​How Immunotherapy Saved a Stage 4 Cancer Patient’s Life

​Diane Lucey has long hair. That's not noteworthy in itself — after all, so do lots of women. But long hair is significant for a woman who has just undergone cancer treatment, which Lucey has. A combination of precision medicine and immunotherapy not only saved her life, but spared her the difficult side effects that are common for cancer patients.

From Stage 1 to Stage 4

Lucey's cancer journey started in January of 2014, when she asked her dentist to check out a spot that had recently developed in her mouth. He sent her to an oral surgeon. A biopsy revealed a diagnosis of neuroendocrine carcinoma.

While there was some good news – it was stage one – she still had to undergo a stressful process of surgery to remove the spot, endure 30 sessions of radiation, and deal with weight loss and fatigue. However, it all seemed worth it as subsequent scans performed in 2014 and 2015 found no signs of cancer.

She said yes to a new job, moved to Leonardtown, Maryland, and moved forward with her life.  Life was going very well for Lucey. Unfortunately, that all changed abruptly in 2016. 

Lucey went in for a routine scan with Amir Khan, MD, an oncologist at MedStar St. Mary’s Hospital. Dr. Khan discovered that not only had Lucey's cancer come back, but it had metastasized and spread to other parts of her body – specifically in her lungs and liver. Her diagnosis? Stage four.

Lucey remembers her sister, who had accompanied her to her appointment, starting to cry. But she didn't allow herself to do the same. "I’m not going to cry about this," she remembered thinking. "This is what it is, and we just gotta go from here."

Finding Answers in New Treatments

Dr. Khan formed a treatment plan right away and sent Lucey to Louis Weiner, MD, director of MedStar Georgetown University Hospital’s Lombardi Comprehensive Cancer Center. Dr. Weiner was able to precisely analyze her cancer on a molecular level and found that it had mutated around 17 times.

Her body was fighting back.

While precision medicine and immunotherapy aren’t as widely known as treatment options like chemotherapy and radiation, Lucey had learned about them while researching her choices. She was hopeful that a combination of precision medicine and immunotherapy might work for her, and she was prepared to advocate for herself. 

As it turned out, she didn't need to fight for the treatment that she wanted. "When I met with Dr. Weiner, I was prepared to bring up precision medicine and immunotherapy — but he initiated the conversation," she recalled. 

She was relieved: "I wanted to hear something other than chemotherapy and radiation, which can really be devastating."

The Treatment Journey and Her Outcomes

In October, she began her immunotherapy treatment. Every two weeks, she would make the 10-minute drive from her home to MedStar St. Mary's, where she received injections of the immunotherapy nivolumab. Other than treatment days, she didn't have to miss any work. 

Having cancer never affected her daily routines, and she never suffered any major side effects except one small rash on her stomach.

As optimistic as Lucey was about the treatment, the results have exceeded even her expectations. Six weeks into the process, a scan revealed that the mass on her liver had shrunk by half, and the tumors on her lungs were shrinking too. After an additional six rounds of treatment, even better news: The lung tumors were gone, and the liver mass – while still present – had continued to shrink.

Lucey is incredibly grateful for the success of her treatment, and for the people who have cared for her and supported her along the way. "Everybody at MedStar has been wonderful. The doctors, the nurses, even the receptionist, Rachel — I love her!"

If she could say one thing to the staff at MedStar, it would be a simple message: "Thank you," she said. "Dr. Weiner and Dr. Khan especially, but the whole staff. I'd hug them all. And I probably have!"

We are here to help.

If you have questions about the MedStar Georgetown Cancer Network or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

Early Detection, Robotic Surgery Help Cancer Patient Avoid Radiation

As a loving husband and devoted father, Earl always took his physical health seriously. He never smoked, scheduled annual physicals and went to the dentist regularly. He was doing everything he could to ensure that he would always be there for his family.

When his daughter complained of a sore throat one day, it's no surprise that Earl jumped at the chance to make it a teachable moment. He explained to his daughter that swollen lymph nodes often accompany a sore throat. As he was showing her how to check her lymph nodes, he noticed that a lymph node on the left side of his neck was enlarged.

While Earl thought this was odd, he decided to wait to talk to his doctor at his upcoming physical, which was just a few weeks away. At his physical, in early November, Earl's primary care physician confirmed that the left neck lymph node was enlarged and required a closer look.

A biopsy was scheduled for early January.

Earl's Diagnosis and Surgery

By the end of January, the results were back — Earl was officially diagnosed with squamous cell carcinoma, a form of cancer that had spread into his lymph node. Earl's primary care physician directed him to an Ear Nose and Throat (ENT) specialist, who identified the primary cancer site at the base of his tongue. The ENT recommended immediate treatment and provided Earl with the names of several specialists in the DC area.

After researching these surgeons online, Earl chose to work with Stanley Chia, MD, Chairman of the Department of Otolaryngology at MedStar Washington Hospital Center.

At this appointment, Dr. Chia evaluated Earl's throat to confirm the primary cancer site was located at the left base of his tongue. He then ordered a PET-CT to make sure the cancer was isolated to only the tongue base and the lymph node in the left neck.

Once it was confirmed that the cancer had not spread beyond the lymph node, Dr. Chia explained to Earl that he was a prime candidate for robotic surgery. The base of tongue can be difficult to reach with standard surgical techniques, and the robotic approach is ideally suited to this approach. Surgery to remove the lymph nodes from the left side of his neck would be performed simultaneously.

Surgery was set for April 4, which was ideal timing for Earl, because it allowed him to keep his plans to spend his daughter's spring break with his family.

While Earl was nervous as his surgery date approached, he was pleased that Dr. Chia took the time to explain the process and answer all his questions, such as "What kind of scarring should I expect?" and "What are the side effects of surgery?"

Surgery was a success. Earl was able to talk the same day as his surgery. He began eating the day after surgery, and within a few weeks, Earl was eating normally again.

Evaluating His Treatment Options

While surgery was a success, Earl knew that he now had to determine if he would continue on with radiation treatment. Fortunately, the biopsy from surgery showed that the cancer was HPV positive, which meant it had a better prognosis than traditional smoking-related cancers. The biopsy report also confirmed that the surgery had successfully removed the cancerous cells in the tongue and neck.

Standard treatment for head and neck cancers after surgery often includes radiation treatment or even chemotherapy. Earl discussed his treatment options with Dr. Chia and Adedamola Omogbehin, MD, on the radiation team at MedStar Washington Hospital Center, and even sought a second opinion.

After evaluating all his options and taking a close look at the side effects associated with radiation treatment, Earl decided to forgo further treatment. He attributes his ability to avoid radiation treatment to early detection, as well as the success of his robotic surgery.

Looking Ahead

Today, Earl is glad to be a cancer survivor, and he has a new outlook on life. He says that the whole process happened very quickly, but that he was very happy with the honest and accurate information provided by Dr. Chia and Dr. Omogbehin.

Earl encourages others to pay close attention to their own personal health and not to be fooled into thinking it can't happen to them. He urges other to be proactive and to get anything that seems odd checked out as soon as possible.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

How One Cancer Patient Found Alternatives to Traditional Anesthesia

Cathy Kalimon comes from a family with a strong medical background. Her father was a physician, and Cathy herself spent more than 20 years as an ophthalmic technician. Having this background has always made Cathy aware of the importance of listening to her body and paying attention when certain medications were prescribed — such as narcotics, which always gave her bad reactions.

That’s why, when Cathy was diagnosed with breast cancer in December 2015, the thought of having to take narcotics again was one of her primary concerns.

“I developed uterine cancer in 2013 and asked for no narcotics, but for some reason, I received narcotics with anesthesia anyway,” she said. The second day after the surgery, Cathy continued to be ill. Knowing that Cathy historically reacted poorly to narcotics, her sisters stepped in to question her doctors.

They discovered that Cathy was prescribed oxycodone for post-operative pain management, the source of her prolonged nausea and illness.

Finding a Solution With Dr. Myers

It was with profound relief that when Cathy faced breast cancer surgery in 2016, she discovered a breast cancer specialist willing to listen and respond to her unique needs at MedStar Georgetown University Hospital.

“I am aware that doctors know more than I do — but I also know what happens to me when I get narcotics,” she said. “One of the first things I said to Dr. Tousimis, my breast surgeon, was: ‘Please don’t give me narcotics.’ I couldn’t imagine having my chest opened and then experiencing such terrible nausea afterward.”

Dr. Eleni Tousimis immediately introduced Cathy to anesthesiologist Joseph Myers, MD, who told her about ComfortSafe, a new technique he developed that uses few, if any, narcotics.

ComfortSafe utilizes a pyramid checklist characterized by a variety of medications, such as IV acetaminophen, nerve blocks and local anesthetics, all of which produce fewer side effects. Stronger medications are used only if needed; otherwise, patients receive milder therapies that are narcotic-free.

Cathy’s worries were eased— not only because her doctors and specialists listened, but also because she discovered possible alternatives to traditional narcotic therapy. “I just couldn’t believe that narcotics were the only way to put you out,” she said.

“Dr. Myers told me it was going to be painful, and I said, 'Not as painful as constantly throwing up' — and I was right,” she added. Cathy explained that there is a difference between pain and discomfort and didn’t feel narcotics would relieve “discomfort."

Looking Ahead to Her Renewed Life

Cathy considers herself fortunate because both her uterine and breast cancers were found early, thus negating prescription of radiation or chemotherapy. She advises anyone who gets a cancer diagnosis to ask plenty of questions from their doctors and to source a professional medical site where information is well-researched, accurate and balanced.

“As patients, we’re all different — and someone else’s awful experience was not my experience,” Cathy shared.

Cathy recovered fully from her uterine cancer. Her breast cancer is being treated with an aromatase inhibitor to lessen the chance of recurrence, and she looks forward to a continued good prognosis.

“I’m very lucky,” she said. “I’m not predicting the cancer will never come back — but I’m not worrying about it every day either,” she added.

Cathy's full story can be viewed here: 

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

Immunotherapy Gave Hope for One Thymic Carcinoma Patient

It started as a nagging thought, back in November 2012. I just didn’t feel like my usual self, but I couldn’t define why, precisely. Little things crept into the cracks of my well-being and seemed to erode my vitality. I developed shortness of breath when I was climbing stairs or working out, but my breathlessness was a little more pronounced than usual. I started having episodes of high blood pressure. That seemed odd to me since I was only 52 and an endurance athlete at the time.

I have always been in tune with the deep, inner signals of my body and very aware of “doing the right things” for my health. So I guess I knew something was wrong. But denial can be a powerful force.

The Bleak Outlook of Diagnosis

One of my strongest recollections of that period of time between symptom onset and my diagnosis was an evening out with my girlfriends in mid-April 2013. They were worried about me, worried that I didn’t seem to feel myself. Of course, I had no explanation for them. I remember our conversation that evening vividly. I tried to describe an “overwhelming sense of un-wellness.” I’ll remember those words forever. Just a week later everything came crashing down. My pillar of denial lay in rubble at my feet.

When I got my diagnosis, I felt like I was sitting in my living room and someone pulled the rug out from underneath both the furniture and me, sending everything that anchored me flying into the air. What came down wasn’t me, or my furniture; it wasn’t even my living room. It was my life. My doctor told me that a CT scan had found a mass in my chest.

I heard the words that terrified me: “You have thymic carcinoma.”

"Okay, stop right there," I said to myself. "I know I didn’t just hear that."

Moments of incomprehensible shock and disbelief followed. How ironic that I actually had prayed for lymphoma. That type of cancer is at least usually treatable. But as luck and fate would have it, my doctor told me that thymic cancer is very rare and usually very aggressive.

“Thymic tumors are rare and understudied,” says Giuseppe Giaccone, MD, Ph.D. “Moreover, there is a clear distinction between the different types of thymic tumors and the most aggressive form, thymic carcinoma – which only represents about 10 percent of all thymic tumors (less than a 100 new cases each year in the United States.) Surgery is the mainstay treatment in thymic tumors, but this is often not possible in thymic carcinomas, because they are already in advanced stage when they are diagnosed. Chemotherapy is then the standard treatment, sometimes associated with radiation, but results are underwhelming, with survival rates in the range of five years.”

From Treatment to Clinical Trial

I found it difficult to stay positive about my prognosis since there was little doctors or specialists could offer at the standard cancer centers. What I did learn over the next two years was that if you need a big fish (which I certainly did), you have to go to the big ponds. As a result, I was able to do fairly well physically and mentally, despite many radiation treatments to various metastatic sites.

I participated in a clinical trial that bought me some time. I learned to live in the moment and not to project the future, or what the future might bring. I kept up on the latest advancements in diagnosis and medication and frequently asked about immunotherapy.

In December 2014, my hopes were realized. I heard about a new immunotherapy trial just for Thymic cancer patients at the Georgetown Lombardi Comprehensive Cancer Center. Dr. Giaccone was the primary investigator (author) of the trial. I was accepted into the trial, and my hopes of finding a durable solution to this disease were renewed.

”At the time, Shannon had a lot of disease in her body, but she was still in good condition and very positive spirit,” shares Dr. Giaccone. “She was a good candidate for a study with pembrolizumab, an antibody that targets the immune system by making it fight the cancer.”

"You Have No Detectable Disease"

Elation cannot adequately describe the excitement and joy I felt after just one treatment. My metastatic sites started to shrink. And in April 2016, I once again heard what I previously thought was impossible: “You have no detectable disease.”

These five words were equally shocking to my original diagnosis but in the most incredible and delightful way. Today, I am filled with gratitude and thanks not just for the blessing of physical healing but also for the restoration of hope.

For those with rare cancers my advice, like so many who fight this disease, is never to stop looking for the "next big thing." I took courage from my hours of research and from participating in clinical trials. Even though my first treatments were ultimately not the treatments, they were the bridge to the treatment that ended my cancer story. So never, ever give up. Persistence pays off.

Shannon's full story can be viewed here: 

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

How a Second Opinion Gave One Neck Cancer Patient a Second Chance

Prior to his diagnosis, Steve L. was a man who lived life to the fullest. He loved his family, as well as his successful career as an IT specialist; he also enjoyed a healthy, active lifestyle. That all changed, however, on March 7, 2014, when he noticed a lump in his neck. Understandably concerned, he began to seek out medical advice.

Three days after he discovered the lump, he went to see his internal medicine doctor. He was scheduled for a CT scan the following day and was sent to a specialist for a fine-needle biopsy.

Then the doctor that performed the fine-needle biopsy delivered the bad news: Steve had neck cancer – not only that, it was the worst possible type, in his opinion. And when Steve asked if he should retire to enjoy what remained of his life, his doctor said yes.

It Was Time to Seek a Second Opinion

After his initial diagnosis, Steve was referred to an ear, nose and throat specialist who was a frontrunner for conducting the necessary surgical procedure. Despite the fact that Steve was disappointed by the doctor's bedside manner, he booked the surgery, not wanting to waste time.

In retrospect, Steve advises, "Definitely bring a family member to go with you to some of those appointments. You're pretty much preoccupied with the worst thing about it, so you've got to keep your head about you when you're in with these doctors."

Steve’s sister, who had accompanied him to the appointment, felt he should seek a second opinion. So she connected with a doctor who immediately contacted MedStar Georgetown University Hospital. Not long after, Steve had an appointment set with Bruce Davidson, MD, chairman of the Department of Otolaryngology-Head and Neck Surgery at MedStar Georgetown University Hospital.

Renewed Hope for Recovery with Dr. Davidson

Dr. Davidson biopsied the tonsil lump, but at the time of surgery, pathology did not find any cancer, so he proceeded with a neck dissection to remove the known cancer in the lymph node.

“These cancers that present in lymph nodes in the neck are called Cancer of Unknown Primary,” says Dr. Davidson. We try hard to identify the original cancer and usually it is in the tonsil or the base of tongue. In this case, we could not identify the cancer on biopsy. In fact even when we pursued tonsillectomy, the cancer was too small to be seen on pathology at the time of surgery. It was only found after further careful study by the pathologist.”

During the neck surgery, Dr. Davidson removed approximately 40 lymph nodes from Steve's neck and discovered cancer in only one of them.

The team then removed Steve's tonsils. There was no obvious tumor in the tissue removed. However, when the tonsil tissues was comprehensively evaluated by pathology, they did indeed find cancer in the left tonsil.

So with a small cancer in the primary and a single lymph node, surgery alone can be curative. However, a wider resection around the tonsil area would be required in order to avoid the need for radiation therapy. Steve went back to Dr. Davidson, who proposed a radical tonsillectomy on the left. After his surgical treatment, Steve has done well. He has undergone PET-CTs for two years. Each time, the results have been negative.

Reflecting on His Treatment and Looking Forward

Today, Steve is in good health once more. "So far, I've been very happy with what they've done. I've lost no mobility.”

As a survivor of throat cancer, Steve has learned a thing or two. "Definitely take your pain meds," he advises, "I learned that one the hard way very early on. If you're in pain, you're going to heal slower."

Most of all, Steve stresses the importance of cancer patients finding a doctor they like and trust. "Don't be afraid to fire your doctor," he says. "Don't be afraid to research your doctor.”

While Steve eventually found his way to Dr. Davidson, the beginning of his diagnosis was rocky, and he credits Dr. Davidson with being a thorough, meticulous professional. "He's a very brilliant man.”

“Cancers of the throat are increasing,” Dr. Davidson notes. “Many of these are in individuals like Steve, who are in the prime of life. While some of these tumors are treated with surgery and radiation and others are treated with chemotherapy and radiation, his case demonstrates a successful treatment using surgery alone.”

Thanks to Dr. Davidson, Steve is looking forward to the many years of good health and great times that lie ahead.

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

How Immunotherapy Gave Leta Brown Her Life Back

Leta Brown had a wonderful life, along with her husband, two daughters and her stepson. But when she was diagnosed with widely metastatic melanoma, she felt the rug had been pulled out from under her and her family. “It was a huge jolt,” Leta shared. “I was left with a really grim prognosis. I wasn’t prepared for that kind of news.”

In April of 2013, a lumpy bruise appeared on the back of her leg. She consulted with her primary care physician, and a leg MRI showed a large metastatic tumor deposit and body CT scans showed additional metastases to her lungs and small intestines.

“When I got the news, it was really hard to get past the finality of it,” Leta said. “That this was going to take away my daughters' mother."

Immunotherapy Clinical Trial with Dr. Atkins

Not long after, while looking for treatment options, she came across an article on immunotherapy. She then found an immunotherapy trial with Dr. Michael Atkins at Georgetown Lombardi Comprehensive Cancer Center, for which she was eligible, due to her diagnosis, as well as her medical and treatment history. He explained to her that cancer cells express proteins that can disable antitumor immune responses; immunotherapy blocks the function of those proteins restoring the function of the immune system so that it can eliminate the tumor cells.

Following a resection (removal) of a large bowel metastasis, Dr. Atkins and his team were able to safely initiate immunotherapy treatments in August 2013.  Her tumor deposits quickly melted away and she was able to return to her daily activities. After one year of therapy, she was disease-free and able to stop treatment without disease recurrence.

“This type of result, while at the time being considered exceptional, is fast becoming the rule rather than the exception for patients with advanced melanoma we see at Georgetown-Lombardi,” Dr. Atkins said of Leta’s outcome.

Reflecting on Her Treatment and Looking Forward

Of her treatment, Leta recalled, “Choosing an NCI-designated Comprehensive Cancer Center like Georgetown Lombardi [one of 47 in the nation and the only one in Washington, D.C.] to receive my treatment was very beneficial when dealing with the latest therapies and in managing side effects. The various departments were aware of what to expect and knew how to successfully treat the side effects. It also made it easier for me to schedule appointments and avoid traveling to multiple facilities to receive care.”

And to others who may find themselves in a similar situation, she says to try not to rush into treatment immediately following a diagnosis; seek other opinions and ask lots of questions.

“Try to let loved ones help you,” she continued. “But allow yourself to handle this experience in a way that works best for you. Well-meaning friends wanted to sit with me through treatments, but that was a time for me to be alone and process my experience without feeling the need to put on a brave face. Say yes to offers that will ease your burden, and say no when you need to.”

To this day, she still has no evidence of the disease.

“I can’t believe how fortunate I am,” Leta said. “I’m looking forward to a really long life… it’s an incredible gift.”

Leta's full story can be viewed here:

We are here to help.

If you have questions about the MedStar Georgetown Cancer Institute or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.