When a person “accepts” metastatic cancer and declines intervention

[Arcadia]

The Atlantic June 25th, 2019 article https://www.theatlantic.com/health/archive/2019/06/immunotherapies-make-cancer-treatment-less-brutal/592378/

“Many researchers and doctors are looking to immunotherapies to wipe out cancers without putting patients through the suffering often associated with surviving the disease. These treatments harness the power of the body’s existing immune defenses, which aren’t very good at attacking cancer cells without medical intervention.

The cancer immunotherapies most widely available now are checkpoint inhibitors such as Keytruda, which take the brakes off the body’s immune responses in order to more effectively unleash them on tumors. Merad said that these drugs have shown particular promise in cancers that are notoriously unresponsive to chemotherapy or radiation. “What was dramatic is that metastatic lung cancer—which doesn’t respond to any therapy—could be cured. The cancer would completely disappear,” she said. “We believe that in the years to come, more than 50 percent of cancer patients are going to receive checkpoint inhibitors.”

The CBS News chief medical correspondent Jonathan LaPook, who moderated the panel, said the most famous recipient of checkpoint inhibitors is probably Jimmy Carter, who was diagnosed with metastatic melanoma in 2015, which had spread to his brain. Normally, survival periods for patients with that type of cancer are less than a year, but Carter is still alive and cancer-free almost four years later.

A second immune system–based cancer treatment, this one in earlier developmental stages, is CAR T-cell therapy. “I think about it as pregaming,” Wayne said. “You’re pregaming your T-cells to be ready to party when they’re back in your body.” T-cells are on the front lines of the body’s immune response, and engineers like Wayne are developing ways to extract them from patients and optimize them to find and fight cancer cells.

“Just like you would give a scent to a bloodhound and say ‘Go get it,’ you’re giving the scent of the cancer to these T-cells and then multiplying them a billionfold and putting them back in,” LaPook explained.

The downside of this treatment is that it’s expensive and time-consuming. T-cells have to be harvested, adjusted, and proliferated from individual patients, which takes four to six weeks. That’s more time than some people have, and T-cells from previous patients can’t be used to treat future tumors in others, although Wayne said that she and other researchers are working on that technology.

Despite the current cost, Merad said there’s still immense cause for optimism for the future of immunotherapies in cancer treatment. “This is just the beginning,” she said. “There are two molecules on the market, but there are hundreds of them we can exploit.””

Edited June 28, 2019 by Arcadia

[Pen]

On 6/26/2019 at 10:19 AM, Katy said:

Part of me wants to level and ask directly. But I’m chicken.

 

@Quill I think you said this not Katy?

 

If it was you, I think it’s okay to go ahead and ask directly.  You could preface with it’s okay if person doesn’t want to answer, or needs time to answer, but you’re concerned and wondering about _____.

 

 

[Guest]

24 minutes ago, Pen said:

 

@Quill I think you said this not Katy?

 

If it was you, I think it’s okay to go ahead and ask directly.  You could preface with it’s okay if person doesn’t want to answer, or needs time to answer, but you’re concerned and wondering about _____.

 

 

Yes, I said it. 

I do have a bit more information today after discussing it with another i,portant person who cares about the ill person. I actually have a better understanding now as to why certain procedures and appointments were not complied with. 

I do not think the person has told doctors there is a deliberate choice to not pursue certain treatments, even if that means cancer advances. I don’t agree with this aspect, but I do see the logic in the choices being made.