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Hope: Helping Your Immune System Fight Cancer

Samuel Slomowitz, MD Cancer

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I vividly remember taking a course in college during which an entire lecture was based on trying to find an all-encompassing definition of the word art. It turned out to be a very difficult task; in fact, we couldn’t find a singular answer that worked for everyone. What I took away from that experience was that the definition was both personal and abstract.

As a cancer doctor, I feel similarly about the word hope. Much like art, we all know hope when we see it, but it can be a very personal definition.

I have many hopes for my patients. I hope they will survive their illness. I hope they will tolerate their treatments. I hope they will cherish their friends and families. I hope I will help them live both better and longer. I hope that, at the end of their lives, they are surrounded by their loved ones. Above all else, I hope they receive comfort and dignity.

So how do I define this personal word hope? Very simply: I see hope as a desire to do better. As a provider, I hope for better options, better treatments. The past 50 or so years have been about chemotherapy and changing the combinations to fit each individual cancer type.

The past 10 to 15 years have been particularly exciting, as we have learned more about the genetics of cancer. This has enabled us to identify very specific mutations then design pills—targeted therapies—to treat those cancers even without chemotherapy. Although successful at times, the results have been far from universal and are slowing.

Although I don’t think we will be able to replace all chemotherapy or targeted therapies anytime soon, we have finally found a safe and reliable way to help patients’ immune systems fight the battle for us.

The concept is not new: People have been trying antioxidants, vitamins and herbs for years with the goal of boosting the immune system. Unfortunately, there has been little to no success in this area, and in some cases the approach actually makes the cancer worse. The immune system is exquisitely complex, and at least in industrialized countries, our immune systems are not failing due to lack of vitamins or minerals.

It turns out there is a complex balance between immune cells—whose job is to stimulate the immune system—and those cells that are trying to calm it down. Although it may seem strange to want less of an immune system, the fact is that if your immune system is too active, it can attack your own body, causing a large spectrum of diseases, some of which are life-threatening. My partner describes this as driving a car with one foot on the gas pedal and the other on the brake, and I can’t think of a more accurate analogy.

For decades, we have been taking the approach of pushing harder on the gas pedal. We have used various immune stimulants, some of which are so toxic they would make chemotherapy blush, and they have to be administered in a hospital intensive care unit. Even vaccine-based approaches have had limited success, despite recent press.

Then someone very smart stopped looking at how to push the gas pedal and instead asked how to cut the brake line. That turned out to be the billion-dollar question. The first drug to answer that question received FDA approval in melanoma.

Recently, we have seen two very exciting new drugs come to market, with clinical trials in most major cancer types. One of those drugs was just approved by the FDA in lung cancer, with several other cancers not far behind and growing at an exponential rate. The results have been truly exceptional.

Only time will tell how successful these new drugs will become. I think they are paradigm-shifting, and I am hopeful. I am hopeful they will enable me to treat my patients better. I am hopeful my patients will be able to live longer and better.

As a parting word, I also hope that as you read this, you will remember that cancer is best prevented and treated early, so I hope you’ll talk with your doctor about what cancers you should be screened for.

Samuel Slomowitz, MD, is board-certified in internal medicine, hematology and medical oncology and is on staff at Simi Valley Hospital. He has offices in Simi Valley and Thousand Oaks.