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pam g: lung cancer

What if chemo and radiation don't work for your cancer?

"I would not be alive today if it were not for this drug."

When Pam Griffith, 65, was diagnosed with stage 3 lung cancer in March 2013, her doctors told her that it was aggressive but treatable. With surgery, chemotherapy, and radiation, she would likely be fine. But that summer, Pam and her husband, Randy, knew that something was wrong. Pam had begun to develop strange lumps in her neck and on the back on her head. A CT scan performed on August 23, 2013, showed that the cancer had spread to both lungs and her adrenal glands. Pam had progressed from stage 3 to stage 4.

At that point, Pam’s oncologist, Scott J. Antonia, M.D., Ph.D., of Moffitt Hospital in Tampa, FL, recommended that she consider entering a clinical trial of a new immunotherapy drug called nivolumab, made by Bristol Myers-Squibb. Nivolumab belongs to a class of drugs called checkpoint inhibitors, which block the “braking system” on T cells. The particular checkpoint that nivolumab targets is called PD-1. By “taking the brakes off” of T cells, nivolumab enables a stronger immune system response against cancer.

A happily retired real estate agent, with two children and six grandchildren, Pam knew that she wanted to fight the cancer in any way she could. The Answer to Cancer (TheA2C) spoke with Pam about her enrollment in the clinical trial and her experience with nivolumab.

TheA2C: What type of treatment did you have when you were first diagnosed with lung cancer?
Pam: They gave me a very strong chemotherapy treatment that involved two chemo drugs at the same time: VP16 and cisplatin. And then I would have to go and have radiation therapy as well. I went through about 7 weeks of the chemotherapy, which really made me quite sick. It was pretty devastating to my system and I didn’t know if I was even going to survive that. The radiation became very difficult towards the end. I wasn’t able to swallow anything and keep food down.
TheA2C: What was the result of that treatment?
Pam: It turns out that the chemo treatments, the radiation therapy, none of that worked for me. In fact, the entire time I was on that treatment, the cancer was spreading throughout my body. During the chemotherapy, my immune system was depressed big time, and the cancer just took over.


TheA2C: When you first got the news that it was as bad as it was, what did you do?
Pam: I can remember to this day what happened. When Doctor Antonia came in—he’d always been upbeat and happy—well, he had a concerned look. He sat down and he brought up the CAT scan on the computer, and we saw all the tumors in my lungs. Some of them were pretty good size and the adrenal gland masses were just…well, they knocked us off our feet, let’s put it that way. My husband and I were both completely shocked and blown away by how bad the cancer had spread.


Dr. Antonia actually told us that they could no longer hope to cure me. My husband was taking notes and at that point he had to leave the room. He closed the notebook and he had to go collect himself. I just sat there. I was just stoic, because I just went numb in my whole body.
TheA2C: What options were presented to you at that time?
Pam: Doctor Antonia said there was a cancer study drug that had just come out and was being tested in clinical trials. The drug is called nivolumab, and it had only been out for maybe 2 or 3 years. He wanted to get me into that study program as soon as possible, because he felt that was the one chance I had. 
TheA2C: Did you enroll right away?
Pam: Initially we had difficulty getting me in, because my blood platelet counts were way low from the last chemotherapy treatment I had. So we had to work at that, and eventually they got up. I got my blood platelet counts up to over 100, which qualified me for the study. And as soon as we did that, Bristol Myers-Squibb approved me and I had my first treatment with nivolumab on September 13, 2013. Two weeks later, I had my second treatment.  
TheA2C: Tell us about your experience on the drug.
Pam: After the second treatment, I noticed something: the lump that was sticking out of the side of my neck had gone way down. And my husband noticed that the lump that was on my shoulder blade had also gone down. And then we started to notice that the lesion that was on the back of my head began getting smaller in size. And I even started feeling a little better.
After the third treatment, I still continued to improve. My hair grew back. We watched the lesion on my head go completely away. You can’t even tell that anything’s ever been on the back of my head. There’s perfectly healthy, normal skin.  
CAT scans showed that the tumors in my lungs have gone—there’s no sign of them—and the tumors that were on my adrenal glands have reduced way down to practically nothing. And the pain that was in my left shoulder, which was due to the cancer spreading into the bone, well, that’s completely gone, too. It’s been filled in by new bone growth, which we see on the CAT scans. It’s just amazing.
Before the treatment, I couldn’t even walk. I was so weak and my breathing capacity was so diminished that it was a struggle to get out of bed in the morning. I couldn’t walk to my kitchen from my bedroom without having to stop and sit down a couple of times, just to catch my breath. So it’s just given me back my life. Even Doctor Antonia has been amazed at how wonderful this drug has worked for me.  
TheA2C: Did you have any side effects?
Pam: The side effects to this drug treatment therapy for me have been quite minimal. It’s just been a blessing and it’s saved my life. My goodness, I hope it saves the lives of many people. I just think it’s a miracle drug—at least it has been for me.  
TheA2C: How did you cope during the whole process?
Pam: I just thought to myself, you know, I’m not going to die. I don't care how bad it looks. I decided I was never going to give up. I would just keep fighting and trying my very best.
Two things really kept me going. One was my trust in God; I realized I had to put things in somebody else’s hands. That, and the love and the support from our family. We have a huge support network of people at our church. I mean, everybody saw me when I was in really bad shape. They all say this is a miracle. 

TheA2C: How do you feel now?
Pam: I have a few body aches, some joint aches, but I’m understanding that that’s a side effect of the drug. At the end of the day, if I have a few aches and pains, I’m still alive and I’m going to enjoy my children, our grandchildren, our friends. I just want to give hope to people who may get the news that I got, because you know what? There’s always a chance.
TheA2C: Anything else you want to add?
Pam: My husband, Randy, and I are most grateful to Dr. Scott Antonia and the entire staff of the Thoracic Unit at Moffitt Cancer Center for the outstanding patient care I have received. Their dedication and hard work has indeed exceeded any expectations we may have had. 

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