Immunotherapy a 'breakthrough' in breast cancer treatment

The immune system is known to be involved in preventing cancer, and the treatment enhances the body's ability to fight cancer cells. While it's unclear if immunotherapy is the lone factor, Witten's tumor showed promising results during her latest check. 

LOUISVILLE — The call came on April 30.

That's when Lindsey Witten learned something that would alter the course of her life.

"It was my right breast that made me go in for a mammogram," she said. "I had a pretty decent lump. The doctor there that day said he would just feel a little more comfortable if we did a biopsy. It came back, and it was breast cancer."

Witten was diagnosed with stage II, triple-negative breast cancer. This meant that the three most common types of receptors known to fuel breast cancer growth were not present in her tumor. Because of her particular type of cancer, many common treatments were off the table.

"It's straight chemotherapy, because it's a very aggressive-growing breast cancer," Witten said. "We needed the chemo to kill it off quicker."

ANOTHER OPTION

During a meeting with one of her physicians, Dr. Laila Agrawal, to discuss how the chemotherapy would work, Witten learned that she may be a candidate for a new, innovative treatment for breast cancer — immunotherapy.

Agrawal, who specializes in breast cancer at Norton Cancer Institute, said that the medical world has known for some time that the immune system is involved in preventing cancer in the body. For years, however, it was difficult to find a way to harness its power in fighting cancer. The FDA just recently approved the first-ever immunotherapy treatment for triple-negative, metastatic breast cancer this past March.

"This year is exciting, because it is the first time that there has been an FDA approval for breast cancer," Agrawal said of the treatment. "Cancer cells figure out how to outsmart the body's defense systems. Immunotherapy unleashes the body’s ability to fight what was hidden by the cancer.”

The side-effects of immunotherapy tend to be less aggressive than those of chemotherapy, though some rare side-effects are possible.

“It seems to be easier on patients," Agrawal said. "There are side-effects that patients can experience associated with immunotherapy. It's that those side-effects aren’t as intense as you would experience with radiation or chemotherapy."

After discussing the immunotherapy treatment with those who have been by her side throughout the whole process — her husband, mother and sister — Witten decided to move forward with it.

"[Agrawal] brought in the research team, and it was the first time I'd ever heard of it," Witten said. "We thought it would be a good idea. Worst-case scenario, she said I could stop it at anytime if I was uncomfortable."

TREATMENTS PROMISING

Witten underwent her first treatment in May, receiving it roughly every three weeks. She starts her treatment days with blood work, which takes roughly an hour. Once her levels are cleared for chemotherapy and immunotherapy — whichever she happens to be receiving that day — she heads to the infusion room, where she'll remain for another three to four hours.

Usually, this means Witten arrives at Norton Cancer Institute at 8:30 a.m. and stays until about 3 p.m. — a schedule that can be tasking on the mind, body and spirit.

"I'm the youngest in my family, and we've never had any kind of breast cancer or anything in our family," she said. "I'm the first, and it was very hard. The one thing that stuck to me was that once my emotions are good and I'm OK with this, my story could help another patient. If this works, then it can help someone else."

A few weeks ago, Witten came to Agrawal for a check-up on her progress. The results were promising. Learning this was an emotional moment for all involved.

"Right now, they can't feel my tumor at all, which is amazing," Witten said. "My tumor literally stuck out like a golf ball. It was probably two visits ago, and [the doctors] could not feel it. It's amazing. They were doing a dance, my sister was crying, and Dr. Agrawal was happy."

‘A BREAKTHROUGH’

Though it's unclear if immunotherapy is the lone factor in Witten's progress, Agrawal said that innovations like it have helped to push the field of cancer treatment forward, adding that it's an "exciting time."

“Immunotherapy is a breakthrough," Agrawal said. "It’s being studied in different types of cancer. Now, when I meet a patient, I feel that it’s very possible that there may be a new option for them. It’s helping patients live longer.”

Witten's tumor was checked again during the last week of September, where those promising results remained. She is expected to receive her last treatment in early October before heading to surgery.

"It's almost done," she said.

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