Jeffrey Arnold, a 70-year-old pancreatic cancer survivor from Needham, Massachusetts, has hiked the 2,198-mile Appalachian Trail three times — twice after his diagnosis 18 years ago — and still logs 10,000 steps a day, a routine his oncologist at Dana-Farber Cancer Institute now treats as a vital sign, blog.dana-farber.org reported.
When Arnold returns from vacation, the first question from his oncologist, Nadine Jackson, MD, is usually, “How far did you walk?” Last time, the answer was 150 miles — a trip on the Portuguese Camino that Arnold called “easy peasy” because hotels and luggage transport were arranged. That is not his usual standard. Arnold has carried his own sleeping quarters on his back across the entire Appalachian Trail three times, braving bears, rattlesnakes, and skunks, and he completed the trail twice after learning he had cancer.
Jackson specializes in treating patients over 65 through a program built on the "four Ms" of an Age-Friendly Health System — Medication, Mentation, Mobility, and What Matters. For Arnold, What Matters means walking, playing a Les Paul electric guitar he bought himself, sketching, and his family.
Defining Core Priorities in Treatment Plans
- “What Matters” — the patient’s own goals and sources of dignity — is now a formal pillar of geriatric cancer care at Dana-Farber, alongside medication, mental health, and mobility.
How a Slow-Growing Tumor Changed One Man’s Answer to “What Now?”
Eighteen years ago, when Arnold was in his early 50s, his primary care provider felt a mass in his stomach. The diagnosis — neuroendocrine tumors on his pancreas and liver — came with a terrifying first reaction. “The first six months, I was like, ‘Oh my god, I’m going to die,'” Arnold recalled. But his oncologist at the time reassured him that these tumors grew slowly and could be managed for years with treatment.
The shock, Arnold said, “kicked me in the pants” and forced a question: “What am I going to do with my life?” The answers came quickly. Three years after his diagnosis he completed the Appalachian Trail for the second time, then again nine years later. Surviving on what fit in his pack across tremendous distances filled him with pride, and he relished the solitude. He also finally bought the guitar, writing “goofy songs” for nobody but himself.
Meanwhile his cancer remained stable, and his care eventually transferred to Jackson, whose program offers tailored, holistic care to patients over 65 with an emphasis on quality of life. For Jackson, that means approaching treatment as a partner and asking what matters to the patient, what provides dignity, and what builds resilience.
When the Cancer Progressed, the Care Team Listened
Three years ago his cancer progressed for the first time in more than a decade, and side effects appeared shortly after he switched therapies. Suddenly he experienced shortness of breath, which alarmed Jackson. "It was good that we knew each other so well," she said. "I knew what was normal for him, and this wasn't."
She connected him with pulmonologists and cardiologists, who determined he was having a reaction to the new cancer therapy. Despite the progression, Jackson and Arnold decided to stop the new medication so he could return to his baseline. Steroids from the pulmonologists fought off the reaction, and cardiologists addressed heart palpitations Arnold had struggled with since childhood. With his health stable, they restarted his original therapy, and his cancer remains stable today.
Resilience Does Not Look the Same for Everyone
Arnold is a unique case — hiking distances that would make the average adult shudder — but Jackson is quick to note that resilience is not one-size-fits-all. “It doesn’t necessarily mean you’re on your motorcycle every day,” she said. “Resilience means that you have choice, you have a level of independence, you have a level of dignity, you have a level of respect, and that, even when the news isn’t great, you can partner with your care team, and do not feel abandoned.”
When he is not on the trail, Arnold tries to reach 10,000 steps daily around his home in Needham, where he lives with his wife. He often walks to his part-time job as a librarian, a role he has held for 25 years. “Walking is my thing,” he said. Along with guitar, sketching, and his child, it is what has fueled him through all the uncertainty.
What Survivorship Support Looks Like After Treatment
Dana-Farber’s survivorship resources note that the years after cancer treatment can bring physical and psychological challenges, including managing the risk of second cancers and long-term treatment effects, and that survivorship programs work alongside a patient’s primary care physician to help them live well beyond cancer, according to the institute’s survivor resources page.
| Aspect of Arnold’s Care | What It Means in Practice | Source |
|---|---|---|
| Mileage check at each visit | Oncologist Nadine Jackson, MD, opens appointments by asking how far Arnold walked | blog.dana-farber.org |
| Four Ms framework | Medication, Mentation, Mobility, and What Matters guide care for patients over 65 | blog.dana-farber.org |
| Therapy adjustment after progression | New drug stopped after causing shortness of breath; steroids and cardiology care restored baseline; original therapy restarted | blog.dana-farber.org |
| Daily activity goal | 10,000 steps per day at home, plus walking to his librarian job in Needham | blog.dana-farber.org |
| Survivorship resources | Dana-Farber offers programs addressing long-term effects and second-cancer risk for adult survivors | dana-farber.org |
Finding Motivation Through Daily Movement
Arnold knows it is not reasonable to tell everyone to tackle the Appalachian Trail, but he encourages everyone to walk more, no matter the distance. He often thinks of a Jamie Lee Curtis interview he once read, in which she described two kinds of people: those who wake up and say, “Good morning, God,” and those who cry, “Good God, it’s morning!” It is crucial, he believes, to be among the first — and to get there, you need to find what matters.
References
- Dana-Farber Cancer Institute Blog — “Finding What Moves You: Septuagenarian Keeps on Walking,” published November 4, 2026 (blog.dana-farber.org)
- Dana-Farber Cancer Institute — “For Cancer Survivors” patient resources (dana-farber.org/patient-family/survivors)
