The lung cancer survivor stories on this page are excerpted from patients with advanced lung cancer that received customized chemotherapy guided by the tumor functional screening methodology used by Dr. Robert Nagourney of Rational Therapeutics.
A more detailed discussion of standard of care chemotherapy and of the customized chemotherapy guided by Dr. Nagourney’s technology can be found on our Cancer Therapy Options page. One of our recommended Right Doctors, Dr. Keith Block uses the services of Rational Therapeutics to develop his customized integrated therapy tailored to each cancer patient he treats. Dr. Block has this to say about Dr. Nagourney:
“Dr. Robert Nagourney has earned international recognition as the most prominent leader in the field of chemosensitivity testing. For over two decades, my medical staff and I have included his chemosensitivity assay as an invaluable tool in helping us select the optimal chemotherapy regimen for our patients. A more primitive proliferative assay led many to reject such testing early on. However, Dr. Nagourney's pioneering work, developing instead a more prominent apoptotic (programmed cell death) assay, has benefitted innumerable cancer patients and played a pivotal role in their treatment response and treatment outcome. I believe all patients deserve the quality of information that Robert's testing provides, and that in the future, oncology practices will routinely incorporate such testing into the optimal care for patients.”
And now for the Lung Cancer Survivor Stories.
Rick was no stranger to life in the fast lane: this former Marine sergeant loved to ride his motorcycle and had a penchant for hard partying. But, in 2004, determined to get his life back on track, Rick checked himself into rehabilitation. Within a year, he had a successful business and was drug and alcohol free. But, his celebration turned to anguish when a routine doctor’s appointment revealed the worst: Rick had stage IV lung cancer.
Rick began chemotherapy treatment. Several months later when Rick arrived for his regularly scheduled chemo infusion at the West Los Angeles Healthcare Center of the VA, he was stunned when the doctor questioned why he was there. That’s when his oncologist told him that the treatment wasn’t working and there was nothing left to do. He was told to get his affairs in order and referred him to hospice care.
Luckily, his friends and family didn't give up as easily as his doctor. That was when he found a physician who gave him a medicine he had yet to try: Hope. “I was put into contact with Dr. Nagourney and introduced to his work when my own oncologist had basically told me to go home and die. Fortunately, in November 2005, my surgeon was able to send a sample of my lung cancer tumor to Rational Therapeutics. There, my cells were tested to show which drugs were resistant and sensitive to my tumor. The result: a combination of two drugs that are not commonly used for lung cancer in the United States.”
“The drug combination Dr. Nagourney prescribed shrank my tumor substantially and I was able to go back to my normal life for a while. But, in 2006, a CT scan showed that I had yet another tumor the size of a lemon in my adrenal gland. In a case like mine, most doctors would have taken this as a sign that my cancer was getting worse. Fortunately, Dr. Nagourney insisted on having that tumor sample biopsied as well. Based on Rational Therapeutics’ functional profiling of the new tissue, it was suggested that I try a new drug — Tarceva. I responded very well. There have been multiple biopsies performed since and they have all shown no recurrence of cancer.”
“Needless to say, I was taken off of hospice care (a story Dr. Nagourney loves to tell) and given my life back. These days, I’m enjoying life – spending time with my girlfriend, Jennifer, riding my motorcycle and working on creating new business opportunities.”
Update by Dr. Nagourney on Rick -April 15, 2014:
When I saw Rick, two weeks ago at our six-month routine follow up he provided a copy of his February 2014 PET/CT scans which, once again, revealed no evidence of progressive disease. With the exception of the skin rashes associated with the therapy, he maintains a completely normal life.
During our discussion he apprised me of an interesting fact. His survival, now approaching 10 years, according to him, constitutes not only the longest survivorship for any patient under the care of the Los Angeles VA, nor any patient under the care of the VA in California, no, he is the longest surviving actively treated metastatic non-small cell lung cancer under the care of the Veteran's Administration. Period! While I cannot, with certainty, vouch for this fact, I am quite certain that he is among the best outcomes that I have seen.
There are several points to be gleaned. The first is that every patient deserves the best possible outcome. The second is that hospice care is in the eye of the beholder. The third is that patients must take charge of their own care and demand the best possible interventions available. As an aside, you might imagine that a federal agency responsible for the costly care of tens of thousands of lung cancer patients every year would pay attention to results like Rick’s. Might there be other patients who could benefit from Ex-Vivo Analysis for the correct selection of chemotherapeutics? One can only wonder.
NOTE: The above account was excerpted and summarized from rational-t.com
Hi, I'm Pat and I'm a cancer survivor. If you or a loved one has just been diagnosed with cancer, you may be scared and confused. I know I was. You are probably feeling overwhelmed by so many decisions suddenly facing you. I've been there too. I've also successfully lived with cancer long enough to know that patients who actively participate in their own treatment decisions do better.
Knowledge is power, and being able to ask questions and make informed decisions can save your life. As a cancer survivor, I'd like to help you navigate your own journey by sharing some of the things I've learned about cancer and how to survive it. The most important thing is this . . . do all you can to find a treatment plan that is right for YOU. When it comes to chemotherapy, one size does NOT fit all.
My journey began on September 15, 2008. That afternoon, while leaving the gym, I had a sudden seizure. I was taken by ambulance to my local hospital in Long Beach, California. A CT scan confirmed that I had two small brain tumors, one of which had caused the seizure. After numerous other tests, I was informed that I had Stage IV non-small cell lung cancer with metastases to my brain.
I was in shock. It was surreal. I was a healthy, 52-year-old woman with no symptoms. I was surrounded by doctors I didn’t know who were telling me things I could barely comprehend. I was told that my cancer was inoperable. I was advised to immediately start chemotherapy and radiation. I was told to go home and get my affairs in order. I was asked if I wanted to talk to the hospital chaplain. I was certainly not given the impression that I could survive, or that I had options.
The only thing I knew for certain was that I was an amateur when it came to cancer and I had no idea what I was supposed to do. Should I just do as the doctors said and start chemotherapy immediately? Would I get sick? Could I survive? Did I have time to wait and do some research? Should I get a second opinion? Were there alternatives? Even if there were, how could I know what was best?
Fortunately, I have a close friend who was, and still is, a pharmacist at this hospital. She insisted I consult with Dr. Robert Nagourney before deciding anything. She told me that he was a highly regarded oncologist and a pioneer in the development and use of “functional profiling,” also known as chemosensitivity and resistance testing. Heeding my friend's advice, a few days later I was seated in the waiting room at Rational Therapeutics. A sign on the wall read “Hope Practiced Here.” That was comforting, because I certainly didn't leave the hospital feeling very hopeful.
I sat quietly as Dr. Nagourney reviewed my medical records. He gave me a physical exam, then asked if I felt sick. I said, “No, I don't feel sick at all; I feel healthy.” What Dr. Nagourney said next really surprised me. He replied, “That's because you're not sick. You have cancer, and my job is to keep you from getting sick.” He explained that, even though my cancer was very serious (having already metastasized, it was technically incurable), he was certain there were treatments that would help. He explained that most oncologists follow standard protocols, treating patients with the same chemotherapy drugs based solely on their type of cancer. Since Dr. Nagourney believes that no two patients are alike, and neither are their tumors, he would do something different. He would test a piece of my tumor first to see which of the many potential chemotherapies would be the most effective at killing my cancer cells. Whichever drug(s) proved most effective in the lab would be the treatment he would prescribe – personalized just for me.
I didn't realize there were so many kinds of chemotherapies, and that despite clinical trial evidence, some drugs might work while others would not. Testing them first in the lab seemed so simple and obvious – if it worked! Did you know that, typically, oncologists prescribe chemotherapy drugs based on standard protocols, or guidelines? These guidelines are developed from years of clinical trial research. Clinical trials test large groups of patients with the same types of cancer to see which drugs produce the best results. The drugs that help the greatest number of patients in a trial setting eventually become the drugs that doctors usually prescribe when treating their own patients.
The problem with this “one size fits all” approach is, that with many types of cancer only about 30 – 40 percent of patients will improve with their first line of treatment. Why such a small success rate? Because a drug can be considered statistically successful simply by being better than the other drugs tested – the lesser of the evils.
So what does that mean for the 60 – 70 percent of patients who fail to get better? It means their doctor must choose a second, third or even fourth line of drugs in hopes of finding something the patient will respond to. With hundreds of potential drugs to choose from, it would be impossible to try every drug. With such small success rates, standardized chemotherapy treatments often do more harm than good. Patients can get sick from the toxic drugs and precious time is wasted. And potentially effective drugs may be ignored. Since I was fighting for my life, I wanted better odds than that!
The alternative to standard protocols is individualized therapy. Dr. Nagourney believes that every patient is unique, and so is their cancer. In order to determine which chemotherapy has the best chance of working, he has developed a test (EVA-PCD functional profile) that reveals how a person's actual cancer cells respond in the lab when different drugs are applied. The reason it is called a “Functional Profile Assay” is that it assesses how a drug functions (performs) in real time on your live cancer cells. The result is a profile of how effective the various drugs were in killing your cancer. The test results can provide your oncologist with a better roadmap in determining what therapy will be best for you.
Studies have shown that patients are twice as likely to respond to treatment when their therapy is based on drug sensitivity testing rather than standard protocols. I knew I only had one chance to get chemotherapy right the first time, so I chose the EVA-PCD functional profile test to give me the best odds. As I mentioned, rather than going down the path of least resistance (standardized chemotherapy), I choose Dr. Nagourney's plan and underwent a small, surgical biopsy in order to obtain a large enough sample of my cancerous tissue for testing.
Obtaining enough cancerous tissue or fluids can be easy or difficult, depending on the type of cancer, the location and amount of tumor cells. My surgeon did have to cut an incision in my side in order to obtain a piece of my lung tumor, but I was out of the hospital in two days with no complications. Often biopsies can be done on an outpatient basis, or be collected from initial cancer surgery. Because my hospital was located nearby, my tissue sample was taken immediately to Rational Therapeutics. But tissue samples can be sent to them via overnight express from all over the world, so location is not a problem.
The most important thing is that enough live cancer cells are present for testing. Needle biopsies do NOT provide enough tumor cells to do a test. Once the sample is received, pieces of your still-living tissue are subjected to various combinations of drugs. Your cancer will be considered sensitive to the drugs that kill the most cancer cells, and resistant to the drugs that are least effective. Often, there will be synergy in which combinations of drugs do better than single drugs alone.
Within one week of my surgery the results were in. Sitting again in Dr. Nagourney's office, I was more than a little anxious waiting for the news. The test results couldn’t have been better. One of the drug combinations that showed a dramatic reduction in my cancer cells was Tarceva and Avastin. In 2008, Tarceva was a fairly new oral chemotherapy that was only used as a second line treatment, after conventional treatment had failed. And it was rarely, if ever, used in combination with Avastin. But Dr. Nagourney was so certain that this was the “cocktail” that would send my lung cancer into remission, that he prescribed it anyways.
He was 100 percent right. And I am so grateful to him for treating me like an individual and not a statistic. My unique Tarceva/Avastin combination is still working and my cancer remains in control. Several years after I started treatment, Tarceva did become a standard protocol for people with a certain type of lung cancer.
NOTE: The above account was excerpted and summarized from rational-t.com
For additional lung cancer survivor stories see Lung Cancer Story-Patients of Dr. Keith Block
For cancer survivor stores of people with other types of cancer see our Cancer Survivor Stories page