Personalized Cancer Treatment

Treatment Gets Personal

One size just doesn’t fit all anymore. Not, at least, when it comes to treating cancer.

Using factors such as a person’s cancer type, disease stage and tumor marker testing results, as well as the person’s age and overall health, physicians are tailor-making treatments and generating increasingly positive results. The traditional treatment options — surgery, radiation therapy and chemotherapy — are now being used in combination with hormone treatment and targeted therapy to battle disease on several fronts. Here, two people with cancer tell their stories about their experience with personalized medicine to fight against cancer. Their stories illustrate the pros and cons of the new and developing approach of personalized cancer therapy.


Needed to Survive

Lori Lober’s inspirational story embodies the power of a positive attitude, being proactive in the search for treatment answers and a strong faith in God. After being misdiagnosed three times, Lori was diagnosed in 2000 with Stage IV breast cancer with metastasis to the liver.

She and her husband, John, went to a comprehensive cancer center where they were given hope. Lori was HER2+ (positive) and qualified for a clinical trial that was testing the newly approved targeted therapy drug trastuzumab (Herceptin) for another indication. Chemotherapy, surgery and additional treatments followed.

Lori continues to take Herceptin regularly. Eleven years later, at age 49, she remains medically diagnosed as No Evidence of Disease. She and John own a custom home-building company and are also distributors for Isagenix Nutritional Cleansing and Replenishing products. Lori has written three books about her experiences, which can be found on her website, She has two stepsons and one son who passed away in 2005.

When I was diagnosed with Stage IV breast cancer with metastasis to my liver in 2000, I was given a 3-percent chance to live for five years. The traditional FDA-approved therapy offered me little or no hope. That was the worst day of my life.

The oncologist then said, however, that he had one place left in a clinical trial with a drug called trastuzumab (Herceptin) and I would be perfect for it. I said yes—and I didn’t even know anything about clinical trials. I believe I was led to that trial. I don’t think there are any accidents when it comes to something like this. We had walked into the doctor’s office with fear and left with hope.

In the late 1990s, I knew something was wrong with my body. I was told, however, after my third mammogram that there was no sign of cancer and to come back when I was 40. I was 38 and had been chasing this for two years.

I persisted, and finally after a positive biopsy, I went to a comprehensive cancer center, where I was accurately diagnosed. That’s where I was told about the clinical trial. It was specifically for women who were HER2+ and had late-stage metastatic breast cancer. In the trial, I took a preadjuvant docetaxel/Herceptin chemotherapy cocktail for six months before my mastectomy surgery. They wanted to make sure the metastasis was shrinking before they even worried about the breast tumor—and it did.

I had successful experimental radiofrequency ablation on my liver and later had a double mastectomy with no reconstruction. After I recovered, my oncologist prescribed the traditional FDA-approved doxorubicin, cyclophosphamide, 5-fluorouracil regime. Finally, I had four rounds of vinorelbine.

When the trial and the traditional therapy were completed, I wanted to know what else was out there. So I went on the Internet and found another clinical trial that involved a cancer vaccine. I took the information to my oncologist, and after further testing, they accepted me. In my mind, this was dotting the i’s and crossing the t’s.

In addition to my traditional medical treatments, I added complementary modalities from the very beginning. I found a nutritionist at a holistic center and had therapeutic massage, reflexology, acupuncture and colonics.

After nearly two years, I was given the good news that the hard work had paid off and there was no evidence of disease. I couldn’t have been more thankful. My cancer journey had not been easy, and in some ways, it was just beginning.

I continue to take Herceptin, and every three weeks I have a triple-dose infusion. I am vigilant about my good health and believe it’s not just any one thing. It’s the Herceptin, thinking positive thoughts each day, taking Isagenix supplements, exercising regularly and giving thanks to God for my husband, my family and wonderful doctors. They all work in harmony. I am also passionate about biotechnology and even had my photo taken with the men who were directly responsible for creating Herceptin.

Almost 13 years later, I truly feel like I am stronger and healthier physically and emotionally than I have ever been. I get up each morning with a purpose because I know what it’s like to have no hope, and I want to give hope to as many people as I can each day.


Successfully Treated with Targeted Therapy

When Maki Inada, PhD, was diagnosed with Stage IIIB non-small cell lung cancer in 2008, it was completely unexpected. She was healthy and exercised regularly and had never smoked. The doctors quickly discovered that the cancer was caused by a mutation in the epidermal growth factor receptor (EGFR) gene.

Her cancer was successfully treated using the targeted therapy drug erlotinib (an EGFR inhibitor), along with systemic chemotherapy and surgery. Four years later, in the summer of 2012, Maki had a recurrence in the same lung. But after a second lung surgery, she is currently cancer-free.

Maki and her husband, Dr. Jeff Pleiss, live with their 18-month-old daughter in Ithaca, N.Y., where they enjoy hiking, running, biking and swimming. Both Maki and Jeff are biology professors, and Maki speaks often about her cancer experience, particularly with her students.

My husband and I had just moved to Ithaca in 2007 from San Francisco. In January, I caught my first cold and had a cough that would not go away for several weeks. I had not yet found a primary-care physician, so my husband suggested that I go to the convenient care clinic.

Luckily, the nurse on call took an X-ray and found a large abnormality, which was a shock. She kept asking me if I had ever smoked. I had not. They gave me antibiotics and told me to come back in three weeks. The repeat X-ray looked the same, so they sent me for further testing. I had a CT scan, a CT-guided biopsy and a PET scan all within a few days and was diagnosed with non-small cell adenocarcinoma.

Luckily, my best friend from graduate school is a pediatric oncologist at a major cancer center. She called and got me an appointment right away with a renowned oncology specialist.

After my examination – and given my Asian, female, nonsmoker status – the oncologist suggested that I take erlotinib. He also recommended standard chemotherapy (carboplatin, taxol). In addition, I had a surgical biopsy in order to get enough of a sample for genetic testing.

This all happened very quickly. We were confident in the oncologist’s advice, so we followed his treatment plan. He worked with my oncologist in Ithaca, and I was able to have my treatment close to home.

I had four rounds of intravenous chemotherapy and 12 weeks of oral erlotinib. My chemotherapy infusion was given one day every three weeks. I was very tired during the days following treatment, but with the exception of my hair falling out, I only experienced mild diarrhea and mild acne side effects.

Originally, I was not a candidate for surgery because I was Stage IIIB. I had a 7-centimeter primary tumor in my upper left lobe and two smaller lesions in the lower lobe. The chemotherapy and erlotinib shrank my 7-centimeter tumor to smaller than 2 centimeters, so I was scheduled for an upper left lobectomy on July 2, 2008.

After surgery, I continued taking erlotinib for two years until the summer of 2010. I went off the drug both to avoid inducing resistance mutations but also in order to try to have children. I got pregnant right away and we had a healthy baby girl the following summer!

I was cancer-free and busy with a new baby, and I thought cancer was behind me. But in the summer of 2012, a routine scan discovered two small lesions in my lower left lobe. It was quite a disappointment. Thankfully, the doctors were able to resect a small portion of my lung to remove the lesions. While the recovery from this second surgery was physically less challenging, the emotional recovery has been a bit more difficult.

I feel like there were a few days when I was really, really scared, but Jeff is the eternal optimist and we tried to focus on other things. We try to stay active, and we have great support from our family, colleagues and friends.

I definitely believe targeted therapy is the way of the future for cancer treatment. I was very fortunate to fit the profile and then to have a treatment work so successfully. Of course I know there is no guarantee, but it keeps me focused on doing what is most important each day.


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