Stemming cancer tide

Health & Beauty | Rick Montgomery 20 Sep 2016

A FORTNIGHT AGO, Rebecca Hertzog Burns turned two. She says that's her age, though she's really 27. After a relapse in her fight with acute myelogenous leukemia, Burns received a stem cell transplant on September 9, 2014, through an infusion of umbilical cord blood from a baby boy.

By her way of thinking, she and her immune system were reborn that day. "My new birthday," says Burns, who has been in remission since.

The treatment she received at the University of Kansas Hospital falls within a broad spectrum of care called immunotherapy. It is the hot topic - the "it" word, in addressing cancer.

While doctors report success combating several types of cancer through different versions of immunotherapy, university clinicians say some of the most remarkable stories arise in the treatment of blood cancers.

Deadly forms of leukemia and lymphoma, which commonly strike young adults such as Burns, are now managed, and in many cases vanquished, using treatments unavailable just a few years ago.

"In 26 years of practice, this is absolutely the most optimistic I've ever been," said Joseph McGuirk, medical director of KU's blood and marrow transplant program. Patients from around the world travel here to take part in experimental trials. "It's not hyperbole at all to say we're in the middle of a revolution in cancer therapy."

The idea is to coax a patient's own body to attack cancer cells. The way of doing that - in short, by harnessing the immune system to do the work that cancers don't let it do - differs from patient to patient, from cancer to cancer.

For former president Jimmy Carter, suffering from an advanced melanoma, the key may have been a "checkpoint inhibitor" drug with the brand name Keytruda. Carter last year stunned the globe when he announced that his immunotherapy treatment, combined with radiation and surgery, eradicated tumors that had developed in his brain and liver.

Immunotherapy is not new, but it is getting a lot of attention now for a reason, McGuirk said. "We've reached this critical mass where, kaboom, all of sudden [immunotherapy] has taken off like a rocket," he said.

By itself or in combination with other treatments, immunotherapy is being credited for putting some terminal cancer patients in remissions that can last for years. Some of the drugs being developed block a mechanism, the immune checkpoint, that cancer exploits to keep the immune system at bay. Other treatments remove from patients millions of disease-fighting cells, reconfigure them in a lab and infuse them back into their sick owners.

The hope is for these so-called T-cells to do the job they're meant to do.

Still, many don't respond to these treatments. For them, conventional steps such as chemotherapy and radiation remain potential lifesavers. But in those treatments' quest to attack all cells they can get, and not only cancer cells, their side effects usually are much harsher than immunotherapy's.

Others warn that too much hype could steal attention and funding from those more traditional strategies and other promising treatments.

"Through the history of oncology, there are periods in which something gets really hot and everyone gets excited that it's the answer," said Otis Brawley, chief medical officer for the American Cancer Society. "The immunotherapy treatments being developed are here to stay. But I worry about research and money shifting away from other approaches."

Burns returned to the KU Cancer Center in late August for her two-year checkup. Everything looked good.

Speaking about the leukemia that developed when she was 20, she said she thought she had it licked once but relapsed in 2014, right after boyfriend Tanner Burns told her father about plans to marry her. She told her boyfriend he couldn't propose until she was well.

She continues to post her progress in a journal on the website Caring- In a recent entry she noted: "Pray for my overall health and wellness This battle is far from over!"

She's only two, after all. As for her and Tanner, they married in July.


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