{"id":13560,"date":"2017-12-22T09:09:21","date_gmt":"2017-12-22T16:09:21","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=13560"},"modified":"2021-09-07T19:41:38","modified_gmt":"2021-09-08T01:41:38","slug":"she-was-given-two-years-to-live-max-that-was-four-years-ago","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/she-was-given-two-years-to-live-max-that-was-four-years-ago\/","title":{"rendered":"She was given two years to live with lung cancer, max. That was four years ago"},"content":{"rendered":"
<\/div>
\"Gail
Gail Sadler, second from left, with daughter Alexis, left, daughter-in-law Kathleen, daughter Shannon, and granddaughter Ava.<\/figcaption><\/figure>\n

It was the week of Thanksgiving, and Gail Sadler\u2019s daughter Alex was back from college for the holiday. Sadler, 52, a competitive tennis and volleyball player in her youth, had not slacked off since. They went to the gym and went hard. When Sadler was working her arms and back, she felt was a sharp pain in her right lat (that\u2019s latissimus dorsi<\/a> for you anatomists).<\/p>\n

\u201cThat\u2019s what you get for showing off, mom,\u201d Alex said.<\/p>\n

Fair enough. But this sort of thing was nothing new for this mom. \u201cI\u2019m always hurt at the gym, trying to push it,\u201d Sadler said.<\/p>\n

But the pain lingered. Her primary care doctor didn\u2019t like it and sent her off for tests. On December 4, 2013, the diagnosis: non-small cell lung cancer.<\/p>\n

Bad.<\/p>\n

It was stage 4, meaning that the cancer had spread, in Sadler\u2019s case from her left lung to her left hip to her right femur, to the T12 vertebra in her spine, to her sternum, to a spot behind her vocal cords.<\/p>\n

Worse.<\/p>\n

She was given six months to two years to live. This just before the holidays.<\/p>\n

\u201cHow can you have Christmas without mom being given a death sentence?\u201d Sadler asked with a laugh. This is a wry woman. And a fighter.<\/p>\n

C\u2019est la vie<\/em><\/strong><\/p>\n

She started with\u00a0chemotherapy. She decided she was going to live while she was dying. When the weather warmed up again, she took daughters Alex and Shannon, granddaughter Ava, son Cameron and his girlfriend Kathleen to Paris in May 2014 to see the French Open. It had been on Sadler\u2019s bucket list. Cameron added to the magic: he snuck off to a jewelry store, bought a ring, and proposed to Kathleen one night under the Eiffel Tower, with Gail and the girls all there for the big moment.<\/p>\n

\"This
Regina Brown, MD, is director of oncology at UCHealth Lone Tree Medical Center and a University of Colorado School of Medicine medical oncologist.<\/figcaption><\/figure>\n

Back home, back to reality, a second-line chemotherapy called docetaxel took her in its grip. She felt worse, she looked worse, the hair went, and it wasn\u2019t working. \u201cWhether the drug failed me or I failed the drug, I don\u2019t know,\u201d she said. In December 2014, a year into her fight, the brain scans came back with more bad news: a brain scan came back with a tumor. Advancing disease had cast its shadow on another Christmas.<\/p>\n

But unbeknownst to her, that previous September, the U.S. Food and Drug Administration had given Sadler and many others a gift: the agency had approved an immunotherapy called nivolumab (trade name Opdivo<\/a>). Immunotherapies tip off the body\u2019s natural defenses to cancers that have found ways to trick the immune system into letting those cancers take over. Nivolumab focuses on T-cells. Sadler\u2019s cancer was sending out chemical signals that fool T-cells into not attacking it; nivolumab blocks those signals so T-cells can go about their killer business. When immunotherapy works, the T-cells can wipe out cancer in ways the field of oncology could only dream of just a few years ago.<\/p>\n

\u201cImmunotherapy has really revolutionized life expectancy for patients,\u201d said Regina Brown, MD, Sadler\u2019s oncologist. \u201cWhen we\u2019re talking about non-small cell lung cancer, especially stage 4, those patients were lucky if they lived six months.\u201d<\/p>\n

Not quite a miracle<\/strong><\/p>\n

Brown is UCHealth Lone Tree Medical Center\u2019s<\/a> director of Oncology and a University of Colorado School of Medicine medical oncologist. She and colleagues prescribed Sadler nivolumab infusions every two weeks starting in June 2015. Earlier this month, Sadler had taken took what she described as \u201cmy 55th<\/sup> hit\u201d of Opdivo. Her scans were clean.<\/p>\n

\u201cIt\u2019s nothing short of a miracle,\u201d Sadler said.<\/p>\n

It\u2019s miracle-by-design. On the pharmaceutical end, there was the decade-plus development of nivolumab as well as the creation of molecular testing capable of determining which patients might benefit from nivolumab or other immunotherapies via straightforward blood tests. And at places like UCHealth Lone Tree Medical Center, there was the hard work of designing a tailored care path for each patient, one involving a lot more than a T-cell tickler.<\/p>\n

In the case of nivolumab, for example, chemotherapy comes first. Even if it doesn\u2019t take the cancer out completely, chemo shrinks tumors and makes nivolumab\u2019s job easier, Brown said. There are also different immunotherapies that can precede nivolumab \u2013 ones designed for cancers triggered by genetic mutations to the ALK gene (such as crizotinib\/Xalkori) or the EGFR gene (such as osimertinib\/Tagrisso). Sadler was also on a drug to slow the bone breakdown her cancer was causing, among others. There were visits with UCHealth lung cancer specialist Ross Camidge, MD, PhD<\/a>, neurosurgeon Kevin Lillihei, MD<\/a>, and radiation oncologist Brian Kavanaugh, MD, MPH<\/a>.<\/p>\n

Most importantly, Brown said, is that the miracle is not a silver bullet.<\/p>\n

\u201cPatients are able to live longer with better quality of life and less evidence of disease, but we don\u2019t have an option for the patient if the cancer comes back,\u201d she said.<\/p>\n

And Sadler has to keep taking Opdivo. Think of it as cancer as a chronic disease, Brown says, with Opdivo analogous to insulin.<\/p>\n

\"Gail
Sadler, on the \u0093up\u0094 of a lot of up-and-down at Red Rocks in February 2016.<\/figcaption><\/figure>\n

\u201cIf you stop the insulin, the diabetes is going to go crazy again,\u201d Brown said.<\/p>\n

All in the \u2018Tree<\/strong><\/p>\n

Sadler sees Brown and does her immunotherapy infusions at the Lone Tree Medical Center, where she and others benefit from care at a fully integrated branch of UCHealth\u2019s National Cancer Institute-designated Comprehensive Cancer Center based at the Anschutz Medical Center in Aurora. For tough cases like Sadler\u2019s, Brown calls into the weekly multidisciplinary lung cancer clinic at the Anschutz Medical Campus, which brings together medical oncologists, oncological surgeons, radiation oncologists, pathologists and radiologists to establish and adjust care approaches. With the full suite of PET, MRI, and CT scanners, chemotherapy stations and the UCHealth TomoTherapy Cancer Care Clinic \u2013 Lone Tree<\/a> a mile down the road, patients can receive all their care in Lone Tree.<\/p>\n

That\u2019s important, Brown said. In the first year alone, a cancer patient can expect the appointments, infusions, scans and tests to add up to 100 visits.<\/p>\n

\u201cI have been in the best hands possible from the minute I walked through the door,\u201d she said. \u201cThey\u2019re amazing.\u201d She described Brown as \u201cthe bomb.\u201d<\/p>\n

While a long way from Paris, Sadler\u2019s living her life while living. She works out; she climbs the Red Rocks Amphitheater steps, though a surgically repaired hip has slowed her down temporarily. She really, really enjoyed a wedding this past August, up in Aspen \u2013 her son Cameron\u2019s, the product of that Eiffel Tower proposal three years ago. He and Kathleen are coming in to spend Christmas with Sadler and family. It should be a merry one.<\/p>\n

\u201cI\u2019m still in the process of redefining myself in 2018 as a woman who\u2019s alive and healthy,\u201d Sadler said.<\/p>\n","protected":false},"excerpt":{"rendered":"

It was the week of Thanksgiving, and Gail Sadler\u2019s daughter Alex was back from college for the holiday. Sadler, 52, a competitive tennis and volleyball player in her youth, had not slacked off since. They went to the gym and went hard. When Sadler was working her arms and back, she felt was a sharp […]<\/p>\n","protected":false},"author":23,"featured_media":13568,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[28,168,6836,1727,170],"class_list":["post-13560","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-cancer-care-oncology","tag-chemotherapy","tag-lung-and-thoracic-cancer","tag-lung-cancer","tag-lung-cancer-program"],"acf":[],"yoast_head":"\nFour years ago, she was given two years to live with lung cancer<\/title>\n<meta name=\"description\" content=\"Surviving lung cancer was Gail Sadler's goal and immunotherapy drugs, which tip off the body's natural defenses to cancers, helped her do it.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/she-was-given-two-years-to-live-max-that-was-four-years-ago\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"She was given two years to live with lung cancer, max. 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