Unanswered questions: immunotherapy for lung cancer

Posted by frandy @frandy, Nov 21 10:23am

I'm on the end of my Chemo & Radiation treatment for small cell lung cancer. My cancer doctor mentioned a one year autoimmune therapy but refused to answer any questions about it until the time comes. To the point that he yelled at me for asking the questions. I am so confused and frustrated. This entire cancer experience is new to me and even though I requested all my risks, systems, procedures, everything explained to me in the very beginning, I learned quickly, my requests were ignored. I'm seeing the top cancer doctors in my area. But, I'm looking at making a decision on to live or die. Please, any information will be greatly appreciated.

Interested in more discussions like this? Go to the Lung Cancer Support Group.

@frandy

I do want to know which one would be used along with side effects. My concern is the doctor got irate before I could even ask that question. He didn’t want me asking anything. I don’t trust him and will not tolerate his behavior.

Jump to this post

I see you're reporting this and switching. Good for you. We did that with my mom.

REPLY
@pml

Hi Frandy,
I'm sorry that you are going through all of this. That must be hard for you! My husband had lung cancer. They gave him an autoimmune therapy drug called Keytruda. He reacted badly to it and almost died. He got Pancreatitis which is a known side effect of Keytruda. It was because of our very good primary doctor and prayers, that he got to the right specialist and after a long battle, my husband was fine. However, he said that he would never have another Keytruda treatment. The doctors didn't like that decision but it was my husband's body and money! (Keytruda cost $25,000 per infusion!) He received two infusions per month. My husband died in July but we had 14 wonderful years together since his cancer diagnosis. I don't think we would have had that time if he had continued on Keytruda.
I would suggest doing as much research on autoimmune therapy drugs as you can before you make a decision.
The Mayo Clinic is one of the best places to do research. Google will also give you a variety of websites to investigate. Don't just take what happened to my husband as the only result. Everyone is different when it comes to medication. Once you have a lot of information, then you can decide what is best for you.

That's not right for the doctor to yell at you! Doesn't he realize that you are the sick patient? You don't yell at sick people! You may want to look for a new doctor. Remember, it's your money and your body. Your doctor works for you. Also take some time to let your body recuperate from the chemotherapy and radiation sessions. And, for yourself. You probably need a break.

Pray about it and God will direct you. You may feel that you are making a life or death decision but it's only God who makes that decision. Just talk to God like he's your best friend and he is. Put everything in his hands and you just relax and enjoy life!
I'll remember you in my prayers.
PML

Jump to this post

PML, thank you for your advice and kind words. Just seeing the warning side affects on TV about Keytruda, I would not take it. The other I would have to research. In the thousands per infusion….. wow. I don’t know if my insurance will pay for it. Maybe that is why the doctor got so irate when I asked him questions about it. Well, will definitely have to do my homework and make some decisions. Thank you for the information.

REPLY
@flusshund

@frandy, I'm so sorry you must go through this experience. As if a lung cancer diagnosis isn't hard enough as it is! Please know that there are better oncologists out there, including those who understand they are treating people, not just the disease.

I'm a 6-year survivor of the EGFR mutation, the last 4 years at stage 4. I moved across the country before my second round of cancer, and I'll tell you what my first oncologist told me when I was looking for one in a new town, "Your primary doctor and your oncologist need to be your friends. You need to trust them. On the other hand, you only need to care if your specialist is good at what they do because you will probably never see them again." If that's not your relationship with your oncologist, change doctors. While I agree this can be a pain in the you-know-where, people are surviving lung cancer longer than ever before, which means this could be a long-term relationship for you.

It sounds like you are asking the right questions and asking for the correct information. Those are reasonable requests for someone in your position. There's no need to get upset with a doctor who is solely focused on his own agenda. Just move on. I sincerely wish you all the best. New treatments for small cell LC have been approved just this year, so you have every reason to hope for the best!

Jump to this post

Just an update: I was assigned to another doctor but he’s on the same team. He could still the doctor I need. I don’t see him until my next round of chemo. I am worried about missing that one round of the bone marrow treatment. But taking one day at a time! God bless and Happy Thanksgiving

REPLY
@frandy

Just an update: I was assigned to another doctor but he’s on the same team. He could still the doctor I need. I don’t see him until my next round of chemo. I am worried about missing that one round of the bone marrow treatment. But taking one day at a time! God bless and Happy Thanksgiving

Jump to this post

Hi @frandy, I hope you had a nice Thanksgiving too! I'm glad that you were able to advocate for what you needed and have been assigned a different doctor. I'm hopeful that its exactly what you need. Hopefully you are feeling good enough to enjoy your time before the next chemo treatment. Missing a treatment can be concerning, of course, but looking forward may help. There's no going back and changing things now, and it may not have much of an impact to the bigger picture. Wishing you the best.

REPLY
@frandy

PML, thank you for your advice and kind words. Just seeing the warning side affects on TV about Keytruda, I would not take it. The other I would have to research. In the thousands per infusion….. wow. I don’t know if my insurance will pay for it. Maybe that is why the doctor got so irate when I asked him questions about it. Well, will definitely have to do my homework and make some decisions. Thank you for the information.

Jump to this post

Frandy,
Best of luck in your research and final decision. Just remember it's your body and decision and your money. Ask God to direct you to the right doctor and the right decision. God is always there for you. I'll remember you in my prayers.
PML

REPLY

How does one afford those immunotherapy treatments?. I have not yet been informed of this treatment. I have my after treatment pet scan on 12/27 and an appointment to discuss the results on 1/3. I did recently have a CT scan and my oncologist says tumor shrunk and what remains can either be cancer or scar tissue. The pet scan will be definite as to which it is. I am staying positive and hoping for the best.

REPLY
@autumnwarriorsr

How does one afford those immunotherapy treatments?. I have not yet been informed of this treatment. I have my after treatment pet scan on 12/27 and an appointment to discuss the results on 1/3. I did recently have a CT scan and my oncologist says tumor shrunk and what remains can either be cancer or scar tissue. The pet scan will be definite as to which it is. I am staying positive and hoping for the best.

Jump to this post

When you were biopsied a piece of the tissue was sent for biomarker testing. At that time your PD-L1 level should have been tested along with genomic mutation testing.

Receiving immunotherapy depends on the result of that test and the stage of your cancer. It is not always indicated in stage1 and some stage 2 cancers.

REPLY
@frandy

Hello Lisa, thank you for your reply. Yes; I’ve seen this doctor two or three times. After this blow up after I asked questions, I found out he decided to change my treatment without saying anything or any explanation. I also have a long term nurse assigned to me since my hospital stay. I was surprised when she told me she witnessed this doctor’s horrible behavior with another elderly patient. I truly believe that he may be jeopardizing my treatment because of his anger. I will be calling an advocate to help me with changing doctors and filing a complaint. I am really worried at this point.
I was diagnosed in August 8, 2024. Started treatment 9/30/24.
I’m not a person to take this kind of “abuse” but stand up to people like this. This doctor really did me over and with no concern for me at all.
I am feeling better but now is when the chemo usually hits me. I feel it will be better this time because the hospital found I had two infections on top of the side effects of the chemo. So I’m trying to do what I can to stay feeling better and stay out of the hospital.
Lisa, I will definitely follow your link and read the information. I need and want to be informed.
Thank you very much; you are greatly appreciated.
Frandy

Jump to this post

Frandy,
I am so sorry you are experiencing this type of treatment from your oncologist. I had a similar experience. The " my way or the highway attitude" by the doctor. In my case my first oncologist wanted to combine chemo with immunotherapy and I wanted immunotherapy only. I went online and looked for other cancer centers. Found one that did a rapid review of health records. They reviewed my records and started me on immunotherapy only in less than 3 weeks. It did mean that I had to drive 4 hrs rather then 2 to get treatment, but for me it is worth it so that I dont have to have chemo

REPLY

UPDATE
Since this is the last week of chemo and radiation, I will see the new doctor again in 6 weeks. During that time I will have labs in 4 weeks and during the 2 weeks following I will have a MRI on my brain. But what I’m concerned and undecided about is the immunotherapy and the possibility of brain radiation. The medicine that will be used for the immunotherapy is Durvalumab Injection (IV). Dr. Farooq stated I would “not” have any of the side affects that I had from the chemo (paper work on the medication contradicts this) along with the research on Mayo Clinic. Doctor said during our visit yesterday said the side affects are extremely rare. I’m concerned that this isn’t the true case. I have major problems just with just the chemo (2 hospital stays and 4 ER visits). Doc said I would have this therapy once a month for 2 years. I don’t want to worry about the brain radiation since it’s not definite yet but can’t help but worry. I don’t think I would go through that if it comes back I need it. It would depend on where the cancer is and how bad.
I’m hoping for any feedback on the Durvalumab. Doc said that is the “only” medication for my type of cancer. I’m wondering just how rare the side affects and damage to organs really are. They already have this scheduled to start on January 6, 2025.
Any feedback back will be greatly appreciated. Thank you, Frandy

REPLY
@frandy

UPDATE
Since this is the last week of chemo and radiation, I will see the new doctor again in 6 weeks. During that time I will have labs in 4 weeks and during the 2 weeks following I will have a MRI on my brain. But what I’m concerned and undecided about is the immunotherapy and the possibility of brain radiation. The medicine that will be used for the immunotherapy is Durvalumab Injection (IV). Dr. Farooq stated I would “not” have any of the side affects that I had from the chemo (paper work on the medication contradicts this) along with the research on Mayo Clinic. Doctor said during our visit yesterday said the side affects are extremely rare. I’m concerned that this isn’t the true case. I have major problems just with just the chemo (2 hospital stays and 4 ER visits). Doc said I would have this therapy once a month for 2 years. I don’t want to worry about the brain radiation since it’s not definite yet but can’t help but worry. I don’t think I would go through that if it comes back I need it. It would depend on where the cancer is and how bad.
I’m hoping for any feedback on the Durvalumab. Doc said that is the “only” medication for my type of cancer. I’m wondering just how rare the side affects and damage to organs really are. They already have this scheduled to start on January 6, 2025.
Any feedback back will be greatly appreciated. Thank you, Frandy

Jump to this post

I was diagnosed with Stage 3 unresectable squamous NSLC in later 2023 After 6-week treatments of radiation (5/week) and chemo (1/month), I was prescribed and am almost done with 1 year of durvalumab (Imfimzi) infusions (2/month)

I have not had any major side effects except some fatigue and shortness of breath. I did get a case of pneumonitis early on in the treatments but the doctor thinks this was from the radiation.

So far the treatments seem to be working but too early to tell. I get CTs every 3 mos

Hope this helps

REPLY
Please sign in or register to post a reply.