Savoring the Simple Pleasures with the Help of Immunotherapy
On an April morning in 2007, Richard Catlett, then age 67, got up early to mow his lawn. While walking through the grass, his leg gave out and he collapsed. That was the start of what would become a seven-year battle with cancer.
The cancer had started in his kidney then spread to his bone. Doctors treated him with surgery, radiation, and a targeted therapy called Sutent® (sunitinib). These treatments worked for a while, but eventually the cancer came back—with a vengeance—spreading to his lungs, liver, and lymph nodes.
In October of 2013, Richard enrolled in a clinical trial of an immunotherapy called nivolumab, which targets the PD-1 checkpoint, at Seattle Cancer Care Alliance in Washington. Richard’s response to treatment was nothing short of amazing.
When I went in to get my results from the study doctor, he handed me the report…The first two words were ’dramatic reduction.’ That’s as far as I read. I started to cry then.
A year later, nearly all his tumors have shrunk down to nothing. He is walking and exercising again, tending to his apple trees, and enjoying spending time with his wife, Dianne, and his dog, Chloe.
How did you first learn you had kidney cancer?
Richard: It was April 17, 2007. The day before, I had been at the gym here in our little town of Sequim, Washington, and I’d gone through my complete workout that I did on a regular basis. So there I was, lean, mean, and strong. The next morning, I got up to mow my lawn at 9 o’clock in the morning and about halfway into the walk across the yard my legs just disintegrated. I fell down. I’m lying on the ground. My leg is pointing east and I’m pointing west and I’m going “What in the world is going on here?” Obviously, I was in pain and there was nobody home out here. We live out in the country on 2-1/2 acres of land. I’m trying to crawl to my truck to get my cell phone, but I couldn’t do it. I can remember lying there thinking, “Well, I guess this is kind of the end of it.
That’s so scary. What did you do?
Richard: What could I do? I started screaming. As if by magic, my neighbor’s face popped over the fence about 150 yards away, and I yelled, “Call 911.” They treated me for a broken leg. A two-inch section of the big bone in the left leg had more or less disintegrated. Nobody talked about cancer at the time, but I was thinking it.
When was it officially determined to be cancer?
Richard: I went to see the surgeon every week after the surgery for checkups and he’d take an X-ray. For some reason, the bone wasn’t healing. After five weeks he said, “I better do a biopsy.” That’s when they found the cancer. I was told it came from my kidney. Two days later, I had a CT scan and that confirmed that I had a 10.6 cm tumor in my left kidney, which had metastasized to my leg.
What treatments did you receive?
Richard: I started on Sutent about six weeks after the leg had been broken, about a week after my diagnosis. I ended up taking that drug for 18 months and I got tremendous results. The liver tumor reduced in size quite dramatically and I felt better. I got to the point where I could get around with a cane and a walker and I didn’t have any other sign of disease. I was NVED—no visible evidence of disease. That was early 2009.
Then a routine CT scan showed that I had a lymph node in my chest that was enlarging. I had surgery to remove that and was NVED again.
About a year later, they found a tumor in my lung. I didn’t want to have surgery again, so I found a study on the internet from Johns Hopkins where they’d used Sutent in conjunction with high-dose focal beam radiation and that’s what I had for the lung metastases. The high-dose focal beam radiation worked perfectly and I was NVED again.
I’m seeing a pattern.
Richard: Yeah. That went on for about 10, 11 months. I was getting CT scans every three months. In September of last year, they found more tumors in my lungs. First I had 8, then I had 12, and then I had 30.
Wow. They were moving quickly.
Richard: It was coming on hard and strong. I was starting to feel terrible. I was having trouble breathing. I just didn’t feel good. And then I found out I had a tumor my spine. I envisioned myself in a wheelchair and then being dead. That’s when I started seriously trying to get into the nivolumab trial. I called the doctor and told him I wanted to get into his trial. I was accepted, and I was due for my first infusion on October 16.
The first two words of the report were “dramatic reduction.” That’s as far as I read. I started to cry then.
How soon after you started taking nivolumab did you know that it was working?
Richard: From the way I felt, almost immediately. You never know for sure, but I felt like there were some serious things going inside my body, and quite rapidly. Eight weeks later, when I went in to get my results from the study doctor, he handed me the report. I looked down and I read it. The first two words of the report were “dramatic reduction.” That’s as far as I read. I started to cry then.
He went on to tell me that I had somewhere over a 50% reduction of my tumor load in eight weeks. That’s from nearly dead to feeling pretty good. The last Friday [in September 2014] I had my sixth CT scan and sixth MRI, and the trend has continued to this point.
What is the status of your cancer now?
Richard: The 30+ tumors in my lung are gone. My bone tumors they can’t find, and haven’t been able to find for more than six months. The liver lesion, which was originally 10.4 cm in length, is now 2.5 cm x 1.5 cm. So it’s decreased dramatically.
Wow, that’s amazing.
Richard: It really is. It’s not only amazing, it’s a blessing.
Originally published January 20, 2015.