Instead of jogging on pavement, Piero Solimano runs in place in his Gulf Breeze, Florida swimming pool. He closes his eyes, imagines himself in a high-intensity soccer game and pushes his legs to eat up the fantasy turf. Solimano, 60, exercises in his pool because it’s easier on his body, which has withstood cancer four times in the past 26 years.

Solimano’s fight with the disease began in 1991 when he was diagnosed at 37 with adenoid cystic carcinoma, which affected the tearing glands of his left eye. After more than 20 years of treatment, recovery and three recurrences, Solimano came to the Metastatic Cancer Program at UF Health for a new kind of cancer treatment strategy — and a new hope for his future.

His original tumor was the size of a lime that formed behind his eye. Surgeons in Los Angeles removed it, leaving some vision impairment. Later, Solimano, and his wife, Magali, moved to Gulf Breeze, to raise their two daughters in a quieter lifestyle and to focus on more healthy living.

By 1998, the cancer spread to Solimano’s femur. The prognosis was “pretty grim,” he said, as Pensacola oncologists told him he needed surgery, and he most likely would not walk again. Solimano’s search for better options led him to UF Health Orthopaedic Surgery – Emerson in Jacksonville, where his cancerous bone was removed and replaced with a mega-prosthesis — substituting metal for the top one third of his femur.

“My recovery from that was painful and long,” said Solimano, who was born in Peru and immigrated to the U.S. when he was a teenager. “I had to learn to walk again, but I recovered beautifully.”

Ten years later, the cancer was back. This time in Solimano’s left hip, involving the muscles and the sciatic nerve, and he sought treatment from UF radiation oncologist Roi Dagan, MD ’07, medical director of the Metastatic Cancer Program at UF Health in Gainesville and the UF Health Proton Therapy Institute in Jacksonville.

“I was at my lowest point ever — almost going mad because of months of no sleep and constant pain,” he said. “I was in deep trouble, and that’s why I’m so grateful to UF Health. Dr. Dagan gathered a big team of people who proposed a radiation treatment that was very targeted.”

Dagan’s plan included aggressive, precise radiation treatments every day for two weeks to attack the three tumor sites in his hip.

“The damage to surrounding tissue was minimal, so I would say this was the best treatment option for me,” Solimano said.

Although the very rare type of cancer has a high propensity to metastasize and spread, it found its match in the UF Metastatic Cancer Program. Metastatic cancer occurs when the cells of the original tumor spread to other parts of the body and, traditionally, are treated as terminal cases.

“Traditionally, the dogma is that metastatic disease is incurable, and that if there’s a metastatic tumor in one organ, then others must be present throughout the body,” said Paul Okunieff, MD, director of the UF Health Cancer Center and chair of the UF College of Medicine’s department of radiation oncology. Okunieff revolutionized metastatic cancer care when he began to treat it with the intent to cure, not just comfort. He brought the program to UF Health in 2009, and with an alliance of experts — including scientists, physicists and healers — the program takes a multidisciplinary approach to treat early metastatic cancer.

“We’ve learned that we need to think about metastasis in the same way we think about the primary tumor: determine how much it has spread, then decide whether it’s treatable based on existing technology,” Okunieff said.

After two weeks of daily treatment, Solimano had to relearn to walk for the second time in his adult life. He has been disease-free for two years since completing this radiotherapy.

“Within three months, his quality of life went from very poor to excellent,” Dagan said. “It’s been miraculously resolved with no evidence of recurrent cancer.”

Now that his days are finally pain-free, Solimano can appreciate the journey and is thankful for the second chances.

“With the pain going away — it has given me an incredible boost,” Solimano said. “I feel amazingly well, and I’m grateful for every minute, every day.

“I wouldn’t want to go through any of these painful experiences anymore, but I wouldn’t change anything,” he said.

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