Immune to Cancer: The CRI Blog



Meet Gordon Levine: CRI ImmunoAdvocate, Stage 4 Colorectal Cancer Survivor, and Immunotherapy Champion

CRI ImmunoAdvocate Gordon Levine’s fight against colorectal cancer was not linear. The lawyer-by-trade first sought treatment in Montreal upon receiving his diagnosis before ultimately being treated in California.

In the space of five days, I needed heart surgery and had a tumor in the colon,” Gordon recalls. “Of course, after that (they ran) a scan to see if it has spread. It had not spread. Then it was a decision, and they decided to do the cancer (surgery first).”

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Gordon’s journey involved meetings with several doctors, a series of surgeries, and numerous lines of treatment with both chemotherapy and immunotherapy spanning the last 10 years, and the unwavering support of his caring wife, Pam. After he was first diagnosed back in November 2014, regular scans became crucial. It was during one of these routine scans that they discovered the cancer had spread.

“I was in remission as of the summer of 2015. I had my heart surgery in the fall, (and) I went back to work in January of 2016,” Gordon says. “(In) August of 2016, (while) doing my routine scans, they saw something in my abdomen. It was confirmed that it was a spread.”

Routine screenings like the one that informed Gordon his cancer had spread in August of 2016 can help save cancer patients’ lives. Years since that screening, prevention and treatment measures for colorectal cancer research have advanced. Thankfully, the death rate for colorectal cancer has dropped over the past two decades, thanks to increased screening and testing. Detecting colorectal cancer quickly is crucial because in the early stages it has a 90% survival rate. However, the available screening tests are still not being used to their full potential, and only 40% of colorectal cancer diagnoses are caught at an early stage.  

Catching colorectal cancer early is critical. There are three standard colorectal cancer screening methods, per the Centers for Disease Control and Prevention (CDC):

1. Stool tests – screening that examines a person’s waste for signs of cancer.

2. Flexible sigmoidoscopy – a doctor checks for polyps, which can become cancerous, or already-formed cancer inside the lower third of the colon and the patient’s rectum.

3. Colonoscopy – similar to a flexible sigmoidoscopy, however, with a colonoscopy the doctor will examine the entire colon and the rectum. Most polyps and some cancers can be extracted during this exam, which can also be used as a follow-up from any other type of colorectal cancer exam. Alternatively, a colonoscopy can be done virtually through x-rays.

Following Gordon’s regular check-up in 2016, things took a challenging turn as his family learned the cancer had spread into other parts of his body. Fast forward to 2018, and it had spread to other organs like Gordon’s lungs and liver as well as his bones. Seeking a fresh perspective on potential treatments, Gordon explored a second opinion. That is when his doctor suggested a game plan involving a combination of two immunotherapy drugs.

As Gordon explored his treatment options, he learned about the array of immunotherapy treatments available for colorectal cancer. With the advice of his doctor, he ultimately took a combination immunotherapy treatment of Yervoy and Opdivo.

Today there are eight FDA-approved immunotherapy options for colorectal cancer that patients can discuss with their own medical teams to identify the best potential option for them. Antibody treatments can dysregulate cancer cell activity and notify the immune system that cancer cells need to be terminated. Checkpoint inhibitors work by blocking proteins on immune cells that cancer cells exploit to evade detection and destruction, thereby unleashing the immune system to attack cancer cells. There are several other immunotherapy treatments that are undergoing clinical testing for potential FDA-approval.

Jorge Marcet, MD, founder, Tampa General Hospital Cancer Institute; Director, Division of Colon and Rectal Surgery; and Professor, Morsani College of Medicine, spoke at the CRI 2024 Spanish-Language Immunotherapy Summit. Dr. Marcet spoke in-depth about colorectal cancer, and reports an overall decline in colorectal cancer in the U.S. over the past few decades while also touting recent advancements in research.

“What we see is that with the use of preventive screening over the last 30 to 40 years, the incidence of (colorectal) cancer in the United States has continued to decline. It is a very common but preventable cancer,” Dr. Marcet says. “(Colorectal) advances are made through studies. In these studies we ask patients to volunteer to (participate in) a new treatment. This is how we make advances that result in better treatments.”

Before his diagnosis, Gordon possessed limited knowledge about immunotherapy. However, by the time he sought a second opinion, after two recurrences following several lines of standard of care chemotherapy, he was hopeful that combination immunotherapy could succeed for his cancer. In fact, after four rounds of treatment in early 2019, Gordon’s tumors were significantly shrinking. By the time of  his most recent surgery in 2021, he became convinced that immunotherapy continued to play a crucial role in suppressing his cancer. His surgeon expressed immense satisfaction upon discovering that the remaining cancer had been localized to a specific area.

“Even though I was off the treatment for a year, (immunotherapy) was obviously still working, containing that one resistant area of cancer that was on one site. After I recovered from surgery,” Gordon remembers. “I put weight back on, I started to exercise and get healthy for the first time in seven-plus years of this roller coaster.”

It is extremely important to have patient advocates like Gordon speak about their cancer experiences, as they can help arm current patients and their families with helpful information. Immunologists also play an important but very different role in the fight against colorectal cancer. From their research to answering questions about where immunotherapy can improve regarding colorectal cancer treatment, CRI scientists are passionate about helping to reduce the number of colorectal cancer diagnoses and deaths.

Manuel Hidalgo, MD, PhD, Professor of Medicine; Walter B. Wriston Professor of Pancreatic Cancer Research; Chief, Division of Hematology and Medical Oncology, Joan and Sanford I. Weill Department of Medicine; Associate Director for Clinical Services, Sandra and Edward Meyer Cancer Center, also recently spoke at the CRI 2024 Spanish-Language Immunotherapy Summit and had some thought-provoking comments on colorectal cancer and immunotherapy.

Dr. Hidalgo underlines the importance of immunotherapy in colorectal cancer. “Can you imagine a rectal tumor? It is cured with two or three injections. This is the paradigm of or the most favorable situation.”

It is of the utmost importance for cancer care advocates like Gordon to speak from their own experiences to help others who might be currently fighting colorectal cancer. Drs. Marcet and Hidalgo have an important role as immunologists to inform the public from a scientific perspective, not to mention the work they do in their respective labs.

Yet, there is another important role that might not receive as much attention, but is critical nonetheless: the role of the caretaker. Pam was by Gordon’s side through all of the adversities he faced with colorectal cancer and its metastasis. She says that for partners of cancer patients, taking care of themselves can help them take care of their significant other.

“I have spoken to many people, and they (ask), how can you still be smiling? I said you have to also do for yourself,” Pam says. “I need to be there for Gordon. But I said I needed to rely on friends and family to help me as well. If you do not (take care of yourself), then you are of no use to your partner.”

Gordon personally gives advice to colorectal cancer patients, but stresses that each patient’s experience is unique.

“Sometimes a clinical trial, even as a first line of treatment, is the right approach to get you the best results. Not every doctor knows everything that is available, especially if you are in a region (where) you do not have access to a hospital that has the most up-to-date treatments.”

Gordon is also passionate about the human connection between cancer patients and those who have had cancer.

“Seeking help from peers, both for emotional support (and) for advocacy support (is important).”

Between advocates like Gordon and Pam Levine who are passionate about cancer immunotherapy awareness and the scientists working tirelessly to make colorectal cancer a disease of the past, we are confident that one day we can create a world immune to cancer.

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