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← Return to Nivolumab aka Opdivo
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I'm on a 4 cucke chemo, just had my 2nd treatment. Unfortunately my oncologist is unwilling or unable to talk to me about Kras mutation, he said 40 percent of cancers have this mutation. Not an issue at this time, promised some creating material never provided it. When I tried to ask about immunotherapy he was very dismissive. We won't talk shout that now, only if it's metastatic..
I have requested a new referral, I'm in Canada and our healthcare has deteriorated unbelievably in the past 8 years.
I do not feel my current oncologist and I can have a meaningful discussion about my care. I'm concerned obviously about that...
Replies to "I'm on a 4 cucke chemo, just had my 2nd treatment. Unfortunately my oncologist is unwilling..."
Has there been any pathological studies done for your tumor for immunetherapy candidacy?
The way anticancer drugs work is that they make the cancer cells "visible" to your immune system, enabling your immune cells to attack the cancer. This is the case for example if PD-L1 was positive in your cancer. The drug would inhibit PD-L1 of your tumor cells and T cells would attack them.
It is entirely possible that your cancer has tested negative for these proteins and therefore the drugs would unlikely work for the cancer. This is true particularly if there are immune cells among the tumor and the tumor tested negative for the proteins.
These drugs can also cause severe side effects as they can cause your immune system to attack healthy cells. Also if your tumor has negative tests, it might mean that in order to get benefit from drug like Nivolumab, it might need to be combined with something like ipilimumab, and even then there is less chance that the therapy works. Unfortunately these combination therapies are also very expensive treatments.
I would ask about the pathology results, did they do any tests for immunetherapy and specific reason why they advice against the drug.
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@zora0121, I'm sorry that you are having to work through this challenge on top of everything else that you are facing. Is there a nurse, or someone, in the office that can provide the materials that you were looking for? They may have more time to respond to direct patient needs.
From what you've described, you may be denied a change in provider. Unfortunately, learning to work with him, or around him, may be necessary. Do you know how long it takes to hear about the referral?
I'm not sure if this is helpful, but the Lung Cancer Canada group is fairly active. They offer Heathcare Navigation Support related to requests for second opinions.
https://www.lungcancercanada.ca/en-CA/Resources/Support.aspx