Mar 16, 2026
Read Time: 3 minutes
Takeaways:
- Advanced prostate cancer treatment is not one-size-fits-all. Patients can work with their care teams to balance longevity with strength, identity, and daily living.
- With early detection, innovative therapies, and supportive programs like exercise and nutrition coaching, living well while in treatment is possible.
Impact: At Huntsman Cancer Institute, J.R.’s journey reflects how personalized, research-driven care can extend survival while protecting the quality of life that makes each year meaningful.
Going the Distance—Still Racing
When J.R. Smith was diagnosed with stage 4 prostate cancer in 2019, racing was never just a hobby. It was identity. Discipline. Community. A way of measuring progress in fractions of a second.
After undergoing surgery, chemotherapy, and radiation at Huntsman Cancer Institute, J.R.’s treatment initially went well. Like many men receiving hormone therapy for advanced prostate cancer, he experienced significant side effects—most notably increased fatigue and muscle weakness from medications designed to suppress testosterone.
Still, J.R. kept racing.
Even with a testosterone level near zero, he continued competing at a high level, pushing himself carefully while listening to his body. By year five of treatment, J.R. was aware of the statistics—general survival rates for stage 4 disease are often cited at three to five years. Reaching that milestone was both sobering and empowering.
“It wasn’t unexpected,” he reflects. “But it did make me think more intentionally about quality of life.”
Choosing Quality of Life
After thoughtful consultation with his oncology team, J.R. made the decision to discontinue the oral cancer medication that was driving much of the fatigue. Quality of life mattered most.
He was able to remain off the drug for an entire year before his prostate-specific antigen (PSA) levels began to rise again. Rather than simply restarting medication, J.R. and his team made a joint decision to pursue a focused, two-week radiation treatment program instead.
The results exceeded expectations.
The treatment went exceptionally well, with minimal side effects and a meaningful reduction in PSA levels. And true to form, he brought his personality into the radiation suite.
“They let me wear my racing helmet during treatment,” J.R. laughs. “The radiation staff got a good laugh out of that.”
It was a small moment—but one that reflects a larger truth: Cancer treatment can still leave room for humanity, humor, and identity.
An Unexpected Detour
Around the same time, J.R. faced another surprise—a melanoma diagnosis. Lesions on his face and chest were identified by a vigilant dermatologist within the University of Utah Health system.
Thanks to early detection and swift care from the medical staff in Clinic 2C, the melanoma was localized and completely removed.
Another challenge. Another hurdle cleared.
Rebuilding Strength
Beyond treatment, J.R.’s care team helped him focus on rebuilding strength and resilience. He met with an oncology dietitian and joined Huntsman Cancer Institute’s Personal Optimism with Exercise Recovery (POWER) fitness program, working with a physician and coach who specialize in exercise and performance for cancer patients.
Four months into the program, the results were tangible.
“I’ve seen an increase in strength and even some muscle mass,” he says. “I didn’t think that was possible with my testosterone levels.”
The structured guidance, combined with evidence-based exercise and nutrition strategies—particularly beneficial for prostate cancer patients on hormone therapy—helped J.R. reclaim physical capacity he feared was gone.
And he hasn’t slowed down.
Racing Forward
Now approaching his seventh year since diagnosis, J.R. continues to race cars at a very high level. His racing community has become intertwined with his cancer journey. J.R.’s co-driver, Donny Edwards, and crew chief, Travis Carpenter, are also patients at Huntsman Cancer Institute. Together, they represent a unique kind of pit crew—bound by engines, endurance, and shared resilience.
J.R. also leads a cycling team that raises funds for Huntsman Cancer Foundation to support research.
“There aren’t enough accolades for the doctors and staff at Huntsman Cancer Institute,” he says. “They’ve become my second family.”
Cancer, unexpectedly, has sharpened his focus.
“It may sound strange, but it’s given me a renewed appreciation for life.”
The race isn’t over.
Seven years in, he’s still accelerating—still competing, still rebuilding, still choosing quality of life alongside cutting-edge care.
And J.R.’s not finished yet.