Written by S. Wang If my diagnosis were five years earlier, I wouldn’t be having this conversation, and more likely, if my diagnosis is going forward five years later. It would be a whole other conversation - Annette R. Listening to the Signs Annette’s cancer story started back in 2015. At that time, she was a full-time university professor, a treasurer for a non-profit board, and a partial caregiver for her mother. Life went well until several incidents while driving made her believe something was wrong with her body. She crashed the right-side tire into a curb and could not hook herself into the seat belt. So she contacted her physician immediately. Her ear, nose, and throat doctor told Annette that her balance was off. More severely, a radiologist said he saw a mass in Annette's brain after examining her MRI (Magnetic Resonance Imaging), recommended by an ophthalmologist. Annette then went to New York for the biopsy as the next step. Luckily the situation took a turn for the better. "The good news is, if there is good news, that it was a lymphoma which is treatable, and we found out that the rest of my body did not have any cancer in it'' said Annette. Enduring Cancer Treatment Annette got into a specialized cancer hospital in New York. From there, she learned that neither radiation nor surgery is necessary for lymphomas, but chemotherapy is a better option for her. However, there was a 60 or 70 percent chance for recurrence. The research team will conduct the stem cell transplant project to improve the recurrence. The treatment started with extremely intense chemotherapy, which wiped out everything in Annette's body. After that, the transfusion was followed by putting the stem cells back in. Annette stayed in the hospital for 45 days for several complications and another month of rehabilitation before she went home. She was too weak to contact people unless the visitors wore the mask. Annette constantly monitored her blood system in the following days and underwent two platelet transfusions. "I learned to give myself neurogenic injection for increasing my white cell count," Annette said proudly. She also went to the stage of nail replacement and hair regrowth. Advice for Cancer Patients from a Survivor After experiencing so many and still having the regular examination every half year, Annette summarized several pieces of advice for someone currently going through medical procedures. Be your own advocate. "If you hear something you don't understand, then don't be afraid to ask." Always bring someone with you. "Bring somebody with you at these meetings if you possibly can because it's tough to remember everything that's said while you go through all of this." Accept help. Let people help you. "So many people wanted to be of help, and my natural nature is to say 'No, Thank You.’ but it is really useful to have people help you, get you food, visit you. So, I believe having friends, family, and support is really important." The Impact of Investing in Cancer Research "If my diagnosis were five years earlier, I wouldn't be having this conversation, and [...]

After sending applications to over a dozen Physician Assistant programs across the country, 22-year-old Erin Janae Lynch was excited to welcome new adventures and changes into her life. She marked this new chapter by spending six weeks volunteering in Mozambique, embracing her passion for marine conservation. A few weeks before her departure, Erin noticed her lymph nodes were extremely swollen.  “My Primary Care Physician referred me to an Ears Nose Throat Specialist who did a needle biopsy,” Erin said. “The results were inconclusive, so we proceeded to do an excisional biopsy. I was diagnosed with stage 2 unfavorable Hodgkin’s Lymphoma on July 30, 2021.” Erin knew she would face changes in this next chapter of her life, but she never expected events to unfold quite like this. Given her aptitude for healthcare, Erin sought a second opinion to gain more clarity around this diagnosis. She soon visited Dr. Ryan Lynch (no relation) and learned of a clinical trial opportunity at Seattle Cancer Care Alliance. “Dr. Lynch told me along with standard treatment, I was eligible for this clinical trial,” Erin began. “He walked me through each treatment type and remained neutral while informing me of my options. Ultimately, I decided to consent to the clinical trial. I know these trials are the next best thing in the world of cancer treatment, and if no one participates in these trials, we can’t make any progress in finding better treatment options.” Soon after that, Erin started receiving AN+AD - two immunotherapy drugs (brentuximab vedotin and nivolumab) and two chemotherapy drugs (doxorubicin and dacarbazine) - all of which are IV infused through a port. The clinical trial investigates how well these drugs work to treat Classical Hodgkin’s Lymphoma and seeks to understand the related side effects.  “I experienced nausea, but it was controlled with Zofran, an antinausea medication,” Erin shared. “I also am experiencing fatigue. After my first infusion, I slept in until 11:30, a big difference for an early riser like me who wakes up at 7 am without an alarm. I had weird sensations of warmth, like a hot flash, while getting dacarbazine infused. I am still early in my treatment, so I haven’t experienced hair loss yet, but I am prepared for that to happen in the next week or so.” The past month threw more curveballs and unknowns at Erin than she had ever experienced before. Having no family history of cancer in any form, everything from the first biopsy was new territory for her and her family.  “I had a hard time with all the unknowns,” Erin reflected. “I am so grateful to have a background in biology and healthcare. That made it easier for me to understand what was going on. But it is hard to feel sick and not know what day you are going to feel better.” Through all the unexpected twists and turns, Erin maintains her positive and hopeful mindset, even when challenging. “It was really difficult seeing my family and friends upset,” Erin stated. “I felt like I was making everyone sad, but I was able to change my mindset and remember that [...]

A 61‐year‐old man with stage III Hodgkin lymphoma was hospitalized for the infection of Covid-19 in the UK. He was hospitalized for 11 days and did not receive any cancer treatment. Four months later, the PET-CT scan result showed that his lymphoma was largely gone! Left: Before, Right: After Everyone were suppressed, including his doctors and the scientists who saw the results, and no one knows what has caused the cancer remission if no anticancer drugs have been given during the course of his disease. After looking at a similar case in the US, doctors and scientists have concluded that the most probable reason of his remission is the combined actions of his immune system: for unknown reasons, the patient’s own immune system was activated by the Covid-19 infection, and the anticancer power of T-cells and natural killer cells was released. Together with their anti-viral functions, they attacked both Covid-19 infected cells and the lymphoma cells. Although this news is very exciting, it’s the only report so far regarding Covid-19 induced cancer remission. The chance of making the Covid-19 infection an anticancer therapy is extremely low as it’s dangerous and even life-threatening to most cancer patients. But what this rare case shows us is a future with hopes: the immuno-oncology drugs and immunotherapies currently under development may actually cure certain types of cancer in the near future. Cancer vaccine-based therapy is one of the options among those emerging immunotherapies. Using genetic engineering technology, scientists could identify unique neoantigens, a type of cancer specific molecules, and then create vaccines that enable the key immune cells, including T-cells, to recognize and kill those cells that carry the neoantigens. Just like what the virus infection did to the cancer patient, after the cancer vaccine is administered, the patient's own immune system will be activated and the T-cells and other immune cells will be taught and directed to recognize and destroy the cancer cells. Several cancer vaccines are currently being tested in clinical trials to see if the combination of cancer vaccines with immune-oncology drugs will bring better treatment effects than using the them alone. New drugs bring new hope. Ask your doctor about the cancer vaccine related therapies and find out if you could benefit from them. Related Video: References SARS‐CoV‐2‐induced remission of Hodgkin lymphoma. British Journal of Haematology; January2, 2021. https://doi.org/10.1111/bjh.17116 Complete spontaneous remission of diffuse large B-cell lymphoma of the maxillary sinus after concurrent infections. Clinical Lymphoma, Myeloma & Leukemia; 2012; 12:455– 8. https://pubmed.ncbi.nlm.nih.gov/23025990/ Individualized neoantigen vaccines. Nature Research; September 28, 2020. https://www.nature.com/articles/d42859-020-00026-3 Personalized cancer vaccine clinical trial to expand following promising early results. University of Arizona Health Sciences; November 10, 2020. https://www.sciencedaily.com/releases/2020/11/201110102550.htm