ImmunoAdvocates Sunshine Pegues Lung Cancer Sunshine’s Story In 2010, Sunshine felt pain in her elbow. Convinced it was arthritis, she continued to see her doctor for almost a year, insisting on further tests as the pain increased. Finally, her insurance company approved a scan that revealed stage 4 non-small cell lung cancer in March 2011. Standard treatment at the time was chemotherapy followed by 35 days of radiation, which burned the skin on her neck. She was in more pain and skeptical of her health care team’s advice. In July 2011, she moved back to her hometown, Seattle, where she enrolled in two clinical trials at Seattle Cancer Care Alliance. The second trial tested an anti-PD-1 immunotherapy, which stopped her cancer from progressing and eventually, caused it to become inactive. Today, Sunshine feels more confident in her health care team, including Dr. Renato Martins, whom she now only sees once a year for routine scans. She feels strongly about patient advocacy and paying it forward, so more people can be aware of and benefit from lifesaving cancer treatments. After years of “inactive” cancer, in July 2021, she was declared NED: no evidence of disease. Questions and Answers How and when did you first learn you had cancer? In March 2011, after a year of pain, I finally got a scan that revealed lung cancer. How did you learn about immunotherapy and why did you decide to do it? I learned about immunotherapy through my doctor. The clinical trial was my only option. I thought I had to live longer than the diagnosis I was given: a 15% chance of surviving five years. What was treatment like? Did you have any side effects? I received treatment every two weeks. The process, including blood work, a physical exam, and then the infusion, took an entire morning. At first, the only side effect was fatigue, but after a few months, that subsided to mostly no side effects. How did immunotherapy compare to other treatments you may have received, if any? There are two differences: The physical difference: Traditional treatment is hard on your body. I prepared for chemotherapy with a diet regiment, trying to flush chemicals out of my system immediately with water. I think, as a result, the effects of chemo were minimal. The effects of radiation, though, were major. I received radiation in three locations (neck, from above and underneath my lung area). After about three weeks, my skin was being burned off my neck to the point where it was gone. I also wasn’t able to swallow anything; my throat felt like it was burning all the time. My diet resorted to slurpees and gelato. I became dehydrated, and instead of being hospitalized, I received liquids nightly for more than two weeks. They had to put me through a skin replacement regiment because air hitting my neck caused me to be in extreme pain. Immunotherapy had none of these side effects. During immunotherapy, I just had to be isolated initially (stayed home and only went to treatments) since it was unknown as to how my immune system would react. Impact to your support system: When you are receiving traditional treatment, your support system is going through that treatment with you. My sister flew from Los Angeles to Orlando during the weeks I had chemotherapy, and my brother altered his work schedule to take me to daily radiation treatment. With immunotherapy, after the initial treatments, I was able to drive myself to treatment. I regained my independence. Are there things that surprise you about the cancer experience? I was surprised about the cost of the trial (see next response). The other item is how well Seattle Cancer Care Alliance treats their patients. They treat you with so much respect and are sensitive to all that you are going through. For example, they do not minimize even the smallest things, like a needle sticking. What would you want another patient to know about immunotherapy or about participating in a clinical trial? There is always hope. Please try it. Ensure you get your insurance preapproval for what the costs will be because it is not free. My insurance was billed for doctor’s visits, the room, nurses, scans every six weeks (and scans are not cheap). The only thing which was “free” was the drug.