John E.: Biomarker testing uncovered a pivotal treatment option

In December, John E. was given a timeline.

A doctor in Grand Rapids, Michigan, told the 44-year-old husband and father of two girls that he had two years to live — and that chemotherapy would be his only treatment option. The message landed with a thud. 

There were no alternative paths discussed and no mention of biomarker testing, a process that can identify certain treatments that may work better for specific tumor types. Still, John respected the doctor’s opinion. 

“When a professional gives you a prognosis like that, you listen,” John said.

But with so much to live for, John wasn’t taking this first prognosis as a final verdict on his life. For options, he approached the Mayo Clinic, which immediately suggested biomarker testing. As a result, John received a radically different perspective.  

“We’ve got another arrow in the quiver,” his Mayo oncologist told him after reviewing his biomarker results.

Those results showed that John’s cancer was HER2-positive — a finding that made him eligible for a targeted therapy already approved by the FDA. It was not a clinical trial. It was a treatment option. He matched through Tempus Testing.

And until that moment, no one had told him it was even possible.

Two Systems, Two Messages

John’s experience highlights a gap many patients encounter: the distance between standard treatment pathways and precision medicine informed by biomarker testing.

At Mayo Clinic, biomarker testing was routine and a part of the discussion with his oncologist.

“Within the first five minutes, they said that I would undergo biomarker testing to know whether there was potential for targeted treatment,” John said.

In Grand Rapids, that conversation never happened.

Instead, John was actively discouraged from seeking second opinions. One physician warned him about “too many cooks in the kitchen.” In response, John quipped: “Yeah, and this is an important meal!”

The contrast became painfully clear after Mayo recommended starting the HER2-targeted therapy right away. John called his oncology office in Michigan, expecting urgency and excitement for another treatment path. Instead, he was greeted with a weeks-long delay for an appointment to obtain a prescription for this new approach. 

“I started crying on the phone,” John said. “I pleaded with the triage nurse and even shared that I was told I’d be on chemo for life. I begged her, human to human, to expedite my request to the doctor to write this prescription.”

John had just been told there was another option, one that could meaningfully change his outlook, and suddenly he was being asked to wait.

Becoming His Own Advocate

Standing in the underground tunnels at Mayo Clinic, John prepared himself for another setback. 

If his local doctor refused, or if there were bureaucratic delays in prescribing the medication, he was ready to return upstairs and ask his Mayo oncologist to intervene directly — even if it meant traveling between states every few weeks to receive care.

“I was desperate, John said. “The desire to see my kids grow up fuels me.”

After further outreach, his doctor in Michigan approved the treatment, and John started the targeted therapy.

The experience reshaped how he thinks about the role patients must sometimes play in their own care.

“This is what advocacy looks like,” he said. “Breaking through bureaucracy, especially when a recommendation is coming from a place like Mayo.”

Why Biomarkers Matter

John has now been on the HER2-targeted therapy for several months. He has metastatic disease in his lungs, but many of the spots have shrunk or stabilized. Two will be treated with radiation. Others are smaller than a millimeter.

He has not experienced major side effects. He works out regularly, follows a Mediterranean diet, and remains active in leading his family’s business. And, perhaps most importantly, he is present — for his wife, Molly, and their daughters.

“This treatment is the reason I can have quality of life,” John said. “It’s the reason I can be a dad and a husband.”

Looking back, he is struck by how close he came to never knowing this treatment option existed.

“Even being college-educated and running a business, you don’t always know what to ask,” he said. “Biomarker testing should be a primary discussion point between doctors and patients. It has the potential to change everything.”

Choosing Health First

Before his diagnosis, John managed a commercial beekeeping operation with nearly 1,000 hives, along with a honey bottling business under the Michigan Bee Company name. The work was demanding — often 80 to 100 hours a week during peak seasons.

Earlier this year, after a difficult family conversation, John and his dad, Joe, decided to sell off the beekeeping side of the business — a momentous change for a family business 100 years and four generations in the making. But John and his family felt it was necessary to make space for John’s treatment, recovery, and time with his family. 

“As tough as that decision was, I will never forget what my dad said to me as he held my hands in our bottling facility in January of ‘25,” John recalled. “He said, ‘John, your job is to get healthy!’”

John now shares his story so others won’t miss the same opportunity.

“I am living proof,” he said, “that knowing your biomarkers can open doors you didn’t know were there … so that you can get healthy.”