As a keen footballer, Cayden was used to the after-effects of a fast-paced match. But he never imagined that twinges in his back after one game would lead to a cancer diagnosis. To make matters worse, fighting off the disease wasn’t the hardest battle he had to face – it was the infections that came with it.
A shock diagnosis
After experiencing consistent back pain Cayden went to his doctor, who thought it was just a muscular issue. But after he became constipated and his spleen became enlarged, it was time to get checked. Within a few days, he was in the hospital and very unwell. The diagnosis was Large B Cell Lymphoma, a high-grade blood cancer.
“It was a shock,” Cayden says. “My family took it hard, especially my partner who was pregnant at the time. It was difficult to comprehend, but I tried to take it in my stride.”
Cayden received chemotherapy, and for a while, it went well. But after about four months, a new threat emerged: a severe bloodstream infection with a bacteria called Pseudomonas aeruginosa.
“I hadn’t heard of this infection before. I felt exhausted and it was a lot. It was worrying, but I knew I was in the best place. At the time, I didn’t realise how serious it could be,” Cayden explains. “But looking back now, things could have been so much worse. You don’t realise how close you are to the unthinkable.”
This bacteria is usually found in soil and water but can naturally colonise the human gut. It’s particularly risky in patients with compromised immune systems, and to add further challenges, it has evolved to resist many of the antibiotics doctors would normally use. This is an issue that has become one of the top ten global health threats, according to the World Health Organisation. Worryingly, antimicrobial resistance (AMR) could lead to as many deaths as cancer by 2050.
Fighting infections
For people like Cayden, whose immune systems are weakened by cancer and the subsequent treatments, their risk of infection increases. In fact, in cancer patients, infection is one of the most common health complications, with infections contributing to half of all deaths in blood cancer patients.
“I’m a strong person and believe that life doesn’t give us more than we can handle, but over time, I have grown to understand the seriousness of the situation I was in, and I definitely have greater appreciation for things. I am lucky to be here and to have access to treatment.”
Thankfully for Cayden, the infection was caught early and cleared so that he could restart his chemo. However, during the antibiotic treatment, it was discovered he had an enzyme deficiency which prevents him from taking several forms of antibiotics. This makes it even harder to find successful treatment options.
Cayden was in remission for nine months before the cancer sadly returned.
He underwent CAR-T therapy, a cutting-edge cellular treatment that helps the immune system recognise and destroy cancer cells. Southampton General Hospital is the first trust in the South East to offer this therapy. In this process, T cells are extracted, genetically modified to target cancer, and then reinfused into the patient.
The treatment worked, and Cayden went into remission again for six months before cancer cells reappeared. This time, he received bispecific antibodies, a treatment which effectively targets aggressive cancers that have returned more than once. After three months, he was back in remission, and to improve his long-term prognosis, he underwent a stem cell transplant to replace damaged blood-forming cells with healthy ones.
A knife’s edge
However, stem cell transplantation does not come without its risks. For Cayden, the transplantation procedure was complicated by a severe episode of mucositis, a condition where there is inflammation of the mouth and gut, which can then lead to life-threatening sepsis.
Cayden became very unwell and was admitted to the intensive care unit at Southampton General Hospital. His episode of mucositis was complicated even further by the return of Pseudomonas aeruginosa, but on this occasion, it was resistant to multiple antibiotics that are usually effective. In combination with Cayden’s inability to tolerate certain types of antibiotics, his treatment options were limited.
“Things happened so quickly. All of a sudden, I had trouble breathing, and then I was taken to ICU and things got serious. I had responded well each time I had a setback, but now I felt I was on a knife’s edge.
“They (the Pseudomonas aeruginosa) kept popping up in different places. It was like they were being chased around my body. We had to try different antibiotics until one worked, but then it would come back again in a different place.
“It’s scary to think that antibiotics will eventually run out. We need more research to find new alternatives. Thankfully for me, we eventually found a solution, but there will be some people who won’t be as lucky.”
Cayden is now in remission, and the stem cell transfer, which came from his sister, is progressing well. He’s back at the gym and looking forward to returning to the job he loves – supporting young people with special needs. But most importantly, he is cherishing time with his two-year-old son Kymarni.
“He’s growing into such an amazing boy with great character. It’s been really hard for us as a family, but the future looks brighter. I still have to be careful and attend regular check-ups, but I am more vigilant about how I feel now. My experience has given me more motivation to see things through and make the most of everything – I’m looking forward, not backwards.”
