At an imposing 6 feet 6 inches and 250 pounds, Brad Samuel hadn’t been daunted by much in life, but Hodgkin’s lymphoma presented a challenge like none he’d ever faced.
After six months of conventional treatment for the cancer, Samuel needed a more aggressive approach. He resolved to meet the challenge, and then some, by undergoing an autologous stem cell transplant.
Hair gone from intensive chemotherapy, his immune system completely wiped out, Samuel would spend his time in the hospital exercising. He roamed the halls in workout clothes, doing lunges, push-ups, squats and 100 laps a day past the nurses station, where the bell mounted to the wall represented triumph against the deadly disease. It would become a focal point of his motivation.
“I did not take my eye off that bell for the entire leg of that journey,” he says. “To survive, I would tell myself that I must beat it mentally, so I have a chance to beat it physically.”
His will to win, combined with the advanced medical treatment Scripps is known for, would see Samuel ringing the bell just three weeks after the transplant.
In late 2021, Samuel went to the doctor for what he thought was a tennis injury. Instead, he learned of a 17-centimeter mass beside his clavicle, plus several smaller growths elsewhere in his body. That’s typical of Hodgkin’s lymphoma, a blood cancer carried throughout the lymphatic system.
By the time of his diagnosis, Samuel’s lymphoma had advanced to stage 4A, meaning it had spread outside his lymphatic system.
He wasted no time looking for treatment options. As a former media executive and CEO of his own consulting firm, Samuel has a far-reaching network of well-connected individuals. He tapped a few for recommendations on top doctors and treatment centers across the country. “I was open to going anywhere,” he stresses. “I just wanted to find the best.”
He found the best only a 10-minute drive from his home. Several friends had steered the Solana Beach resident to Scripps, and the care of Alan Saven, MD, and James Mason, MD, both oncologists and hematologists at Scripps Clinic Torrey Pines and the Scripps Blood and Marrow Transplant Program.
Scripps Bone Marrow Transplant Program, part of the Scripps Center for Organ and Cell Transplantation, is well-known for expertise and innovation, facilitating bone marrow and stem cell transplants for people across the country.
Specialists work in collaboration with comprehensive teams across the Scripps system to ensure patients receive the highest quality health care possible. It’s also the primary collection source for the National Marrow Donor Program in Southern California and the Department of Defense, as well as the largest collection site in the world.
“We’re actually one of the longest established programs in the country,” notes Dr. Mason, the bone marrow transplant center’s director. Launched in 1980, the program was the first in San Diego, and among the first in the nation, to conduct stem cell transplants.
“We have a very well-developed program here,” Dr. Mason says, “and we do a lot of cutting-edge work.”
However, leading-edge treatment isn’t always the first stop on a lymphoma patient’s journey, and it wasn’t for Samuel.
His initial treatment was more conventional and required 12 sessions of chemotherapy: two per month for six months. Samuel leaned on his supportive partner, Tami, as he approached the first session, unsure of what to expect.
At one point Tami suggested, “Why don’t you plan to be comfortable? Wear sweats, bring your slippers, maybe a robe?” But then Samuel recalled advice Dr. Saven had given him: “If you don’t feel sick, don’t act sick.”
Samuel didn’t feel sick. He felt like going to battle with the illness that threatened to upend his life. He invoked the competitive spirit of basketball great Michael Jordan and wore a pair of the athlete’s signature Nike Air Jordan Ones.
Samuel brought work to do at the clinic, and even logged into a couple of Zoom meetings while receiving his chemotherapy. He felt so strong and optimistic after the first session, he decided to repeat the approach.
He bought another pair of Jordan Ones for the second session, then another for the third, and so on: Twelve pairs of sneakers for 12 treatments in what he came to regard as a competition for his life.
But even for a guy of Samuel’s size and energy, cancer can be tough to beat.
“To survive, I would tell myself that I must beat it mentally, so I have a chance to beat it physically.”Brad Samuel
In general, Hodgkin's lymphoma is one of the more curable and treatable lymphomas. But taking the right approach is key. Samuel’s disease was resistant to conventional treatment. By the time Samuel’s chemo course finished, most of the original masses were gone, but tests revealed a new one had appeared.
“I definitely was shaken,” Samuel concedes. But he tapped back into that competitor spirit. “If you take a page out of Jordan’s book,” he says, “you don’t win every game you play, right? You’ve got to get up for the next game.”
His doctors told him he could avoid hospitalization and continue pursuing conventional therapy or commit himself to the rigors of an autologous stem cell transplant. At this point, taking the cautious approach felt like playing for the tie, says Samuel. “I’ve never played for the tie in my life. I play for the win.” So, on the advice of his doctors, he went for the win.
Many patients whose Hodgkin’s lymphoma is resistant to conventional treatment can be cured by escalating the dose of chemotherapy and doing autologous stem cell transplantation, explains Dr. Mason. Autologous means the stem cells are drawn from the same person receiving the transplant.
Step one requires collecting bone marrow stem cells from the patient and freezing them. Next, the patient gets a potent dose of chemotherapy to completely eradicate the cancer.
“The problem is that it also kills all of the bone marrow where you make your blood, where you have immune cells that fight infection, where you have red blood cells that carry oxygen and clotting cells," says Dr. Mason.
The powerful meds literally take a patient’s white blood cell count to zero. This means the body cannot physically fight any threat on its own.
“Right when you think your body is not going to able to fight anymore,” Samuel says, “that’s when they rescue you with your own stem cells.”
It’s a harrowing process. But putting the stem cells back in the body only takes about an hour,” Samuel says, “It’s weirdly anti-climactic.”
Administered through an IV, the stem cells find their way back into a patient’s bones where, within a couple of weeks, the production of blood cells resumes — minus the cancer.
The concept of autologous stem cell transplantation has been around for decades and was fairly well established when Dr. Mason entered the field in 1991. However, the last 40 years have seen many refinements, beginning with how stem cells are collected.
“Patients in those days had to have a true bone marrow transplant, where you literally had to go into the patient beforehand with very long needles and extract bone marrow in the operating room,” he says. Today, patients receive a course of medication that induces bone marrow stem cells to enter the bloodstream. The blood gets drawn from one arm, the stem cells are filtered out with a centrifuge, then the blood is immediately returned into the other arm.
“At any given moment,” the doctor points out, “only a very small amount of blood is actually outside of the patient.”
Other advances making the process less debilitating include more effective antibiotics, antivirals, antifungals and antinausea medications. That means patients have more energy with which to heal. But that doesn’t mean more bed rest. In fact, the doctors at Scripps encourage their patients to be up and active, to keep their bodies — and their outlooks — as strong as possible.
“We want them up and about, even in the middle of the transplant,” Dr. Mason says. “We want them walking around and exercising.”
And that’s where having a guy like Brad Samuel can make a difference for other patients and staff. “He’s a very dynamic individual, with a great deal of positivity and gumption,” notes Dr. Mason.
Heading into his treatment, Samuel pieced together a daily exercise regimen with the help of his brother, Derek, a master physical therapist who helps elite athletes recover from injury, including champion golfers and All-Pro NFL players.
Rather than a hospital gown he walked his hundred laps a day in gym clothes, greeting and connecting with everyone on the wing: doctors, nurses and custodial staff, in addition to fellow patients. Several even took to joining his workouts. “We got a crew of people,” Samuel says. “What an incredible vibe it gave people on the floor.”
On the day Samuel finally rang the bell mounted by the nurses station, a crowd gathered to cheer him along. He praised his Scripps doctors and nurses, whom he calls “experts, not just in the practice of medicine, but in the practice of humanity.”
And, of course, he credits the lifesaving advanced medicine practiced by the Scripps Blood and Marrow Transplant Program. But Samuel has no doubt that, at that moment the medicine had done everything in its power, a winning attitude pushed him over the top.
“Nobody can tell me that, if it’s a tiebreaker, your mind can’t push it over the edge one way or the other,” he says. “Don't give up hope. Ever. Double-down on it.”
This content appeared in San Diego Health, a publication in partnership between Scripps and San Diego Magazine that celebrates the healthy spirit of San Diego.