My Immunotherapy Journey During Lung Cancer

My mother was diagnosed with metastatic breast cancer in the 1990s and suffered through regimen after regimen of chemotherapy. I found it painful to even watch the effect of the harsh chemicals on her body. Relief was my initial reaction when she told me she had decided to forego the last chemo recommended by her oncologist.

Then, in 2015 almost 20 years later, I heard that former President Jimmy Carter was diagnosed with metastatic melanoma. The most dangerous type of skin cancer had spread to his liver and brain. Carter had surgery to remove a mass on his liver, followed by radiation to treat the spots on his brain. Finally, the former president received four rounds of immunotherapy using the drug, Keytruda (pembrolizumab). Hence, hearing Jimmy Carter’s cancer story, I finally felt hopeful. Now Carter’s cancer is cured, and on October 1, 2024, he will be 100 years old.

Were we approaching the day when chemotherapy was no longer the first-line treatment for most cancers?

Five years after my mother’s death I had been diagnosed with ductal carcinoma in situ, the earliest form of breast cancer. I opted to have a mastectomy because of a possible family history of breast cancer. Only, another year or so later, I noticed a sense of weakness in my left lower leg and foot. An MRI revealed a meningioma, a benign tumor in the lining of my brain. It was removed successfully, and I stayed well for about 15 years. My health was good, but cancer continued to run rampant in my family, both nuclear and extended.

However, I was in the position to, hopefully, follow in Jimmy Carter’s footsteps in 2018. Diagnosed initially with stage 2 non-small cell lung cancer, my disease was restaged after the tumor in my left lung was surgically removed. During the surgical procedure, my doctor took lymph nodes from my chest. The nodes were biopsied, and many of them were discovered to be malignant. The members of the tumor board at the hospital where I was treated discussed at length, even argued, before deciding to delay chemotherapy for me, just long enough for my thoracic surgeon to remove the tumor from my right lung.

Remembering my mother’s experience, I felt terrified by the concept of chemotherapy. I attended my final appointment with my thoracic surgeon. He listened patiently as I shared my anxious thoughts about chemo, then recommended an oncologist whom he thought highly of. As a demonstration of his trust in the oncologist he had referred, my doctor told me that his mother was currently traveling almost an hour to and from appointments with that oncologist. Saving the good news until last, my surgeon told my husband and me, “Your PD-L1 score is at 60%; you are a good candidate for immunotherapy.”

Wow, it was just what I wanted to hear. I asked, “Might the oncologist treat me with immunotherapy, instead of chemotherapy?”

The doctor responded, “I don’t know.” I wondered whether he really did not know.

If I was afraid of receiving chemo, I was totally overwhelmed by the consultation appointment I had with my new oncologist just one week later.

He sat right in front of me, looked deep into my eyes, and spoke too rapidly for my stressed mind to absorb his words or their meaning. He told me exactly what to expect from my lung cancer treatment, especially what I would go through between then, early September, and the end of that year…four rounds of cisplatin chemotherapy.

My oncologist and I reconciled; he was an amazing cheerleader-working with all his strength, physical and emotional, to help his patients beat cancer. I respected his medical knowledge and experience.

Chemo was a struggle, but I made it through. That same day, my final day of treatment, I found myself back in my doctor’s office. He talked to me about daily radiation, as well as optional Imfinzi (durvalumab) immunotherapy.

It was the worst possible time to discuss my personal greatest hope for a cure for cancer, mine and many others. I was totally burned out by chemotherapy! Why was my oncologist sending me to two important consultation appointments, when I could barely stand up and walk from my comfy recliner to the bathroom in my home?

But with a lot of support and encouragement from my husband, I made it to both appointments the following week, most importantly the session with the leader of the immunotherapy and drug development center in the oncology department at the premier medical center in my city.

Once I met her, my doubts were quelled. My body and mind could cope with another year of treatment.

I’m not a scientist, but to the best of my understanding immune cells travel around in the body looking for germs and other foreigncells to attack. Imfinzi is an immunotherapy drug that binds to the protein, PD-L1, in cancer cells, to help immune cells kill those cells better. It is used to treat lung cancer, as well as other cancers. It is one of the types of immunotherapies known as checkpoint inhibitors.

Except for one rather unique side effect, my year of immunotherapy was largely uneventful. An allergic reaction to poison ivy led to a counter-reaction, which was easily cured by taking oatmeal baths. Other than that, I simply sat in the cancer center monthly for a 45-minute infusion, then went on with my life.

In spring 2023, I reached the five-year mark, cancer-free.

Did Imfinzi cure me of stage 3B Lung cancer? Maybe. More likely, it was a combination of treatments, with my experienced and knowledgeable doctor and my perseverance in battling an ominous disease.

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