Immunotherapy Gives Some Patients New Weapon
UPDATE 5-25-2019: Paul Barbary's cancer is in remission. He will be among the featured speakers at this summer's Relay for Life event in Alton to provide hope and inspiration to others who are in the fight and to remember those who have lost their struggle against cancer.
Paul Barbary, 68, an independent insurance agent in Alton says when he first learned he had something called squamous cell carcinoma, it was like he was listening to a story about someone else.
Barbary received the diagnosis in the fall of 2017 and two weeks later, he underwent a 15 hour surgery. ‘Everything will be ok,’ he told himself. He prepared for the worst, making sure his wife was aware of the location of important papers and passwords. Barbary wrote a multi-page letter to a friend and put it in a sealed envelope, only to be opened if he didn’t make it out of surgery.
Barbary survived and was back at work within five weeks, but with lots of physical changes—part of his left ear was removed and was replaced with tissue from his leg, requiring him to wear a hearing aid. Surgeons used a ligament from his leg to keep his mouth from drooping and inserted a platinum implant to help his left eyelid close.
He also learned this his pay-it-forward philosophy of life, which earned him at least one public recognition for his volunteer support of children’s organizations, came back to him in the form of legions of supporters who surprised him with their sentiments and generosity.
“People call me every day. Every day. Every single day! I’ve been tremendously fortunate. So, if this thing had to happen to me, I’m the luckiest man in the world,” said Barbary.
Despite his extremely positive attitude and efforts to re-frame his situation as an opportunity, Barbary’s cancer returned with a vengeance. Barbary learned he represents the one-percent of patients whose specific type of cancer metastasizes to bones and internal organs.
So he is trying immunotherapy. His Medical Oncologist is Dr. Manpreet Sandhu, who is also Chief of Staff for OSF HealthCare Saint Anthony’s Health Center in Alton. Dr. Sandhu says cancer cells thrive because they are able to hide from your immune system. Certain immunotherapies can mark cancer cells so it is easier for the immune system to detect them.
“So the idea of immune therapy is to block that evasion … block that suppression that cancer cells have created around themselves and unlock the immune system to where it can then identify this cancer as a foreign object and start killing it,” she explained.
Melanoma was the first cancer for which immunotherapy was used successfully to treat a cancer that historically did not respond to chemotherapy. Sandhu said leveraging the body’s immune system has also been successful in treating cancer types of the liver, blood and lung, including non-small-cell lung cancer which she points out is the number one cancer killer worldwide.
There has also been some success revealed in a small but recent study involving 50 patients who, like Paul Barbary, had squamous cell melanoma that spread to bones and internal organs. Dr. Sandhu said immunotherapy was successful in 50-60 percent of patients.
She is hoping Barbary’s first scan later the first week of the new year will show positive results.
“This is a rare scenario. Standard chemotherapy really does not work that well. This is obviously a break-through.” She added, “In the absence of any other viable or effective treatment options, this is obviously something you hang on.”
Dr. Sandhu said about five percent of patients receiving immunotherapy experience serious side effects such as colitis, pancreatitis, and other negative impacts when the therapy overstimulates the immune system and it attacks other, healthy cells. She’s been able to prevent severe side-effects by closely monitoring and offering patients early interventions, including stopping the immunotherapy for a while.
Barbary knows immunotherapy takes longer than chemo and radiation to detect its impact so he’s been waiting and will learn more with that all-important scan. He’s encouraged by the information he’s read and from anecdotes from many people who have reached out with stories of patients they know who have experienced a range of positive results.
“To totally getting rid of it … to fighting it into remission. People said the cancer is still there but it’s not going anywhere and they continue take this therapy for every three weeks or so for the rest of their lives. So, everybody’s body is different. Everybody’s going to tell a different story,” he added with his usual optimistic tone.
Barbary hopes he winds up with one of those great stories and that the immunotherapy Dr. Sandhu is providing helps write a happy ending and a happy new year.