New drugs changing the outlook for many terminal cancer patients
Published Sunday, December 10, 2017 10:00PM EST
Last Updated Monday, December 11, 2017 5:02PM EST
Ask any cancer specialist practicing today, and he or she will likely have a recent story of a patient who was given a terminal diagnosis but who is still alive and doing much better than expected, all thanks to a new generation of drugs.
New classes of medications are helping those with advanced cancer to defy the survival odds by re-training their immune systems to fight the cancer and stop their illness from worsening.
Anne-Marie Cerato is one of those patients. Eight years ago, she noticed an odd lump on her collarbone. After a battery of tests, Cerato was stunned to learn she had lung cancer. The then-32-year-old had never smoked a day in her life, was in excellent health, and had no symptoms of illness.
She underwent treatment, but two years later, she got more devastating news: the cancer had spread to her other lung and was inoperable. Her condition was now terminal.
Believing that she didn’t have long to live, Cerato quit her job as a teacher and started travelling the world.
“I figured at that time I had two years, if I was lucky,” she says, “So I said that is how I am going to live. I am going to live my life to the fullest and when death comes for me, I will greet him as a friend.”
That was almost seven years ago.
By defying the usual odds, Cerato is now part of a new trend in cancer medicine: super survivors who are living longer than ever before.
In the United Kingdom, agencies like Macmillan Cancer Support have started to keep track of these "super survivors," with an estimated 17,000 people now living for years with a terminal diagnosis. More importantly, many of them are healthy.
There appears to be no agency doing the same tracking yet in Canada, but the cohort of patients in this group is growing.
“These are good problems,” says Dr. Mark Doherty, an oncologist at the Odette Cancer Centre at Sunnybrook Health Sciences Centre in Toronto.
“We want people to live longer, we want them to feel better. It's fantastic to see this."
Many of these cancer patients are surviving thanks to still-experimental drugs that help control the cancer.
“We have seen that from clinical trials, from lung cancer immunotherapy, 20 per cent of those patients are alive at five years -- which is unheard of with the old chemotherapy drugs,” says Dr. Doherty.
Patients taking these new medications are not considered cured, but their cancer diagnosis shifts, from a certain death sentence to a manageable chronic disease.
In Cerato’s case, she takes just two pills a day as part of a clinical study of a drug called lorlatinib.
She is able to take the drug because her tumours carry a rearrangement in a gene called ALK (anaplastic lymphoma kinase). It’s a trait that occurs in just three to five per cent of lung cancer cases, but lorlatinib is designed to target exactly this type of cancer.
Macmillan Cancer Support UK says that with the new survival trends after a "terminal" diagnosis, there are new difficulties. More doctor visits, more long term uncertainty.
Regular scans are needed to make sure the cancer is still in check and each upcoming test gives rise to what some have dubbed "scanxiety."
“I live a strange life where I live in three-week increments -- even scan-to-scan, which is every six weeks,” Cerato says.
But after seven years, she not only manages to cope with the apprehension and variability of her days -- she is thriving.
Cerato is now doing so well, she's considering returning to work as a teacher. She speaks to other patients diagnosed with lung cancer, and has also met and married her partner, Patrick.
“I have this amazing man who understands me for who and what I am. The world is my oyster and I have someone to share that dream with and it is a wonderful thing,” she says.
With continuing good health, Cerato says she is always aware of how lucky she is and that she is in many ways a pioneer.
“I have gotten this lottery ticket where I have more time. I don't know how much time. I actually don't care how much time, as long as I can make the time right now be meaningful.”
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip