The Journey from Diagnosis to Remission

Ryan Goepel, aware of his struggle with gout, didn’t always manage it as well as he could have. This inflammatory condition can flare up due to various lifestyle choices, causing significant discomfort.

During a trip in September 2024, the Florida father of three felt pain in his knee and thought it was just another gout flare. But when the pain persisted, he decided to see his doctor. After some medication and blood tests, he got an alarming call just two days later.

“She said, ‘Stop whatever you’re doing, and go straight to the hospital.’ I was like, ‘What do you mean?'” Goepel remembered. “She told me, ‘You have no immune system. I don’t know what’s wrong. Just go.’”

Goepel hurried to a nearby sports medicine hospital, where further blood tests were conducted. He felt increasingly uneasy when an oncologist came to discuss the results.

“I asked, ‘Why are you here? I just have a sore knee,’” he said. “And she replied, ‘Actually, you have leukemia.’”

His situation was critical, with doctors warning his girlfriend that hospice care might be necessary for the then-49-year-old.

“It was so severe that they didn’t tell me directly; they just informed my family,” Goepel recounted. “They basically told her to make arrangements because I wasn’t likely to survive.”

“Not done yet”

Refusing to give up, Goepel’s girlfriend sought a second opinion. Eventually, he was transferred to Sylvester Comprehensive Cancer Center in Miami, where a biopsy confirmed he had acute myeloid leukemia (AML), a type of blood cancer that generally has a five-year survival rate of around 30%.

The situation was complicated by the genetic characteristics of Goepel’s AML. His variant was considered adverse-risk, explained Dr. Justin Watts, a hematologist-oncologist. This meant traditional chemotherapy was unlikely to be effective, since it could potentially weaken him without combating the cancer, endangering his life quickly. And even if it worked initially, the risk of relapse would be high.

However, there was a glimmer of hope: a spot was available in a clinical trial led by Dr. Watts, testing whether two medications used for older AML patients could be effective for younger people like Goepel. Given the genetic profile of his cancer matched that of much older patients, he was deemed a suitable candidate.

“Joining the trial was a no-brainer,” Goepel said.

“My girlfriend gave me a journal on the first day, suggesting I might want to write my thoughts, and I had no idea what to say, so I simply wrote, ‘I’m not done yet.’ I went to the doctors and asked, ‘What do I need to do? Stand on one foot, take this pill? Just tell me!’”

A clinical trial with remarkable outcomes

Just a day after starting the trial, Goepel began his treatment with two medications: a daily pill for 28 days and an infusion on a daily basis for the first week. Remarkably, his cancer started to respond right away. Within two weeks, he was in remission, a change he described as “bonkers.”

He wasn’t alone in achieving such results. Data published in the academic journal Haematologica reported that out of 36 patients, 25 observed their cancer shrink or vanish during the trial, with 19 entering complete remission. Goepel was among those who entered remission the same month he first noticed his sore knee.

Typically, only about 44% of patients with adverse-risk AML respond to standard treatments. Additionally, trial participants had shorter hospital stays, fewer blood transfusions, and experienced fewer complications compared to those receiving conventional care, based on the trial outcomes.

Dr. Mihir A. Shukla, a hematologist not involved in the study or Goepel’s treatment, noted that these results, combined with findings from another Phase 2 study, raised questions about potentially altering long-standing treatment approaches for these patients.

Life after leukemia

Following the trial regimen, Goepel still required a bone marrow transplant, a procedure that can rebuild one’s immune system and may cure leukemia, according to Dr. Watts. More than half of the trial participants underwent transplants, and both of Goepel’s sisters were ideal matches. He had the transplant in November 2024.

“Everything came together so quickly; it felt like a blur of luck,” Goepel said. “Honestly, I was at the right place, at the right time, with the right people. And it worked.”

After the transplant, Goepel spent three weeks in the hospital while his immune system was rebuilt, followed by another 100 days in isolation at home. He faced some post-transplant complications, including rotavirus and pneumonia, but both conditions were managed, and tests indicated the transplant was successful.

Now, two years cancer-free, Goepel’s journey seemed implausible at first, according to Dr. Watts.

“I can’t say for sure, but he likely wouldn’t be alive today if we had opted for standard treatment instead,” Watts remarked.

Research into treatment options for adverse-risk AML patients continues, and Goepel will have regular check-ins with his medical team to monitor the effectiveness of his transplant and ensure his cancer remains in remission.

Meanwhile, Goepel is finding his stride again. He and his girlfriend tied the knot in November 2025, coinciding with the one-year anniversary of his remission. He’s even starting to travel once more while reflecting on the past couple of years and what life beyond cancer will look like.

“It’s not exactly returned to ‘normal’—you lose track of what that is—but it’s more about not living in fear of a comeback,” Goepel said. “If I get a sore throat, I don’t immediately think, ‘Oh no, is it cancer?’ It’s just a sore throat. I’m learning to relax and actually enjoy life again.”