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Karin Wenger * was in Thailand during the summer holidays when she realized
that something was wrong with her body: despite the good food she had little appetite. Until then, the 55-year-old still had something in his line
have to be careful to keep their desired weight, but now she has suddenly taken to the inside
little time several kilograms. When a cough became more severe and she was visiting the family doctor on her return, she discovered something that did not belong to her and sent Wenger to Basel Teaching Hospital
. Diagnosis: Wenger's lung developed a malignant tumor, a so-called non-small cell
Bronchial carcinoma that already affects a lymph node and metastases
he was trained on the adrenal glands. "My first instinct was: This thing has to come out immediately," recalls Wenger. But although the tumor is about three centimeters
The diameter was relatively small, surgery was out of the question – it was too close to the airways.
Heavy chemotherapy has pushed back the malignant cells a little,
A slightly less maintenance treatment should control cancer
hold. But then something happened sooner or later in this type of cancer
always happens: he became resistant to drugs and continued to grow. if
strong as Wenger at the end of March 2015, suddenly had little air. for her
Support the airways and keep it open until further notice has become its prompt
Stents used, a kind of wire mesh tube. Primary tumor in
The lungs were irradiated several times in April, at least for its rapid growth
stop for the moment. Wenger 's body reacted strongly, chronic pneumonia and 41 degrees Fieber tied him to bed for four weeks, only high doses of cortisone and antibiotics brought relief. Once again, the question arises: what to do next?
Recognizing Cancer Cells
Alfred Zippelius, Deputy Chief Medical Officer, Oncology, University Hospital
Basel, who has accompanied Wenger from the beginning, introduced him to the choice: another
Chemotherapy cycle, associated with strong side effects and luck
only 10 to 15 percent that she will answer. Where the
Try to stop cancer with the help of immunotherapy. The goal of chemotherapy is to use as many cancer cells as possible with the help of toxic substances
with the side effect that even healthy body cells die.
"In some patients who respond to immunotherapy, the tumor disappears completely."
Alfred Zippelius, Oncologist
Immunotherapy, on the other hand, is not targeted directly at cancer. On the contrary, she tries this
Allow the patient's immune system to recognize and recognize the cancer cells themselves
to face them. Again, there can be side effects, because sometimes the unleashed immune system attacks cancer instead of
Body on, for example, rashes or sometimes dangerous
Inflammation of the lungs, intestines, liver or thyroid gland can lead to it.
Nevertheless, immunotherapy is promising: in 2013, the journal "Science" called it "breakthrough of the year". Alfred Zippelius also speaks of a long-awaited breakthrough in oncology. Although he admits, "Unfortunately, immunotherapy can only help a minority of patients." For lung cancer, it is 20 to 25 percent, for other types of cancer between 30 and
40 percent who have immunotherapy. And there are also cancers like
Pancreatic cancer, for example, where up to now, no success
achieved. However, Alfred Zippelius points out: "Patients who respond to immunotherapy often respond with persistence.
the tumor completely, for some it just does not grow further. "For a long time, we, the immunologists, were outsiders in oncology," explains Daniel Speiser.
Doctor and immunologist. For cancers such as skin cancer or lung cancer, which were previously safe death sentences, there are now patients still alive after five to ten years. "
" Immunologists have long been cancer patients in oncology. " Daniel Speiser, Physician and Immunologist
That the body can help itself in the fight against cancer is not a new knowledge." Already in the 1890s, the New York surgeon William observed
Coley that sarcomas – malignant tumors of connective tissue – at individuals
Patients disappeared after having a high bacterial infection
Had a fever. As a result, he injected killed bacteria directly into
tumors of his patients and therefore caused a cure for some. 1909
German doctor and researcher Paul Ehrlich has expressed the thesis that
the human immune system can detect and destroy cancer cells.
However, it took more than 100 years for the first immunotherapeutic drug to enter the market. For decades, researchers in Germany and abroad have been working on various approaches, without the hope of breakthrough has come. "For a long time, we, the immunologists, were outsiders in oncology," explains Daniel Speiser.
Doctor and immunologist at the Ludwig Cancer Research Center and the Department of
Oncology of the University of Lausanne. He's been on the subject since the 1980s,
as one of the first in Switzerland
First Successes
He was not discouraged by critical voices and skeptics. Already as a young boy
Doctor at the University Hospital of Geneva, he had seen with his own eyes, what
The role of the immune system plays in patients with leukemia: after a bone marrow transplant, he repeatedly saw patients who would have died shortly after treatment because they were so full of leukemia cells. "But the opposite happened: in a few days, the donor's immune cells killed the leukemic cells and the patients became healthy again." Since then, he is interested in the immune system forces in the fight against cancer, even without transplantation [19659002] 
Williard Neals was suffering from advanced lung cancer: after irradiation of the tumor, the American received immunotherapy every two weeks, destroying the tumor. Photo: Getty Images
The first successes appeared ten or so years ago in the fight against blacks
Skin cancer. As in this cancer classic treatments such as chemotherapy
Radiotherapy has little or no effect, that it is always open here
Reinhard Dummer, head of the Skin Tumor Center at the University Hospital Zurich, had to experiment with new approaches. "I have treated several thousand patients in unsuccessful clinical trials." This has changed with the introduction of new immune antibodies. Shortly after the beginning of the millennium, he began to associate the first patients with clinical trials
treat. "The efficiency was not immediate, but after several years
we found that about 20 percent of the patients were still alive, in the control group
he was only 2 to 5 percent.
In 2011, the first immunotherapeutic agent was used in Switzerland for the treatment
approved by black skin cancer, meanwhile, there are already several. Patients with black skin cancer, cancer of the head and neck, kidney, bladder and
Lung cancer is treated today in Swiss hospitals by immunotherapy. Depending on the type of cancer, it is a first-line treatment or used concomitantly or after chemotherapy.
"I would have done almost anything to pay for this treatment." Karin Wenger, cancer patient
when Karin Wenger was confronted with the question of how to proceed
should, was in Switzerland, a single active ingredient on the market. And this one was
first approved for the treatment of black skin cancer. For patients with cancer
At the time, several clinical trials were underway to which Wenger could have participated. "It was out of the question for me," she says. "I did not want to risk being assigned to the control group and just getting standard chemotherapy." The only option left was the approved drug.
to pay out of pocket
With about 10,000 francs per infusion administered every two weeks,
a very expensive option. "Like Mr. Zippelius and the lung specialist at the time
I asked him what they would do for me. Mr. Zippelius said that he would sell the Mercedes that he did not have. I replied that if necessary I sell the BMW that I have. I would probably have almost everything
made to pay for this treatment. This little chance for a piece of more
of life.
The society must decide
Today the health insurance funds support the treatment of an immunotherapy
even with lung cancer. But the high cost of new cancer drugs
remains an unresolved problem. "The treatment of a single patient can
costs 100,000 francs a year, "says oncologist Alfred Zippelius.
"When multiple drugs are combined, even multiple times.
we will massively burden our health insurance. »The immunologist of Lausanne
Daniel Speiser says, "We need to use these expensive therapies because we use them
Save lives. But as we have at current prices in a few years
The pharmaceutical industry and health care must collaborate more closely. Daniel Speiser, Physician and Immunologist
Among other things, new pricing models are being discussed, so that expensive drugs are only paid should be, if they actually work and
prolong the life of a patient. "The pharmaceutical and health care industry urgently need to work more closely together, so that further development
is coordinated and costs can be better understood, "says Daniel
Speiser
Meanwhile, science is intensively investigating what we call biomarkers, that is,
Genes, molecules or cells that can be used to predict
how a disease develops or if a medicine works. "Currently
we still have no way to clearly predict who will receive immunotherapy
and who will not benefit, "said Ulf Petrausch, oncologist and immunologist
at OnkoZentrum Zurich. "In 60% of patients, expensive drugs are used for free."
"Society Must Decide: Do We Want to Give Patients New Expensive Drugs?" Ulf Petrausch, Oncologist and Immunologist [19659002Siàl'avenirseulslespatientstraitésparimmunothérapieétaienttraitésceuxquienbénéficieraientcelapermettraitd'économiserleseffetssecondairesdespatientsetlescoûtsélevésdescompagniesd'assurancemaladieSelonMPetrauschnilasciencenilesmédecinsnepeuventrésoudreleproblèmedescoûts"Enfindecomptelasociétédoitdécider:iscequenousvoulonsenvoyercesnouveauxmédicamentscoûteuxànospatientscontinueràselever?"
Karin Wenger has finally had its immunotherapy but not alone
Pay the bag. A pharmaceutical company has just had an early access program
for a drug yet to be approved, Alfred Zippelius has registered Wenger and other of his lung cancer patients. And already a few weeks
later came the commitment. End of May 2015 sank at Basel University Hospital
the first dose of the drug in Wenger's veins. The side effects were similar to those of chemotherapy; they were less tight, but they did not have it
after months new: debilitating fatigue, gastrointestinal problems, joint pain. His thyroid was inflamed and stopped working. but
cancer also responded: metastases had already decreased significantly in July.
After a few months they had completely disappeared and until today they did not come back. And this, although Wenger received the last infusion in February 2017. His lungs are severely healed by radiotherapy
and so not easy to judge, but to date cancer also seems
stay quiet there. Wenger's immune system keeps him in check.
"I was only one of the first lung cancer patients in Switzerland to receive immunotherapy." Karin Wenger, Cancer Patient
Fatigue is still preparing me today, "says Wenger. She needs ten hours of sleep each night, she has to
to go to bed again in the afternoon, she can not stay long at the same time
to focus, takes more time than before for everything. And the stents in their airways
during that time, they grew up, secretions and bacteria accumulate behind them
so Wenger has a chronic cough and inflammation. "But I live," she says. "I can adapt to side effects." And she adds:
"I was one of the first lung cancer patients in Switzerland, the one
Got an immunotherapy. Nobody has when they've used me stents
I'm waiting to survive so long. And without them, I would suffocate in a very short time, they are my rescuers.
* Name changed
(Swiss Family)
Date created: 23.07.2018, Date Posted: 20: 34 clock
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