Looking back on cancer thanks to new immunotherapy treatment
MINNEAPOLIS (KMSP) - The long punishing journey for Keith Mangan started 15 months ago.
"I was suffering from fatigue, that was really the only symptom I had," Mangan recalled.
Doctors soon diagnosed him with colon cancer. At first, things looked hopeful. Chemotherapy appeared to halt the growth of the tumor in his colon. But then surgery revealed a grim prognosis -- the cancer was starting to invade into the pancreas and kidneys.
They tried more chemo but the cancer was accelerating.
"It was very difficult to hear, because the first thing you think of is he's not going to make it," said his mother, Nova Orveis.
This is where Mangan's cancer crisis came to a fork in the road. He could choose to live the rest of his days as comfortable as possible, or take a shot at an experimental drug that's part of a clinical trial.
"He's telling me if this drug doesn't work, I may have like 2 years left," Magnan said. "That's really hard to think about."
Researchers at Abbott Northwestern hospital in Minneapolis wanted to see if Mangan's colon cancer would respond to immunotherapy, a developing science that some believe could revolutionize the way cancer is treated.
"I think it is the biggest breakthrough in the treatment of cancer in my career," said Dr. Joe Leach, director of oncology at Allina Health. "I think, I hope, that 10 to 15 years from now we will look back and view this treatment as what led to a cure for many cancers."
What's unique about this approach is it relies on the patient's own immune system to go after the cancer.
Normally, our immune system attacks things that are foreign to our bodies. But cancers have a way of hiding in the dark, tricking the immune system into thinking it's a friend and not a foe. Immunotherapy uses drugs that can turn on the light, so the immune system sees the cancer and can destroy it.
"They're not chemotherapy, in fact these are probably the easiest treatments I've ever seen. I mean, they, for most of my patients have virtually no side effects," said Leach.
Unlike chemo, Mangan had no hair loss or nausea from the immunotherapy treatments but he did develop a high fever.
"The whole bed would shake, his eyes rolled back almost like he was having a convulsion," his mother said. "He was shaking so bad from the chills."
His immune system shifted into overdrive. It was attacking not only the cancer, but healthy tissue like his kidneys.
"I had renal failure, was on dialysis for about a month and a half," said Mangan.
Doctors gave him steroids to calm down his immune system but the steroids then caused bleeding ulcers in his intestines. Despite these complications, it appears as though the immunotherapy is working.
"I got a scan that showed the tumor was shrinking, so that was really hopeful, " said Mangan
In December, surgeons went in to remove what cancer was left. They sent the tissue to a pathology lab for analysis.
"My oncologist came by and told me the tumors are dead, it was great." he said.
This is the hope of immunotherapy that it will stop even the most advanced cancers in their tracks and add years to a person's life. But the chief medical officer of the American Cancer Society cautions it's still very early.
"I'm very excited about immunotherapy, but I don't want people to think it is the holy grail, that it's going to be the cure for all cancers," said Dr. Otis Brawley. "Clearly some people are benefiting from immunotherapy."
That's the disclaimer for now "some" people are benefiting, but not all.
"We need to understand why do they work in some people and not work in others and frankly we don't know the answer to that right now," said Leach.
The FDA has approved immunotherapy for certain types of lung cancers. It's also become the preferred treatment for some melanoma skin cancers.
These drugs carry a hefty price tag. Many cost ten thousand dollars a month,
"The biggest obstacle to advancing immunotherapy in all cancer therapies is cancer clinical trials," said Brawley.
Brawley explained a lot of questions about this promising new treatment could be answered if more people like Mangan were willing to go into the studies.
It's been 6 weeks since Mangan had the remnants of his last tumor surgically removed and according to his scans there is no evidence of cancer any place in his body. For now, the research is showing immunotherapy is effective for 2 or 3 years before it stops working.
Learn more at www.cancer.org