Survivor Begins Opdivo and Yervoy Treatment for Mesothelioma
January 19, 2021
When I decided to stop mesothelioma treatment in July 2020, my focus was on preserving my quality of life.
Last year, my chemotherapy drug gemcitabine wasn’t making much of a difference, and I felt like I was out of options. I had even tried immunotherapy for a year without strong results.
I told my oncologist that I wasn’t interested in hospice. Not yet, anyway. I knew it might be an option down the line, but I wasn’t ready to give up the fight.
It was more important that I enjoy my days as they came and continued doing things independently.
Getting Started on a New Immunotherapy
Late last year, the FDA approved Opdivo and Yervoy in combination for mesothelioma. In the same month, I attended my nephew Tyler’s wedding, one of my long-term goals in my eighth year as a pleural mesothelioma survivor. Not an easy feat to accomplish during a global pandemic.
Once I heard about the new immunotherapy option, I was interested in giving it a try.
In 2019 I started Keytruda, an immunotherapy drug also known as pembrolizumab. I had turned to Keytruda as an option after a challenging experience with chemotherapy.
Unfortunately, the medication did little to manage my cancer, which led to my decision to discontinue treatment. I’ve always been open to new options, though.
When I learned about Opdivo and Yervoy, which also go by the generic names nivolumab and ipilimumab, I started discussing them with my doctor.
My oncologist believed that the new immunotherapy option wasn’t a good fit because I didn’t see results with Keytruda.
Thankfully, the pharmacist at my old treatment center knew the drugs weren’t precisely alike and helped me get a second opinion. In the world of cancer medicine, second opinions are one of the best ways to advocate for yourself.
That pharmacist, and my new oncologist, understood the value of pursuing a new treatment option. On Dec. 23, 2020, I received my first infusion of Opdivo and Yervoy immunotherapy.
Initial Experience with Opdivo and Yervoy
From my experience with Keytruda, I knew a bit about what to expect with immunotherapy. Side effects can show up at any time, and it varies for every patient.
Education is crucial for patients who are new to immunotherapy. The way it affects your body isn’t the same as chemotherapy and other treatments.
Patients have to look out for inflammation reactions, which could happen anywhere throughout the body. Pneumonitis in the lungs, gastritis in the stomach and colitis in the colon are some common reactions.
Immunotherapy regularly affects hormones, too. When I was on Keytruda, the doctors were continually adjusting my thyroid medication. I had a similar reaction with my first infusion of Opdivo and Yervoy, but this time with dizziness and vertigo caused by the pituitary gland.
On New Year’s Day, a week after my first treatment, I experienced severe vertigo. It was the type of symptom that I knew required a trip to the emergency department.
With my history of mesothelioma treatments, I have a pretty good idea which side effects are stable. Nausea and other mild issues are things I’ve come to expect – what I have, I have.
More importantly, when starting a new treatment you must be ready to identify any new or worsening side effects.
I told the emergency department doctor my entire mesothelioma health history, including what was new. Since the doctor had a clear picture of my current treatment, I could get a medication for my vertigo that wouldn’t interact with the immunotherapy.
I also made sure they checked my thyroid levels in case Opdivo and Yervoy had altered them.
After taking meclizine for a couple of days, my vertigo resolved and hasn’t returned. Since then, I’ve had my second treatment without significant issues.
Embracing New Mesothelioma Treatment
The immunotherapy treatments are very similar to my chemotherapy experiences. The medication is given the same way, through a vein or port. The nursing staff made me feel comfortable, and the whole appointment took about three hours.
My second appointment was a little longer since my doctor knew about the vertigo episode. The treatment required an additional signature for safety.
Since I started Opdivo and Yervoy, I’ve had slightly more shortness of breath and a little more fatigue, but I’m used to that. The treatment center had some initial concerns about me wearing a face shield instead of a cloth mask, but they were eventually accommodating.
I’m excited to start my journey with this new mesothelioma treatment. Whether my cancer responds to the new immunotherapy remains to be seen. The first scan will be three months after I started treatment.
Either way, I’m in good hands with a new health care team that’s willing to fight as hard as I am. If the choice to stop treatment comes up again, I’ll face it head on. Until then, I plan to keep living as well as I can and celebrating every day like a holiday.