NOTE: This is a guest post written by Marty Fagan (husband of Chris Fagan)
A Look Back
In August of 2016 we were able to positively confirm via a lung biopsy that I (Marty Fagan) had stage IV cancer. The exact type of cancer though was difficult to distinguish.
This morning I looked back at some emails from this time period and it reminded me that at first, we thought my cancer could be bladder, squamous, or basal cell. Messy and confusing.
It was at this point that Chris went into research and cancer project manager overdrive:
- Had my lung biopsy samples sent to multiple labs and learned the language of tissue samples.
- Chris coordinated the genomic testing on my lung biopsy sample. This genomic testing is what ended up giving us a path to treatment.
- With the genomic information in hand, Chris commenced with understanding the data and speaking with experts.
- After one oncologist recommended a possible treatment to start, Chris connected with the doctor at Mayo who had run the original trial for that drug. He let us know that my cancer didn’t have the gene that was necessary for this drug to work, and thus the drug would only make me ill from the side effects. We moved on from that oncologist.
- Chris then began speaking with immunotherapy experts from Harvard, Mayo, and Mass. General. Finally they classified my cancer as squamous cell carcinoma. My cancer was a highly mutated skin cancer with no clear treatment path, but recent immunotherapy trials were showing great promise in melanoma patients, and my cancer had much in common with melanoma.
- Chris made multiple (easily in the hundreds) appointments for me at Mayo in Minnesota and Seattle Cancer Care Alliance (SCCA).
- She coordinated all of this over the next several years.
- From 2016 to 2019 we tried two different immunotherapy treatments. Neither stopped the slow moving cancer train.
- By this time we had switched completely to SCCA and my oncologist is Dr. John Thompson. Side note: Dr. Thompson and most of his staff have read Chris’s book, The Expedition. They’re all big fans of hers!
- Dr. Thompson had a combination immunotherapy treatment in his back pocket that he wanted to try. He actually had run a trial for a similar combo.
- The sign to go ahead and start this treatment came in Dec. 2019 when cancer showed up on my sacrum.
- Chris was of course still coordinating my appointment, and I was still running the 2 miles each way from work to the appointments.
- We started the new treatment on January 23, 2020
Last week I had a CT scan which showed my cancer is now officially stable. Some of the tumors in my lungs are just plain gone and the couple that were near the 2 cm size are now 30-50% smaller and not growing. For perspective, 1 cm is about the size of a pea. Insignificant.
With that result we were now able to stop treatment and monitor every 3-4 months.
A quick explanation on the workings of immunotherapy to provide perspective. Unlike chemotherapy, immunotherapy keeps working after you stop treatment. Immunotherapy has not been around that long, one of the best studies is the CheckMate 067 trial which looked at 945 melanoma patients over the last 5 years. 52% of the patients treated with the immunotherapy combo, the same one that I did, are still alive and treatment free after 5 years whether they had a complete or partial response to the treatment. Which is strong evidence to show that if you get a response, that response can be long lasting.
Stopping treatment is an amazing feeling after so many years. Hard to describe, but I want to say thanks to my amazing wife. What a life of adventure we’ve had; feels like a movie at times. I’d like Kevin Costner or Tom Hanks to play the old/current me. Scarlett Johansen will be Chris.
I also need to thank Dr. Jim Allison. In 2018, Dr. Allison won the Nobel Prize for discovering the immune system’s role in defeating cancer. His research led to the discovery of the T-cell receptor and its role in fighting cancer. He developed and then fought for over a decade to bring the drug Ipilimumab to the market. This is the drug that ended up working for me, and it’s now saving thousands of lives.
You can find the Jim Allison documentary, Breakthrough, on Amazon and other streaming services. Science. I wish I could hug him.
Thank you, Chris and Keenan, for being so strong the last few years.
Let’s now all hope that the second half of 2020 will start to turn and become a great year. It can. Vote.