Half of the patients with advanced lung cancer, America's deadliest, reject treatment, study says

Fifty-two percent of metastatic lung cancer patients fail to get life-extending treatments, a new study finds.

According to a recent story by Simar Bajaj in The New York Times, the reason they skip such treatments as chemotherapy, immunotherapy. and targeted therapy is, experts suggest, because of "access issues, fatalism, and shame."

The Times article reports that the study, published in JAMA Oncology, "analyzed more than 250,000 people on Medicare between 2006 and 2021, with an average age of 73, and found that the proportion of patients who received these treatments increased only slightly over time, to 48 percent from 45 percent."

More than 110,000 Americans are annually diagnosed with metastatic lung cancer, the deadliest cancer in the United States.

Dr. Carolyn J. Presley

But over the past 15 years, Dr. Carolyn J. Presley, chief of thoracic medical oncology at Ohio State University (who wasn't involved in the study ), is quoted, dozens of promising new drugs have come to market. For some patients, a pill can hold the disease in check for years, "so the fact that so many older adults are not getting treatment is really, really sobering."

Some patients who smoked "might feel like they brought this disease upon themselves," Bajaj's story says,  and — according to Dr. Adam Fox, pulmonologist at the Medical University of South Carolina, who led the study — the stigma not only contributes to diagnostic delays but also to patients feeling unworthy of care.

Fatalism, the lingering belief that metastatic lung cancer is hopeless and treatment is unlikely to help, might be adopted by some primary care and emergency medicine doctors, the article suggests.

As for access issues, "one of the biggest barriers to treatment is not being diagnosed in time. Screening can catch tumors early, but it remains widely underutilized, largely because most people don't know it's available and complicated eligibility criteria make it difficult for docs to figure out who qualifies," Bajaj's piece notes.

More information on Stage 4, metastasized disease can be found in Rollercoaster: How a man can survive his partner's breast cancer, aVitalityPress book that I, Woody Weingarten aimed at male caregivers. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter. Check out my other website at https://woodyweingarten.com for details.

Immunotherapy in clinical trial takes one-third of patients from hopelessness to a potential cure

Despite multiple myeloma having been considered incurable, a third of patients in a clinical trial have lived without detectable cancer for five years.

Patients in the trial conducted by Johnson & Johnson researchers had been facing "certain, and extremely painful, death within a year," according to a story by Gina Kolata in yesterday's editions of The New York Times.

But after five years, the immunotherapy developed by Legend Biotech, a company founded in China, seems to have made the cancer disappear in a third of the patients — "a result never before seen in this disease."

Dr. Norman Sharpless

"In my 30 years in oncology, we haven't talked about curing myeloma," the Times quoted Dr. Norman Sharpless," professor of cancer policy and innovation at the University of North Carolina School of Medicine and a former director of the National Cancer Institute. "This is the first time we are really talking seriously about cure in one of the worst malignancies imaginable."

The study by Johnson & Johnson, which has an exclusive licensing agreement with Legend Biotech, was published in The Journal of Clinical Oncology and reported yesterday at the annual conference of the American Society of Clinical Oncology.

"The Legend immunotherapy is a type known as CAR-T," Kolata's article explains. "It is delivered as an infusion of the patient’s own white blood cells that have been removed and engineered to attack the cancer. The treatment has revolutionized prospects for patients with other types of blood cancer, like leukemia."

Treatments for multiple myeloma are extremely costly. They can run more than $100,000 —  "hideously expensive," according to Dr. Carl June of the University of Pennsylvania. Total cost over the years can be millions of dollars, usually paid by insurers, "and it doesn't even cure you," he told the Times.

Thirty-six thousand Americans each year develop the deadly blood disease, which eats away at bones so it looks as though holes have been punched out in them, elaborates June. Bones can collapse. 

"It's a horrible, horrible death," says June.

More information on clinical trials can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten aimed at male caregivers. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter. Find out more on my blog, https://woodyweingarten.com.

Cancer vaccines are new type of immunotherapy that might help in fight against breast cancer

Virtually everyone's talking about vaccines, pro and con, regarding Covid-19 but other vaccines merit major attention as well.

According to an article by Cynthia Weiss of the Mayo Clinic News Network in today's daily Marin Independent Journal, cancer vaccines are "another type of immunotherapy that is being developed and tested for breast cancer."

Weiss' story goes on to say that such vaccines can "help train the immune system to see and 'memorize' antigens, or proteins, found on the surface of cancer cells, so that the immune system can fight these antigens if encountered in the future."

The vaccines, the piece adds, "are being studied in different breast cancer settings: treatment of current cancer; prevention of cancer recurrence; or to decrease the risk of cancer spreading to another part of the body, or metastasis."

Dr. Pooja Advani

Weiss' piece is a question-and-answer format with facts supplied by Dr. Pooja Advani, a Mayo Clinic oncologist and hematologist in Jacksonville, Florida.

Immunotherapy, not incidentally, is a comparatively new treatment for breast cancer that's also been used in treating lung and kidney cancers as well as melanomas. 

It "harnesses the body's immune system to help fight cancer," the Mayo Clinic information indicates.

Currently, Advani's information states, "immunotherapy is approved primarily for patients with metastatic or locally advanced triple-negative breast cancer, which is an aggressive subtype of breast cancer, representing 10%-15% of breast cancer, with limited treatment options other than chemotherapy."

Immunotherapy is not immune to side effects, however. Typical ones, according to the story, "can include fatigue, chills, body aches, injection site pain, infusion-related reaction, headache, flu-like symptoms and gastrointestinal symptoms."

And that's not all. Weiss' Q&A piece asserts that immunotherapy "also can affect live function tests; cause respiratory symptoms, such as shortness of breath, cough and fever; cause symptoms of overactive or underachieve thyroid glad, or adrenal gland; and rash."

But most of those symptoms, it should be noted, "are mild to moderate and reversible, if detected early and treated in a timely manner."  

More information about recent treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Doctors cite value of immunotherapy

Lung cancer patients are heavily benefitting from new treatments, Parade magazine reports

A lot of good news has been developing in the past several years about finding and treating lung cancer, according to Parade magazine.

A recent article by Marygrace Taylor suggests that, despite the disease growing for both never-smokers and women, "there's reason to be optimistic."

How so?

"There's been a huge jump in how long people are living with lung cancer," the piece quotes Dr. Nathan Pennell, Cleveland Clinic oncologist, as saying. "It's an extraordinary change."

Dr. Nathan Pennell

The Parade story then goes on to cite the value of such treatments as immunotherapy, which "helps the immune system better recognize and remove cancer cells without necessarily impacting normal cells," according to Dr. Jacob Sands, an American Lung Association spokesman. 

More than 1,000 clinical trials are currently studying how patients "can benefit from checkpoint inhibitors, immunotherapy drugs that block proteins that cancer cells use to stave off attacks from the immune system," Taylor writes.

Pennell adds that "we now know that if you add a checkpoint inhibitor to chemo, people live substantially longer" — and most likely with fewer side effects.

Dr. Jacob Sands

Sands also points to the efficacy of an advanced screening tool like low-dose CT scans, which "catch cancers at earlier stages when they're more likely to be cured."

Another new weapon in the war against lung cancer is stereotactic ablative radiotherapy (SABR), a specialized form of highly targeted radiation "often used to treat patients with early-stage lung cancer when surgery isn't an option."

One recent trial, the article reports, found the treatment "could double survival time without progression of [the] disease."

Finally, advanced bronchoscopy, which uses a lighted tube to examine abnormal parts of the lung just as traditional bronchoscopy does but also utilizes "smaller, more powerful tools" to create 3D maps of patients' lungs and helps doctors access areas that the traditional method can't reach.

More information about innovations in cancer treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at caregivers.

FDA approves 31 new therapies in one year

New screenings and treatments are helping to boost the number of cancer survivors in the U.S.

By 2026, some 20.3 million cancer survivors will be living in the United States — up from 15.5 million a decade earlier.

That, according to a recent article in Parade magazine by Sheryl Kraft, is because innovations in screening and treatment are helping patients beat the odds.

"In just one year," the piece reports, "31 new therapies to treat more than 16 types of cancers were approved by the U.S. Food and Drug Administration."

Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society, believes that screening can save lives. "Some estimates say that we can decrease the number of colorectal deaths by 12,000 to 20,000 if screening guidelines were followed."

Dr. Jame Abraham

And Dr. Jame Abraham, director of Cleveland Clinic's Breast Oncology Program, notes that hormone therapy might be all that's necessary to treat 70 percent of women with the most common form of breast cancer. 

"That means a large number of patients can safely avoid chemotherapy," the Parade story quotes her as saying. "We can individualize treatment and make sure we are prescribing the right treatment for the right purpose."

It was tough previously to identify which women with early-stage breast cancer were at risk for recurrence, so many had received unnecessary chemo, radiation and hormonal therapy. But a groundbreaking study known as the TAILORx trial found that many women could be saved from "unnecessary side effects like fatigue, hair loss, nausea, vomiting and anemia," the quote continues.

Another new treatment, immunotherapy, which "works by reprogramming a patient's own immune cells to find and attack those cancer cells through the body," also is being held out as innovative — and the American Society of Clinical Oncology's "advance of the year."

Immunotherapy now is being heralded as "extremely promising for treating triple-negative breast cancer, one of the most difficult-to-treat breast cancers," after having already been shown to have "significant results in young patients with a form of leukemia and adults with multiple myeloma (a type of blood cancer) and lymphoma (a type of cancer involving cells of the immune system)."

Yet another new testing method, CancerSEEK — according to the Parade piece, "a simple blood test, which in its research phase was performed on people already diagnosed with cancer," can identify markers for for tumors containing mutated DNA in the bloodstream. 

These markers are associated with eight common cancer types: breast, lung, colorectal, ovarian, liver, stomach, pancreatic and esophageal.

Lastly, the story cites a less invasive and faster lung-cancer technique called microcoil localization, "which can pinpoint and remove small bits of affected tissue using a needle inserted through the chest wall to remove the cancer at its earliest stage."

Minimally invasive surgery — instead of the currently popular "lobectomy, which removes a portion of the lung by opening up the chest, followed by radiation and chemotherapy."

More details on new techniques and treatments can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

New insights, treatments, tests in disease 'war'

Medical community is starting to believe less is more when it comes to cancer treatments 

More and more doctors and patients apparently are using less aggressive weapons to fight cancer these days.

Dr. Justin Bekelman

A story by Laurie McKinley in yesterday's Washington Post quotes Dr. Justin Bekelman, a radiation oncologist at the University of Pennsylvania, about the medical community's focus on the "war on cancer."

Historically, he says, that phrase "implied that more is better and decimation is desired."

McKinley's story contends, however, that the idea is "falling out of favor," not only because it "subtly blames patients" who die "but also because it doesn't capture a world of new biological insights, improved treatments and molecular tests that are transforming how cancer is treated."

According to Bekelman, "Knowing when not to treat" can be "great medicine" — because, the story charges, oncologists equipped with new tools and evidence can cut back on toxic and costly approaches likely do more harm than good.

Cancer, nevertheless, is not monolithic, the story indicates.

Rather, some cancers "need to be bludgeoned, but others can be treated with more tailored therapies or simply watched."

Although the latest mindset of "doing less in the face of danger" can be "emotionally difficult" for both patients and physicians, the article notes, proof that less is more has been frequently popping up lately, including a landmark clinical trial published in June that found more than "two-thirds of women with early-stage breast cancer can safely avoid chemotherapy." 

Not to mention the fact, according to the piece, that "men with early-stage, low-risk prostate cancer are rapidly embracing 'active surveillance' over surgery — and avoiding possible complications such as incontinence and sexual dysfunction," and that throat cancer caused by human papilloma virus, because it varies from other types of the disease, allows a cutback "in a brutal treatment regimen and [reduces] the risk of potentially devastating disfigurement."

The Post story also mentions the emergence of immunotherapy, usually less toxic than chemo, "as a first-line treatment for many patients," and cites a recent study showing that "people with advanced kidney cancer can skip surgery to have their kidneys removed and instead go right to drug treatment."

De-escalation isn't happening universally, however. 

McKinley contends that the "most common form of thyroid cancer, which poses little risk, is often still treated with unnecessary surgery, experts say. And some malignancies, such as pancreatic cancer, are so lethal that doctors are racing to find ways to ramp up treatment."

Details on trends and clinical trials in treatment can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

New drugs can lead to 'varied, bizarre' problems

Cancer-killing immunotherapies can cause major side effects in otherwise healthy organs

New immunotherapies can eliminate cancers but may also cause big problems with healthy body organs. 

According to a recent story by Laurie McKinley in The Washington Post, the perplexing side effects can range from inconsequential to severely dangerous, even life-threatening.

The article cites the case of a 55-year-old patient whose therapy "knocked back her cancer [but] also gave her 'almost every 'itis' you can get'… arthritis-like joint pain, lung inflammation called pneumonitis and liver inflammation that bordered on hepatitis."

The woman, McKinley's piece continues, warns "that highly touted immunotherapy treatments have downsides as well as benefits and to watch for complications, because 'not all doctors know all the side effects.'"

The upside is clear, however.

Checkpoint inhibitors, the new therapies, "offer a tantalizing chance for survival for patients with advanced melanoma and hard-to-treat cancers of the bladder, kidney and lung," the story says.

The downside? 

"The treatments, designed to unleash the immune system to attack malignancies, also can spur an assault on healthy organs, causing varied and bizarre side effects ranging from minor rashes and fevers to diabetes and deadly heart problems."

Dr. Drew Pardoll

Some of the symptoms, unfortunately, can fool doctors because they "can mimic those of the flu, infections or even food poisoning. That lack of awareness [by physicians] can be dangerous, given that quick intervention is the key to preventing serious damage."

The Post article quotes Dr. Drew Pardoll, director of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, as noting that immunotherapy "has a completely different side-effect profile than chemotherapy, and that has caught some physicians off guard."

Doctors, including emergency-room physicians, dermatologists and gastroenterologists, Pardoll insists, "need to go back to school" to earn about immunotherapy.

The side effects, McKinley writes, "occur in 15 to 70 percent of immunotherapy patients, depending on which drug is used and whether the medications are used individually or combined with one another or conventional cancer treatments."'

Are the cancer treatments worth using despite the side effects?

According to Kevan Herald, an immunologist and endocrinologist at Yale University, they absolutely are. "If it's a choice between staying alive and developing diabetes versus not, I'd always pick taking the drug and managing the diabetes."

Jeffrey Bluestone, an immunologist at the University of California, San Francisco, is also quoted in the Post piece. "The last thing you want to do is scare people away from lifesaving treatments," he maintains.

Questions about new treatments, drugs and research on life-threatening diseases are addressed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Rare, aggressive, often-fatal cancers cured

Immunotherapy puts ovarian cancers in 4 countries into remission despite docs' qualms

Although physicians declared that immunotherapy couldn't cure their ovarian cancer, the docs were mistaken.

According to a recent story by Gina Kolata in The New York Times, four young women — living in different countries — "had an extremely rare, aggressive and fatal form of ovarian cancer" and weren't expected to live much longer.

All four managed to get immunotherapy and their cancers, in total contrast to conventional wisdom, went into remission.

Dr. Jedd Wolchok

Kolata quotes Dr. Jedd Wolchok, chief of the melanoma and immunotherapeutics service at Memorial Sloan Kettering Cancer Center in New York, as saying, "What we are seeing here is that we have not yet learned the whole story of what it takes for tumors to be recognized by the immune system."

He contends that researchers and medical personnel "need to study the people who have a biology that goes against the conventional generalizations."

Dr. Drew Pardoll

Dr. Drew Pardoll, who directs the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins Medicine in Baltimore, notes that although four women hardly constitutes a clinical trial, "it is the exceptions that give you the best insights."

The cancer that had struck all four was hypercalcemic small cell ovarian cancer, which, Kolata writes, "occurs in a woman's teens or 20s [and] is so rare that most oncologist never see a single patient with it."

Immunotherapy drugs have been successful in treating lung cancer, a genetic type of colorectal cancer and melanoma but cancers of the prostate, pancreas, breast and ovaries have rarely responded.

More details about cancer research and trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

$373,000 per regimen for new treatment

FDA gives its okay to a second gene therapy that can send blood cancer into remission

The FDA has approved a new gene therapy for adults with aggressive non-Hodgkin's lymphoma.

According to a recent story by Denise Grady in The New York Times, Yescarta was okayed for patients who've undergone two regimens of chemotherapy that failed.

The Times article notes that the therapy "is part of the rapidly growing field of immunotherapy, which uses drugs or genetic tinkering to turbocharge the immune system to fight disease. In some cases the treatments have led to long remissions."

The therapy, which turns cells into "living drugs," is made by Kite Pharma.

Approval by the Federal Drug Administration was its "second in a radically new class of treatments that genetically reboot a patient's own immune cells to kill cancer."

The first was Kymriah, made by Novartis. It was okayed in August "for children and young adults with an aggressive type of acute leukemia."

That one costs $475,000 per dose, although the company has said "it will not charge patients who do not respond within the first month after treatment."

Yescarta isn't quite as expensive — $373,000 per treatment.

Dr. Frederick L. Locke

Dr. Frederick L. Locke, a leader of a study of Yescarta (and a specialist at the Moffitt Cancer Center in Tampa in blood cancers), is quoted as saying, "We're excited. We think there are many patients who may need this therapy."

Grady's story says "about 3,500 people a year in the United States may be candidates for Yescarta," which is intended "to be given once, infused into a vein, and must be manufactured individually for each patient."

Side effects, as with many therapies, can be daunting.

Life-threatening issues that stem from the Yescarta treatment can include "high fevers, crashing blood pressure, lung congestion and neurological problems," the story indicates.

According to Grady, two patients in the study that led to the drug's approval, "died from side effects," although doctors — through training and experience — apparently "have learned to manage them better."

The study, which was conducted at the Dana-Farber Cancer institute and Brigham and Women's Cancer Center in Boston, involved 111 patients at 22 hospitals.

"Initially," Grady's piece delineates, "54 percent [of the 101 who received Yescarta] had complete remissions…Another 28 percent had partial remissions [and] after six months, 80 percent…were still alive. With a median follow-up of 8.7 months, 39 percent of the 101 were still in complete remission — a much higher rate that achieved with earlier treatments — and 5 percent still had partial remissions."

Dr. Caron A. Jacobson

Says Dr. Caron A. Jacobson, who helped do the study: "You're really seeing people get their life back. After a couple weeks in the hospital and a couple weeks at home, they go back to work. On its face, it's quite remarkable and revolutionary."

The treatment, the Times explains, "was originally developed at the National Cancer Institute, by a team Dr. Steven Rosenberg led. The institute entered an agreement with Kite in 2012, in which the company helped pay for research and received rights to commercialize the results."

The drug giant Gilead reportedly bought Kite two months ago for $11.9 billion.

"In just several decades, said Dr. Scott Gottlieb, the FDA commissioner, "gene therapy has gone from being a promising concept to a practical solution to deadly and largely untreatable forms of cancer."

A look at many treatments and clinical trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

'Mismatch repair-deficient' genetic flaws studied

Tumor cell testing might show if new immunotherapy could target your particular cancer

The more gene mutations hidden inside your cancerous tumor, "the better chance your immune system has to fight back."

That's what Lauren Neergaard, an Associated Press medical writer, wrote recently after a newly approved landmark drug became "the first cancer therapy ever cleared [by the Food and Drug Administration] based on a tumor's genetics instead of the body part it struck first."

Keytruda, an immunotherapy, apparently might help those whose disease is among those with a common genetic flaw — called a mismatch repair defect — carried by seemingly unrelated cancers.

Genetic testing can show if a patient is a candidate for the precision immunotherapy.

Neergaard's story indicates that Johns Hopkins researchers estimate "about 4 percent of cancers are mismatch repair-deficient, potentially adding up to 60,000 patients a year."

Widely available tests to tell who's eligible for the immunotherapy cost between $300 and $600.

The flaw, Neergaard's article says, "is more common in colon, endometrial and gastrointestinal cancers but occasionally in a list of others." 

Dr. Bert Vogelstein

According to Dr. Bert Vogelstein, a cancer geneticist at Johns Hopkins, where the new use for the immunotherapy was discovered, the more mutations in a tumor, the greater the chance that at least one of them produces a foreign-looking protein that is a beacon for immune cells." 

More information on cancer research is contained in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Blacks, Hispanics, Asians lose 'huge advantages'

Minorities underrepresented in drugmaker-sponsored clinical trials on immunotherapy

Cancer patients who are people of color apparently are disproportionately being left out of experimental trials on immunotherapy.

According to a piece by Denise Grady last week in The New York Times, researchers are aware folks getting the treatments "have been overwhelmingly white."

But scientists claim they're trying to remedy the situation.

Some cancer centers are attempting to bring the trials to black, Hispanic and Asian patients instead of making those potential clinical trial participants come to them.

Immunotherapy, which the article calls "the hottest area in cancer research and treatment," involves drugs that help immune systems fight cancer.

The Times piece focuses on two major 2015 studies of "nivolumab, a type of checkpoint inhibitor, one of the most promising drug classes for cancer," and says that "patients taking it [in both tests] lived significantly longer than those given chemotherapy."

In the first case, 92 percent of the patients were white; 88 percent were in the second. Census figures for 2015 show Caucasians make up only 77 percent of the U.S. population.

According to the Times piece, researchers say studies of nivolumab may omit minority patients "because it can take longer to find and enroll them," an obstacle disliked by drug makers such as Bristol-Myers Squibb, which financed the lung and kidney studies of that particular med.

Testers, the Times article notes, claim that one major cause of the problem is that "people in minority groups tend to have lower incomes and less education, and therefore less awareness of medical studies and how to find them."

Another reason may be that many live in areas that don't have easy access to a prime cancer center.

Dr. Julie R. Brahmer

Moreover, the piece goes on to quote Dr. Julie R. Brahmer of the Johns Hopkins Kimmel Cancer Center as saying, "minority patients with cancer are more likely to have other, poorly controlled chronic diseases like diabetes, that make them ineligible for studies."

In addition, some financial hurdles may be impossible to surmount — "frequent trips to the hospital, requiring time off work and expenses for travel, parking and child care. Some doctors simply assume that lower-income, minority patients could not afford it."

The irony, the Times indicates, is that clinical trials, which usually provide expensive drugs and treatments without charge, "can be a lifeline" that offer "huge advantages" such as "new treatments that may otherwise be unavailable."

Information about cancer research can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

N.Y. Times story tells of 'tumors melting away'

Experimental immunotherapies now sometimes replace chemo as a treatment for cancers

Immunotherapy.

Long word. Comparatively short history.

But one suddenly filled with lots of promise about fighting cancer.

A recent story by Denise Grady in The New York Times deals with how a patient's own immune cells may now help — even when standard treatments fail.

The experimental treatment, according to the article, has resulted in "remarkable stories of tumors melting away and terminal illnesses going into remissions that last years."

Those stories, Grady writes, are backed "by solid data [and] have led to an explosion of interest and billions of dollars of investments…Pharmaceutical companies, philanthropists and the federal government's 'cancer moonshot' program are pouring money into developing treatments."

The explosion, the story continues, "has brought new optimism to cancer doctors — a sense they they have begun tapping into a force of nature, the medical equivalent of splitting the atom."

Dr. Jedd Wolchok

The Times quotes Dr. Jedd Wolchok, chief of melanoma and immunotherapeutics services at Memorial Sloan Kettering Cancer Center in New York City, as saying, "This is a fundamental change in the way that we think about cancer therapy."

Immunotherapy — which "tries to help the immune system recognize cancer as a threat, and attack it" — now sometimes replaces chemotherapy, which attacks cancer cells more directly.

Two new techniques stand out.

The first "creates a new, individualized treatment for each patient by removing some of the person's immune cells, altering them genetically to kill cancer and then infusing them back into the bloodstream."

The second involves mass-produced drugs (called checkpoint inhibitors) "that do not have to be tailored to each patient. [They block] a mechanism — called a checkpoint — that cancer uses to shut down the immune system."

Those drugs are not cheap — they cost about $150,000 a year.

And that's not the biggest downside.

Grady notes that "immunotherapy has worked in only a minority of patients, and researchers are struggling to find out why."

Immunotherapy and other treatment innovations are addressed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.