When 66-year-old farmer Craig Smith developed urinary burning symptoms during Minnesota’s busy soybean harvest season, he immediately visited his doctor. Initially treated with antibiotics, his condition worsened until he began passing blood. His wife insisted they drive directly to Mayo Clinic in Rochester, where he was diagnosed with metastatic urothelial cancer that had spread to his spine.
That evening, Smith received a call from a Mayo physician asking whether he wanted to maintain his health for several years or pursue a cure. Smith responded without hesitation: “I want you to cure it.”
Smith had balanced farming with a 45-year career as a welding instructor, developing vocational programs while managing his 2,000-acre farm. After his 2023 diagnosis, he paused both responsibilities to focus on treatment at Mayo Clinic Health System, undergoing chemotherapy, radiation, and immunotherapy.
Metastatic bladder cancer that has spread beyond the bladder is typically considered inoperable and incurable. However, Smith responded exceptionally well to spinal chemotherapy and radiation. This positive outcome led his oncology team to propose an innovative surgical approach, removing his bladder, prostate, and 36 lymph nodes. Although active cancer cells remained in his bladder—posing a recurrence risk—Smith has now been disease-free for nearly two years.
His success inspired a new clinical trial testing this aggressive multimodal approach in other bladder cancer patients. Seventeen participants are currently enrolled, with promising early results. Advances like immunotherapy and biomarker tracking help identify patients most likely to benefit from such interventions.
The study, accelerated through Mayo’s Rapid Activation Pathway, combines systemic treatments targeting cancer throughout the body with surgery to eliminate the primary tumor. Supported by philanthropic donations, the research aims to expand curative options for more bladder cancer patients.
As Smith resumes farming, teaching, and family life, his case underscores a focused commitment to transformative cancer care. “Our only goal,” says Dr. Orme, “is to help patients live better and longer.”
