The Breakthrough & Immunotherapy

April 2, 2019 • #

I’ve been listening to the audiobook of The Breakthrough, Charles Graebel’s book about the origins and effectiveness of immunotherapy for cancer treatment.

There’s been a draft post in my archive for months to tell a longer version of the story on my cancer diagnosis and treatment. It’s been something that’s hard to write up in detail — hard to muster the motivation to spend time on the topic any more than I have to. I’ve had good news since late 2017, but still dwelling on it too long is not something I’m interested in. Usually would rather move on to other things.

But reading this book I couldn’t help but post about my experience. I did so today on a Twitter thread (mostly since I have more reach there than here), but here it is for posterity, assembled in a format easier to consume for those not on Twitter.

Here’s the full thread:

I’m currently reading “The Breakthrough” from @charlesgraeber, a story on the background of immunotherapy treatment for cancer. A few thoughts on this from a patient, survivor, and receiver of one of these treatments. (1/x)

2/ In late 2017 after my second surgery for stage IV colon cancer, I got permission to receive an immunotherapy (nivolumab, AKA Opdivo) near the end of my chemo regimen.

3/ My 2nd surgery had removed what they could see on any of the scans prior, but I wasn’t out of the woods yet — after surgery I had about 4 more rounds of chemo and a year of the immunotherapy treatment ahead.

4/ I always had an okay response to the chemo until some neuropathy set in toward the end. Only mild nausea along the way. I was on FOLFOX, which can be rough for many patients, but probably my young age & good health made it easier to take.

5/ But once that was over and I was only on the immunotherapy, the contrast between the treatment methods of the last 100 years — the triad of “cut-poison-burn” (surgery-chemo-radiation) — and IT was enormous. I had 2 of those, and of course, neither was a comfortable experience.

6/ Immunotherapy is a completely different thing. Rather than acting on the mutated cells, it acts on your immune system. Cancer cells do what they do by duping your immune system into not attacking them.

7/ Immunotherapy treats your immune system (to activate, in the case of nivolumab) — blocking this signal from cancer cells so the T cells will attack.

8/ I got a dose of nivolumab every 2 weeks for 30 minutes via IV, with zero side effects. I would get an infusion w/ an hour visit to the clinic, then head to work like nothing happened. My blood chemistry would fluctuate a bit, but not enough to create noticeable side effects.

9/ An eye-opening moment that highlighted my own good fortune was learning how new this treatment really is. Nivolumab wasn’t FDA-approved for colon cancer until late July 2017 — nearly a month after I was initially diagnosed.

10/ The timing was perfect, and I have a world-class treatment team at @mayoclinic that were up to speed on the latest treatment options, trials, and genetic testing strategies required to fit patients to options.

11/ Here we are about 6 months beyond my last round of immunotherapy treatment. Two sets of follow up MRIs were all clear. Back to normal life with a renewed respect for how quickly it can go south on you.

12/ I wanted to call attention to this book and can attest to first-hand experience with immunotherapy. It’s a generational medical breakthrough that’s not well known enough when it comes to cancer treatments.

13/ It should be celebrated & reinforced, with more public success stories. There’s a chance that this is the treatment methodology that shatters this disease forever.

14/ Last thing: If your doctor recommends a colonoscopy, do NOT avoid it. It’s not that bad a procedure and can find all sorts of bad early signs well ahead of an advanced stage. It’s much, much, much easier than what might happen down the road if you avoid early detection!