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jesse c: pancreatic cancer

How has having cancer changed you?

"They get a pancreas cancer cell, kill it, hook it up to other factors, and then they inject it into you like they would any other vaccine."

As a retired pharmacist, Jesse Cugini, 65, knew that science advances through research. When he was diagnosed with pancreatic cancer in 2008, he was receptive to the idea of contributing to that research through a clinical trial. After having surgery to remove his tumor, Jesse enrolled in a clinical trial of a cancer vaccine being pioneered by Cancer Research Institute scientist Elizabeth Jaffee, M.D., at Johns Hopkins University in Baltimore, MD.

The cancer vaccine, called GVAX, is composed of pancreatic tumor cells that have been genetically engineered to produce a molecule called GM-CSF, which is known to stimulate the immune system. These cells are first irradiated to weaken them, and then injected under the skin. The idea is that the GM-CSF will stimulate immune cells called dendritic cells to pick up tumor antigens, present them to T cells, and trigger an immune response.

Jesse has been receiving the vaccine for 5 years now. A CT scan in February 2014 showed that he was still free of disease. TheAnswertoCancer (TheA2C) spoke to him while he was traveling on vacation in sunny California with his wife, Flavia.

TheA2C: How did you find out you had cancer?
Jesse: Back in August of 2008, I had an itch with no rash over my entire body. I went to my family doctor and he decided to run blood work and it came back with high liver enzymes. So then he sent me to a GI (gastrointestinal) physician who did an ultrasound, which showed I had a tumor in my pancreas. 
From there I did my own investigation about where I wanted to be treated. I checked out a couple different facilities, and I decided to go to Johns Hopkins. 
TheA2C: Tell us a little bit about the vaccine.
Jesse: The vaccine, to the best of my knowledge, works in this way: they get a pancreas cancer cell, kill it, hook it up to other factors, and then they inject it into you like they would any other vaccine—be it the flu vaccine, shingles vaccine, polio vaccine, etc. It’s much more complicated than that, but basically that's it in a nutshell.
TheA2C: Is the idea that the vaccine is supposed to keep the cancer from coming back? 
Jesse: Yes, the purpose is to keep the cancer cells from coming back. So if there are cancer cells in the body, then the vaccine triggers the immune system to attack those cancer cells and get rid of them. 
TheA2C: Once you started the vaccine, did your cancer stay in remission?
Jesse: In November of 2010, another tumor showed up on the other end of my pancreas, so everybody was pretty upset. Dr. Barish Edil, my surgeon, went in and removed the other end of the pancreas along with the spleen and, lo and behold, to their amazement that tumor was not cancerous. They said it was one of the first times there was a recurring tumor on the pancreas that wasn't cancerous. They were very relieved about that. 
Once I recovered from the surgery, they put me back on the vaccine. I've been doing the vaccine with the pancreas team, led by Dr. Jaffee down at Johns Hopkins, every 6 months ever since.  
TheA2C: What did your doctor tell you about the prognosis when you were first diagnosed?
Jesse: Dr. Edil told me not to think about statistics because as you know the stats for cancer of the pancreas are very grim. Instead, he said to be optimistic, but to also keep your feet on the ground. And that's what we try to do. It was sound advice. 
TheA2C: Why did you decide to do the vaccine trial? 
Jesse: My wife and I decided to do the vaccine for two reasons. One is selfish: conventional therapies don't do much for cancer of the pancreas. The second reason is that I happen to be a retired pharmacist, so I know that somebody's got to be a guinea pig to move a treatment forward. And we felt that if anything good can come out of this vaccine for other people, then it’s worth it.
TheA2C: Would you recommend this immunotherapy to a friend or a family member who was in a similar situation?
Jesse: Absolutely. 
TheA2C: How has this experience changed your outlook on life?
Jesse: When you’re healthy, you hear these dramatic stories about cancer changing people’s lives. Well that’s true in my case. It has made me a calmer person as I’ve learned not to worry anymore. It has made me live one day at a time, as life becomes a bunch of moments. This experience has made me enjoy the wind and the birds chirping. You'll never believe that unless you're in this situation.

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