Immune to Cancer: The CRI Blog

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Joseph R’s Immunotherapy Story

Melanoma

If you never give up on yourself, there’s always a chance that something good might come out of it.

Joseph’s Story

By the time Joseph Rick considered going on a clinical trial, he had already bought a grave. Thirty-two weeks of chemotherapy and nine general anesthesia surgeries to remove parts of his colon, stomach, liver, lung, and pancreas had all failed to stop the encroaching melanoma. The 40-year-old psychologist-in-training weighed just 90 pounds, down from 210, and was ready for hospice.

At the recommendation of a visiting nurse, he decided to contact Antoni Ribas, MD, PhD, at the UCLA Jonsson Comprehensive Cancer Center, who was conducting a clinical trial of a new immunotherapy drug called tremelimumab. Tremelimumab, developed by Pfizer/MedImmune, falls into a class of drugs known as checkpoint inhibitors. These drugs bind to and block molecules on T cells that serve as “brakes”—in this case, a molecule called CTLA-4. By “taking the brakes off” T cells, tremelimumab enables a more powerful immune response against cancer.

The Answer to Cancer (A2C) spoke to Joseph about his experience with immunotherapy and the stranger who changed his fate.

Questions and Answers

How did you learn about immunotherapy and why did you decide to do it?

For about five years, from 2007-2012, I was doing chemotherapy treatments and clinical trials at West Penn Hospital in Pittsburgh, PA, and it just wasn’t curing it. So my oncologist, Dr. Antonios Christou, recommended that I go to a bigger facility. That’s what brought me to Johns Hopkins Hospital, and to Dr. Leisha Emens.

What was treatment like? Did you have any side effects?

It wasn’t what I had initially expected. I thought it would be a series of injections, but instead it was an infusion. I would lie in the Clinical Research Center at UCLA, and they would infuse me over a period of five hours. When the infusion was complete, the nurses would come and check my vital signs every 15 minutes for the next five hours. It was like a 10-hour day. That was the first week of January of 2004.

When I went back after two weeks, I was in Dr. Ribas’s office, and I had on one of those examination gowns. Dr. Ribas started to examine me and he said, “My God.” And I said, “What?” And he said, “Those lesions… they’re gone.” I looked at my arm and shoulder and I hadn’t even noticed they weren’t there anymore. “Oh my God, this is gonna work!” he said. “This is gonna work!” “Yeah, yeah, whatever,” I replied—because at this point I was still very sick, very weak, and feeling skeptical.

Over the next two or three months, I started feeling better. I started eating again. I started putting on a little bit of weight. I think I gained 30 pounds in three months. That was a lot considering I only weighed 92 pounds by that point. I was basically a 6’4” skeleton of skin and bones.

Are there things that surprise you about the cancer experience?

Well, it’s like I got a second chance at life. Before I got sick, I had just completed my post-Master’s hours in clinical psychology and was working towards becoming a licensed marriage and family therapist. I worked really hard to get all these hours, and I was doing it on top of working full-time as an accountant and a teacher. And then I got very sick, and basically I lost all the hours that I invested. But then I got the immunotherapy and I got better, and I had to decide in my late 40s, okay, what am I going to do with my life?
 
In 2010, I registered for school and started a doctoral program in psychology. I’ll be starting my last year in the program this fall. I am within reach of obtaining a lifelong goal of earning a doctoral degree and eventually becoming a licensed clinical psychologist. That’s something I never could have imagined 12 years ago when I was so sick and fighting for my life.

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