couldn't accept that fate. She traveled to different hospitals until she heard about Northwestern’s Double Lung Replacement and Multidisciplinary Care (DREAM) program, which has set out to offer the procedure to patients whose cancers have not responded to other treatments. The DREAM program has completed 40 lung transplants in patients with other advanced cancers, but this was the team’s first transplant for a colorectal cancer case.
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“When other hospitals told her there was nothing more that they could do, she really didn’t take no for an answer. Instead, she became part of medical history,” Catherine Myers, a pulmonologist at the Northwestern Medicine Canning Thoracic Institute, said at the press conference.
Tackling transplantation. Myers and Ankit Bharat, chief of thoracic surgery at Northwestern Medicine and director of the thoracic institute, said at the conference that the program aims to prove that lung transplant can be used successfully as a form of cancer treatment.
“By doing this surgery, we’re hoping that we can create a system where lung transplant is a treatment for cancers that have spread to the lungs. It’s done in the liver transplant world,” Myers said. “We really want to change the paradigm around using lung transplant to treat these cancers.”
The procedure was a bit more challenging than other double lung transplants, as the surgeons had to be careful not to release any cancerous cells into her bloodstream. “It’s a much more tedious dissection,” Bharat said.
Rather than taking one lung out at a time, which is typically done in double lung transplants, the Northwestern surgeons remove both lungs at the same time along with the surrounding lymph nodes, then wash the airways and chest cavity before transplanting the new lungs.
For Wilk, it was a success.
“She’s over three months out, and based on all the testing that’s available to us, including DNA testing in the blood, there is no sign of cancer left in her body now,” Bharat said.
Today, Wilk is easing back into running, enjoying her work at an elementary school in Minnesota, and hoping to someday run in the Chicago Marathon.
“It’s amazing. I can’t believe it. I still have that heightened [feeling] like, ‘What should I be worried about? What’s going to happen now?’” Wilk said at the conference. “Hopefully over time, I won’t have that feeling.”