June is Immunotherapy Month!

Who knew? LOL! It seems like there is something to celebrate every single month of the year! There’s absolutely nothing wrong with that!

Sad Facts About Lung Cancer

When I was first diagnosed with cancer back in October 2012, no one expected me to live very long. Stage IV lung cancer is pretty deadly. The following facts are from the American Cancer Society’s Web site about lung cancer in 2015:

  • About 221,200 new cases of lung cancer (115,610 in men and 105,590 in women)
  • An estimated 158,040 deaths from lung cancer (86,380 in men and 71,660 among women)

Lung cancer accounts for about 27% of all cancer deaths and is by far the leading cause of cancer death among both men and women. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. 

The later the stage of the cancer, the more likely it is that you will not survive even a year. Only 4% of those diagnosed with late stage (aka distant or metastisized) cancer are expected to live five years after diagnosis. The following information is copied from the American Lung Association:

Survival Rates

  •  The lung cancer five-year survival rate (17.8%) is lower than many other leading cancer sites, such as the colon (65.4%), breast (90.5%) and prostate (99.6%).
  • The five-year survival rate for lung cancer is 54.0 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage. For distant tumors (spread to other organs) the five-year survival rate is only 4.0 percent.
  • Over half of people with lung cancer die within one year of being diagnosed. 
Lung Cancer Diagnosis and Survival by Stage
http://www.lung.org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet.html 

If you let yourself think about it much, it will scare the living daylights out of you! According to Lung Cancer Alliance, 432 individuals die of lung cancer every single day.

Funding …. Or Lack Thereof

Before I step off of my soapbox, I need to address the sad lack of funding for lung cancer. It makes my blood boil. It should make everyone’s blood boil. Since lung cancer is the third most common (behind breast and prostate) and the most deadly cancer there is, it is bound to impact your life either directly (you get diagnosed yourself with it) or indirectly (someone you love gets diagnosed with it).

When someone hears a person has lung cancer, the first question is not, “Will they survive?” Nope, the question everyone asks is, “Oh, do they smoke?” Because we all know that (1) lung cancer only happens to smokers and (2) all smokers deserve to die of lung cancer because they brought it upon themselves. Right?

NO!!!!

Let’s look at some facts. These are for 2015; they are not old and outdated.

In 2015, the Centers for Disease Control and Prevention (CDC) estimates that 157,499 men and women will die of lung and bronchus cancer. (I realize this number differs slightly from what the American Cancer Society estimates. I do not know why the numbers are different, but they are both estimates.) During the same time, 52,028 people are expected to die from colorectal cancer, 41,557 women from breast cancer, 38,797 from pancreas cancer, and 27,245 men from prostate cancer.

Despite common belief, lung cancer affects never-smokers, too. And, in 2015, 28,192 of them are expected to die from the disease.

The fact is that only 20.9% of those diagnosed with lung cancer are active smokers. Nearly 18% (17.9%) have never put a cigarette to their lips. And, 60% are former smokers. Some of those former smokers have not smoked for 40 or more years. (These stats come from the CDC report, “Cigarette Smoking Among Adults – United States, 2006″.) So much for the fact that only smokers get lung cancer.

The federal government devotes billions of dollars to health issues. Funding for cancer is estimated to be $5,414,000,000 in 2015. Of that, $255 million will be dedicated to lung cancer.  That amounts to a measly $1,153 allocated for each person expected to be diagnosed with lung cancer. Per death (158,040) from lung cancer, $1,619 is allocated.

By contrast, a total of $685 million is expected to be designated for breast cancer projects. According to the American Cancer Society, a whopping 231,841 individuals (mostly women, but men also get breast cancer) will be diagnosed with invasive breast cancer during 2015.  An additional 60,290 will be diagnosed with carcinoma in situ (the very earliest stage of breast cancer). Of all of those diagnosed, a total of 40,290 are expected to succumb to their breast cancer. The federal government is spending $17,002 in 2015 for every death that will occur from breast cancer.

Prostate cancer is the second most prevalent cancer in the United States. In 2015, the American Cancer Society expects that 220,800 men will be diagnosed with prostate cancer. It is expected that 27,540 men will perish from their prostate cancer. The federal government is expected to spend $255 million on prostate cancer (the exact same amount as being spent on lung cancer) in 2015. For every death from prostate cancer in 2015, Uncle Sam is spending $9,259.

Let’s look at this again:

Breast Cancer                        40,290 deaths                          $17,002 allocated
Prostate Cancer                   27,540 deaths                         $   9,259 allocated
Lung Cancer                        158,040 deaths                         $   1,619 allocated

Does anyone else wonder why the disparity?

But, I digress. This post is about Immunotherapy.

Immunotherapy – A Life Giver

If one must be diagnosed with cancer, this is not a bad time. Scientists and researchers are on the brink of making astonishing discoveries. More strides are being made now than in previous decades. Exciting strides!

Immunotherapy is a treatment that allows a person’s own body to attack cancer cells. According to the Cancer Research Institute, immunotherapy “represents the most promising new cancer treatment approach since the development of the first chemotherapies in the late 1940s.”

Yes!! I agree!! Having been put through the horrors of chemotherapy, I can attest that immunotherapy is exciting. For anyone wishing to learn more about immunotherapy, a good place to start is the Cancer Research Institute.

When I was first diagnosed with lung cancer, I started a chemotherapy protocol of Carboplatin, Avastin, and Alimta. Avastin is not technically chemotherapy. It is a drug designed to starve tumors of blood supply (anti-angiogenic therapy). Alimta and Carboplatin are both chemotherapies that attack tumors, but also affect healthy cells. They are basically poisons. The hope is that they do more damage to cancer cells than healthy cells.

I can’t begin to describe what it is like to go through chemotherapy. I would get my infusions on a Thursday. By Saturday, I was in bed, except for when I had to be up throwing up. For two or three days, I would be so sick, I could just barely move. No anti-nausea medicine worked. On top of the extreme nausea, a fatigue that cannot be described set in. It was difficult to walk from the couch to the restroom or to the refrigerator without resting.

You gradually begin to feel better. By the end of the second week after the infusion, I could make myself, through sheer will power, go to agility practice. This is a testament to just how much I love agility! By the third week, I was feeling pretty good, considering.

Toward the end of the time that I received my chemo infusions, I was starting to get very depressed. It seemed so futile to finally feel better just to knowingly make myself sick again with yet another infusion. I am afraid that if the infusions had lasted much longer, I would have either quit them or would have had to take anti-depressants.

And, the fact is, I was healthier than most who were getting chemotherapy. My blood tests remained perfect throughout my treatments. Most people, at the least, have their white blood cell counts tank. No one really knows why mine didn’t. My blood pressure also stayed in the normal range.

Since you are being infused with poison when you are getting chemotherapy, you can only get it for so long before the benefits are outweighed by the drawbacks. Chemo itself can (and does) kill cancer patients. As noted by the World Journal of Clinical Oncology:

Over the past few decades, platinum based chemotherapy is the standard of care for advanced stages of NSCLC. These systemic therapies have significant toxicities and confer unacceptable morbidity.

My tumors responded well to the chemo treatments. They shrank by half or so. But, as soon as the chemo stopped, the tumors took off. They were back to their initial size in a matter of weeks.

My oncologist told me that I basically had two options. I could either (1) undergo a different kind of chemo, one that historically made people sicker and was less successful than the first treatment I received, or (2) I could get into a clinical trial and at least help researchers understand some of the new and coming treatments for lung cancer patients in the future.

I didn’t think for a second about the choice. I opted for participation in a clinical trial. I had no desire to be sicker than before! And, if I was going to die, I might as well be a guinea pig for those coming behind me. I really didn’t think much about the clinical trial affecting ME positively.

Nevertheless, the best thing that has happened to me during this cancer journey was the decision to participate in a clinical trial. Few choose this route. I’m astonished by that. I would more than likely be dead if I had chosen to just continue with the traditional treatments.

I started immunotherapy treatments in July 2013. Information about the trial I am participating in can be found at https://clinicaltrials.gov/ct2/show/NCT01673867?term=BMS-936558+Docetaxel&rank=2 and http://news.bms.com/press-release/opdivo-nivolumab-first-pd-1-inhibitor-demonstrate-superior-overall-survival-versus-sta. Unlike chemo treatments, immunotherapy does not poison you, so the treatments never end (unless they quit working). Because immunotherapy isn’t poisonous, you don’t suffer the horrid side effects of chemotherapy. Or, I haven’t. Some people don’t have quite the same positive reaction that I have, but many do.

I have been getting immunotherapy for nearly two years now. I get treatments every two weeks. I have CT scans every 6 weeks (so often, that I can now drink barium without gagging).

Like when I was getting chemotherapy, my blood tests have remained perfect throughout the treatments. Blood pressure and oxygen levels have stayed in the normal range. The only side effect from the immunotherapy that I have suffered is that my thyroid has quit working properly. No big deal. I just take Levothyroxin every morning to keep the thyroid functioning as it should.

The CT scans have shown that the tumors have not grown nor spread at all since I began immunotherapy. One radiologist who reads the scans calls the tumors “scars.” My oncologist does not necessarily agree that they are simply scars. Since we don’t know for sure, we continue the treatments. At the least, it is an insurance policy against the lung cancer.

Because of immunotherapy, I have totally reclaimed my life. I am back to running agility regularly. I keep testing my stamina levels and I keep passing those tests!! WhooHoo!!

As you have seen from my previous blog posts, I started a garden for the first time ever. I go to the movies and out to eat with friends. My calendar rarely has a day without something scheduled to do.

No one knows how long the immunotherapy will continue to work. But, from what researchers know now, patients do not build up a resistance to it like they do to targeted therapies. In addition, it appears that the immune system continues to work against tumors for an extended time even after treatments end.

Immunotherapies are being tested on all kinds of cancer. The Cancer Research Institute (CRI) shows how it is working on their site at http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers. The following quote is from the CRI:

From the preventive vaccine for cervical cancer to the first therapy ever proven to extend the lives of patients with metastatic melanoma, immunology has already led to major treatment breakthroughs for a number of cancers. Every cancer type is unique, though, and immunology and immunotherapy are impacting each cancer in different ways.

In the future, those diagnosed with cancer may never have to go through the horrors of chemotherapy. Perhaps even surgery and radiation can be avoided through the use of immunotherapy. And, the death rates from cancer may decline sharply.

Let us hope!

P. S. If you have cancer and you are interested in immunotherapy, you can find out what trials are available by visiting the Clinical Trial Finder.

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