Dr. John Walker doesn’t mince words when he describes the immunotherapy movement. “We’re in a position today where nearly half of the patients we will see in our cancer centres may qualify for one of these immunotherapies,” says Walker, a medical oncologist and associate professor in the department of oncology at Edmonton’s Cross Cancer Institute. “Revolution is absolutely the right word for it.”
Worlds apart from other “traditional cancer therapies” like chemotherapy, immunotherapy involves assisting a patient’s immune system to better fight cancer. Cancer cells have been found to express a molecule onto white blood cells that triggers the natural “off switch.” Immunotherapy helps reverse this action by introducing laboratory-raised monoclonal antibodies that bind to white blood cells known as T lymphocytes, or “T-cells,” that disable the connection between the cancer and the T-cells, turning off the “off switches” and allowing them to fight the cancer cells.
Though Walker doesn’t hesitate to call immunotherapy game-changing, he does note there’s still plenty of work to be done.
“We haven’t really seen the full impact of immunotherapy, which is really what’s most exciting,” he says.
Today, Walker says much of the exciting immunotherapy research in Alberta focuses on using immunotherapy drugs along with other agents to treat patients who haven’t seen benefit from the treatment alone.
With an abundance of Alberta Cancer Foundation-backed immunotherapy research projects taking place, patients remain at the core, undergoing unprecedented clinical trials to help advance cancer care. We spoke with Albertan cancer survivors who share their inspiring experiences with immunotherapy.
Despite feeling healthy, Lorne Cochrane decided to go for a check-up shortly after his twin brother, Lloyd, underwent a lower lobectomy in 2012. Lung cancer had been prevalent in the Cochrane family, though history didn’t make Lorne’s stage 4 diagnosis any less surprising.
“When they told us that he was past surgery and onto palliative, and that he’d only have a short time to live, we were shocked,” says Lorne’s wife, Mary Cochrane.
Lorne was given 12 to 13 months to live after beginning palliative chemotherapy treatment in summer 2012. Lorne and Mary began actively searching for alternative treatments, asking Lorne’s oncologist to consider him for any clinical trials.
“I said ‘I’m young, I’m healthy, I feel good. If any clinical trial or anything comes up, throw it my way,’” says Lorne, who was 52 when diagnosed.
Chemotherapy was proving ineffective and following a CT scan in mid-August 2013, a halt was put on treatment, and Lorne was told to head home to enjoy the remainder of his days.
Just weeks later, however, the Cochranes received a phone call — a clinical trial had come up. Lorne was entered into a randomized process to decide if he would undergo further chemotherapy or an immunotherapy trial. When his oncologist told them it would be the latter, they felt hopeful.
“It was a celebration knowing it was not chemo,” says Lorne.
For the trial, the Cochranes made the five-hour round trip from their acreage north of Edmonton to the Cross Cancer Institute every two weeks. Within eight weeks, the congestion in Lorne’s lungs began to clear, an early sign that his body was taking to the treatment. A CT scan at week 15 delivered concrete proof — the majority of his more than 25 active cancer spots had shrunk down to a point of immeasurability.
“It was just disbelief that it worked that fast,” says Lorne.
Positive results continued from there, and after carrying on with treatment for two more years, Lorne made the choice to stop in 2017. He’s since been monitored regularly through CT scans, which show no signs of cancer returning.
Since 2017, the Cochranes have stayed in the realm of cancer care. Recently, they’ve been working with lung cancer-specific foundations to discuss stigma and raise awareness about the disease. Lorne also shares his hopeful story through media appearances, social media and more.
“Probably the most rewarding thing about living through this is realizing that [other patients] aren’t going home and living in doom and gloom,” says Lorne. “There is hope.”
After an initial diagnosis in 2007, Cam Lane says his experience with melanoma became a seemingly endless loop of minor operations to remove lesions on his right leg.
“It was basically cut and scan, cut and scan,” says the Edmonton native, who was 35 at the time of diagnosis. “[I was always] checking in, ‘Are there oncology treatments that would be available to me other than the chemotherapy?’ The answer was always no.”
In late 2013, his cancer had progressed to stage 4 after spreading to his lungs.
Research showed that survival rates for stage 4 melanoma were low with the treatment options available at the time. Even when Dr. Walker, who was Lane’s oncologist, first approached him about taking part in an immunotherapy trial in December 2013, there was still no indication that treatment would work.
“It was hopeful that it would do something, but there was no evidence,” recalls Lane.
Despite the uncertainty, Lane underwent testing and was found to be eligible for the trial after the largest spot in his lung had grown just beyond the required threshold.
The trial began with weekly IVs, lasting about two hours at a time. One week in, Lane’s right leg swelled up to roughly twice its normal size, and more than 20 blisters appeared on his skin. Dr. Walker assured him that the reaction was positive — it indicated his immune system was fighting cancer microsites.
Following a CT scan at the three-month mark, Dr. Walker showed Lane a picture from the scan of the target lesion, which he says was roughly 90 per cent gone.
“It looked like someone had just taken an eraser to it and just scrubbed it out,” says Lane. “It was the first time I felt ‘Hallelujah. I might actually get through this.’”
In July 2014, Lane was told he was the first patient on the trial to have a complete response, with no active trace of cancer showing up on his scan. He kept up with treatments for the next three years and by 2017 decided to step away. Six years later, he says cancer isn’t something he worries about anymore.
Like the Cochranes, Lane has stayed connected to cancer care. He’s found a spot on the National Cancer Board of Canada as a patient representative and shares his story through speaking engagements and other initiatives.
“Hopefully it’s helpful for other people, but it’s almost been like a form of therapy for me,” says Lane of sharing his story. “Something could emerge up in the future, but right now, I’m enjoying life and being able to contribute back.”
Thanks to immunotherapy, Henry Schuetz has more time with his family
Henry Schuetz had never heard of immunotherapy when his doctor brought up a clinical trial in 2014.
“I didn’t have a clue what it was,” says Schuetz, who was diagnosed with stage 4 renal cell carcinoma in late 2013 at the age of 40. “[My oncologist] never said it would save my life. But he wanted to prolong it.”
The eight months preceding had been difficult. A painful backache, paired with fatigue and weight loss, led Schuetz to get tested on December 13, 2013. That same day he was told he had two years to live.
“It was my worst nightmare,” says Schuetz. “[My] first thought was ‘I’m not going to see my daughter graduate, or my son get married, or my grandkids.’”
Beyond an operation that removed his kidney where the cancer began, Schuetz was kept off treatment for the next several months, allowing him to spend time with his family while monitoring continued. Eight months after his diagnosis, he was approached about taking part in a clinical trial at the Cross Cancer Institute, an opportunity he jumped at.
Schuetz underwent three out of the four scheduled sessions in the six-week trial, stopping after having side-effects that required additional medication that made him ineligible for the final dose. Treatments were delivered intravenously, taking about an hour at a time. Through it all, Schuetz wore a Superman shirt — a nod to his late father who shared his love of the superhero.
While Schuetz worried that not taking part in the fourth session would affect his outcomes, three proved to be enough. At the end of the trial, he was shown his initial and final scans, which displayed how cancerous spots on his lungs had largely shrunk, and in many cases, fully disappeared.
“I honestly don’t think without the clinical trial that I would have survived,” says Schuetz.
In December 2019, Schuetz underwent a non-invasive operation to remove a tumour found in his brain, and in April 2020, he had a follow-up operation that used a gamma knife treatment to help remove additional cancer cells in the area. In July, he underwent surgery to remove a tumour on his tongue, and ongoing tests have shown no current active cancer cells.
Today, Schuetz lives in St. Albert with his girlfriend, who, along with his mother and the rest of his family, he credits as being a much-needed support system. In summing up the experience, one word comes to mind.
“Relief,” says Schuetz. “I [got to see] my daughter graduate and my son get married [and I got to meet] my three grandkids.”