Sometimes it feels like getting a hoped for result after enduring cancer is like going into the witness protection program. A return to health is happy news, but it's not automatically a happy ending. Sure, you like to believe you're safe. You sometimes even forget just how much danger you were in. But there's always the fear. The fear that the vengeful killer will find you. You speak of your disease in terms of recurrence rates, and how many years out you are. But what if, in addition to the incredible feat of getting to go on with your life, you could eliminate that agonizing suspense as wellâand swiftly?
When earlier this week, 91-year-old former President Jimmy Carter announced to his Sunday school class in Georgia that "the doctors determined that I didnât need any more treatment" for cancer, there were cheers from admirers and well-wishers around the world. It wasn't just good newsâit seemed incredible news.
After all, just last August, Carter had revealed that he had melanoma that had metastasized to his liver and brain. But he also said that he was starting a course of treatment that featured a combination of radiation and a newer protocolâan immunotherapy drug called Keytruda to stimulate his body's own immune system to fight the cancer.
By December, he was able to reveal that his most recent MRI "didn't find any cancer at all." And now, though his spokesperson says that he will "resume treatment if necessary," his current schedule appears to be freed up from drug infusions. This is not just a miraculous turnaround. This is, for a growing number of us, just how it's supposed to go.
Cancer cells can move quickly. Cancer treatments, in contrast, can move frustratingly slowlyâand often with a passel of grueling side effects. For decades, the standard assumption has been that a serious diagnosis equals months of hair loss and weight loss and puking. That's now changing, and that change isn't just offering the possibility of freedom from disease, but from anxiety as well. I know firsthand.
Five years agoâone year after a successful initial surgery for itâI was rediagnosed with melanoma, this time at Stage 4. I was fortunate to enroll in an early clinical trial for a combination of immunotherapy drugs, Yervoy and Opdivo, to trigger my body's defense system to recognize and kill my cancer cells.
Just days after the first treatment, I could see a visible tumor under my skin beginning to shrink. By my first set of scans, 12Â weeks later, I presented no evidence of disease. I've stayed like that for four yearsâ¦and counting. Because I was in a trial, my course of treatment was lengthy; but for many patients, a course of immunotherapy can run as few as four infusions spread over the course of just three months.
And remember, we're talking about a treatment for advanced cancer hereâcancer like Carter's and mine. When my doctors published the early results of my trial three years ago, the words that leapt out at me were "rapid" and "durable" tumor regression on patients who successfully responded. That's because the immune system, as any of us familiar with the principles of vaccination can tell you, learns, understands, andâremarkablyâremembers. And it's a quick study.
Carter's choice to be so public with his experience has been a source of hope and an educational opportunity for countess others facing similarly frightening diagnoses. But while immunotherapy is now showing promising results in not just melanoma but lung, renal, and other cancers,Â it is still not widely used, nor for every cancer. Not everyone qualifies for it, and among those who do, the results are not always as decisive as Carter's have been. Yet a shift has occurred in how doctors and patients view cancer treatment, and that is undeniably thrilling.
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Many of us, as skeptical consumers of the healthcare industry, have a conflicted relationship with it. We question if a treatment is too aggressive, too invasive, goes on to- longâand we worry it's not enough. I used to as well, but now I don't. In much the same way that I never fret that I will get polio, I don't agonize that my melanoma will recur. I believe that, thanks to science, my body now knows what to do. I believe Carter's does as well.
You can read more ofÂ Mary Elizabeth Williams' story in the May issue ofÂ Health, and in her forthcoming book,Â A Series of Catastrophes and Miracles: A True Story of Love, Science, and CancerÂ ($26; amazon.com).