Dear Rene and Edward Chee,
My NSCLC progressed after my 10th (20 weeks) Nivolumab infusion (mono therapy). To-date, I have done 15th Nivo infusion (as of June 20th).
My Oncologist has paused the Nivo treatment pending further biopsy test results. Thus far, I have experienced significant mouth ulcers and in my recent CT scan of July 4th,
mesenteric panniculitis was evident. Do you think the mesenteric inflammation & ulcers are associated with the Nivo treatment?. With this in mind, is it advisable to start Rene's regime of high dose omega 3?. Would high dose omega 3 exacerbate my current situation?.
As always, thank you in advance for your help.
Sincerely,
Raymond
We’re really sorry the cancer is growing during PD1. We wish you much strength as you make treatment decisions.
PD1 side effects:
I’m not familiar with ulcers and mesenteric inflammation during PD1 treatment. But in general with PD1, inflammatory side effects are common.
Omega 3
Omega 3 may quell inflammation. However, often if there are inflammatory side effects, doctors may prescribe steroids. If steroids are prescribed, it will be better not to do omega 3 due to the additive effect. Be cautious with omega 3 when there may be procedures done where there’s a bleeding risk.
We recommend rereading Chapter 16:
- the immunotherapy strategy that we would do if my cancer were to return,
- the problems of PD1 monotherapy (Section "First, the early trials that validated PD-1")
- importance of a multipronged strategy – since you’ve been on PD1 for a while, perhaps something to consider is to generate T cells against cancer. Chapter 16, Table 3 has a list of treatments for generating T cells against the cancer. Also revisit the example of the melanoma patient who failed CTLA4 and PD1, and only had tumor shrinkage after radiation and PD1 (Chp 11, Section "Radiation: An Immunotherapy Accessible to All").