When it comes to your cancer treatment, ignorance can kill you...
About a month ago, we wrote an article on prostate cancer. And in response, one reader – D.F. – shared some useful insight from his own journey with prostate cancer...
I was first diagnosed in my mid-60s, which was too young (in my opinion) to chance a "wait-and-see" approach. My urologist gave me literature to read and told me to decide what I wanted to do. The literature seemed to offer a choice between surgically removing the prostate and months of radiation treatment, both of which had unwelcome side effects.
Fortunately, I discovered CyberKnife through a tip from an oncologist friend. That was over 10 years ago, and I still have my prostate and have had no recurrence of cancer. Side effects were minimal. So I mention this to help others, as it is still not widely known, and urologists are still not mentioning it as an option.
D.F. brings up two very important points... First is his mention of CyberKnife, which is a form of radiation therapy.
With CyberKnife, a robotic arm delivers a concentrated beam of radiation to the existing tumor, while minimizing the healthy surrounding tissue's exposure to radiation.
This system was developed at Stanford University in the early 1990s. And while CyberKnife doesn't remove a tumor, like in surgery, it can more directly destroy tumor cells and stop a tumor from growing, with less peripheral damage
The second important point is the fact that D.F. only learned about this treatment option through a friend who just so happened to be a cancer specialist. Without this friend, D.F. could have had a very different – and potentially deadly – outcome.
D.F. should have learned about CyberKnife from his doctor... But unfortunately, this doesn't always happen. That's why I want to empower you to take your health into your own hands.
So, if you're ever considering cancer treatment options, make sure your doctor explains and spells out (preferably in writing, to keep them honest) what they recommend for treatment.
Do some investigating before your follow-up appointment and have questions prepared for your doctor. Write your questions down and record the answers. Or even better, bring someone along to your follow-up visits. They can act as a second set of ears to compare notes with afterwards. This assures a better decision-making process, once armed with the facts.
And then, ask more questions and do more research, so that you're able to make the best decision for you. (I've linked some helpful websites at the end of this article to you get started, and also to help you avoid unproductive internet "rabbit holes.")
The traditional treatments for cancer include surgery, radiation, and chemotherapy. More often than not, doctors combine these treatments in various ways based on your specific cancer. They're known as the "cancer triad" and have been used together for decades.
Surgery is fairly straightforward. It involves removing the tumor and as much affected tissue around it as possible.
Radiation uses high-energy radiation waves (like gamma or X-ray waves) to focus in on the cancer and kill the DNA in the cancer cells. The problem, of course, is that radiation also causes cancer because it can mutate the DNA in nearby healthy cells. Sometimes radiation might be used before surgery, for example, to shrink a tumor enough for it to be better removed.
Chemotherapy involves strong medications given at regular intervals. These drugs kill fast-replicating cells, meaning they target and kill cancer cells. But other fast-growing cells are also killed, including the ones lining your stomach (leading to nausea) and your hair (leading to hair loss).
While we've seen advances in each of these three treatments as well as novel combinations of them to fight cancer, there's now a fourth option. It's currently being tested in thousands of clinical trials and some options are already available. This is the "Living Cure" I've written about many times. (If you don't already have my book The Living Cure, click here for a copy.)
The Living Cure is immunotherapy. It's a way to train your body's own immune system to fight cancer. That means the power to beat cancer is already inside of you. Doctors just need to figure out the best way to turn it on.
In 2013, immunotherapy was named "Breakthrough of the Year" by Science magazine. That's on par with past breakthroughs, such as sequencing the entire human genome and cloning a living mammal.
And in 2018, two of the pioneers of immunotherapy research won the Nobel Prize in Physiology or Medicine for their work.
This is truly a game changer for how we treat – and cure – cancer.
Currently, more than 20 immunotherapies have received U.S. Food and Drug Administration ("FDA") approval, and more are in testing phases.
The best responses come from combination therapies. These combine immunotherapy with chemotherapy or radiation. The idea is that chemotherapy may already stimulate the immune system, but it needs a boost from the immunotherapy to work better...
It turns out some tumors are "cold," meaning they are shut off from the immune system's attacks. New research investigates how certain immunotherapy drugs can turn on these cold tumors, making them vulnerable to old-school chemotherapy drugs. That's how certain treatment combinations take down a tumor's defenses and kill it.
There are now approved immunotherapy options for many types of cancer, including:
And many more...
In 2018, the FDA approved a few immunotherapy drugs for first-line treatment for some cancers. That means patients don't have to endure rounds of radiation and chemotherapy first and only start immunotherapy as a last resort.
One of those first-line options focuses on advanced triple-negative breast cancer. This is one of the most difficult types of breast cancer to treat, so hitting it right away with immunotherapy shows a lot of promise.
Eventually, we hope to see immunotherapy options available for all cancers as first-line options or in combination with other treatments.
But keep in mind: immunotherapy drugs – like all drugs – have the potential to cause unwanted side effects. The immune system is complex and varies widely from person to person, so folks taking immunotherapy drugs need to be monitored closely by their doctors.
Before you start any treatment option, make sure you ask about possible side effects to look for so that they can be addressed early on. Don't be afraid to ask questions. And don't shy away from getting a second (or even third) opinion.
Imagine a day when you get a cancer diagnosis and it's immediately sequenced to determine the genetic makeup. Then you get a personalized treatment that's tailored exactly to your cancer. It could mean the difference between months or years of uncertainty and total remission. That's the future we want to see.
What We're Reading...
- American Society of Clinical Oncology's list of questions to ask your care team.
- Something different: "Dolly" the dinosaur had the flu.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
March 3, 2022