What We Know About Why Some People Never Get Covid 19

Americans who haven’t had covid-19 are now officially in the minority. A study published this week from the US Centers for Disease Control and Prevention (CDC) found that 58% of randomly selected blood samples from adults contained antibodies indicating that they had previously been infected with the virus; among children, that rate was 75%.

What is different about that minority of people that hasn’t yet gotten infected? Stories abound of close calls, of situations where people are sure they could have (or should have) gotten sick, but somehow dodged infection. Not all the questions are answered yet, but the question of what distinguishes the never-covid cohort is a growing area of research even as the US moves “out of the full-blown” pandemic. Here are the possibilities that scientists are considering to explain why some people haven’t contracted the virus.

They behave differently

We’ve seen it play out time and time again—some people adhere more strictly to protocols known to reduce transmission of the virus, including wearing a mask and getting vaccinated. Some people avoid large public settings and may have even been doing so before the pandemic, says Nicholas Pullen, a biology professor at the University of Northern Colorado. Then again, that doesn’t tell the whole story; as Pullen himself notes: “Ironically, I happen to be one of those ‘never COVIDers’ and I teach in huge classrooms!”

They’ve trained their immune systems

The immune system, as any immunologist or allergist can tell you, is complicated. Though vaccination against covid-19 can make symptoms more mild for some people, it can prevent others from contracting the illness altogether.

Growing evidence suggests that there may be other ways that people are protected against the virus even without specific vaccines against it. Some could have previously been infected with other coronaviruses, which may allow their immune systems to remember and fight similarly shaped viruses. Another study suggests that strong defenses in the innate immune system, barriers and other processes that prevent pathogens from infecting a person’s body, may also prevent infection.

An innate immune system that’s already not functioning as well due to other medical conditions or lifestyle factors such as sleep or diet may put a person at higher risk of getting sick from a pathogen. There’s not single answer here yet, but initial studies are intriguing and may offer avenues for future treatments for covid-19 and other conditions.

They’re genetically different

In the past, studies have found interesting associations between certain genetic variants and people’s susceptibility to communicable diseases such as HIV, tuberculosis, and the flu. Naturally, researchers wondered if such a variant could exist for covid-19. One June 2021 study that was not peer reviewed found an association between a genetic variant and lower risk of contracting covid-19; another large-scale study, focused on couples in which one person got sick while the other didn’t, kicked off in Oct. 2021.

“My speculation is that something will be borne out there, because it has been well observed that resistance embedded in genetic variation is selected in pandemics,” Pullen says. But most experts suspect that even if they are able to identify such a variant with some certainty, it’s likely to be rare. For now, it’s best for those who haven’t gotten covid to assume they’re as susceptible as anyone else. Whatever the reasons some people haven’t yet gotten sick, the best defense remains staying up to date with vaccinations and avoiding contact with the virus.

Source: What we know about why some people never get covid-19 — Quartz

“Being exposed to the SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” study author Rhia Kundu said in a statement, using the scientific name for the coronavirus. “We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.”

The study, which examined 52 people who lived with someone who contracted the coronavirus, found that those who didn’t get infected had significantly higher levels of T cells from previous common cold coronavirus infections. T cells are part of the immune system and believed to protect the body from infection. “Our study provides the clearest evidence to date that T cells induced by common cold coronaviruses play a protective role against SARS-CoV-2 infection,” study author Ajit Lalvani said in a statement.

Researchers cautioned that the findings should not be relied upon as a protection strategy. “While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone,” Kundu said. “Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.” And the findings on the subject have been inconsistent, with other studies actually suggesting that previous infection with some coronaviruses have the opposite effect.

A major question that has come from the so-called ‘never COVID’ group is whether genetics plays a role in preventing infection. In fact, the question has spurred a team of international researchers to look for people who are genetically resistant to COVID-19 in the hopes that their findings could improve therapeutics. “What we are doing essentially is that we are testing the hypothesis that some people might not be able to get infected because of their genetic and inborn makeup, meaning that they might be genetically resistant to COVID,” says Spaan, who is a member of the COVID Human Genetic Effort.

The effort has sequenced genetic data from about 700 individuals so far, but enrollment is ongoing and researchers have received thousands of inquiries, according to Spaan. The study has several criteria, including laboratory test confirmation that the person has not had previous COVID-19 infection, intense exposure to the virus without access to personal protective equipment like masks and an unvaccinated status at the time of exposure, among others. So far, the group doesn’t know what the genetic difference could be – or if it even exists at all, though they believe it does.

“We do not know how frequent it is actually occurring,” Spaan says. “Is it like a super rare individual with a very, very rare mutation? Or is that something more common?” But the hypothesis is “embedded in human history,” according to Spaan. “COVID is not quite the first pandemic that we are dealing with,” Spaan says. “Humans have been exposed to viruses and other pathogens across time from the early beginning, and these infections have left an imprint on our genetic makeup.”

Those who haven’t gotten the coronavirus are “very much at risk,” says Murphy of Northwestern University. “I think every unvaccinated person is going to get it before this is over.” Experts stressed that research to determine why some people get COVID-19 while others don’t is still very much underway, and no one should rely on any of the hypotheses for protection. Instead, those who haven’t gotten the coronavirus should continue mitigation measures that have been proven to work, like vaccination and mask-wearing.

“You don’t ever want to have COVID,” Murphy says. “You just don’t know which people are going to get really sick from this and die or who’s going to get long COVID, which is hard to diagnose and difficult to treat and very real.” But with coronavirus cases on the rise and mitigation measures like mask mandates dropping left and right, it’s not an easy task.

COVID19: Face masks could return as cases spike Financial Mirror

06:48 Tue, 21 Jun
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Mutations In Animals Shed New Light on The Process of Aging

Genetic changes – known as somatic mutations – occur in all cells throughout the lifespan of an organism. While most of these mutations are harmless, some of them can impair normal cell functioning or even start a cell on the path to cancer.

Since the 1950s, scientists have speculated that these mutations may also play a role in aging processes. However, due to technological limitations, they could not properly test this hypothesis.

Now, a research team led by the Wellcome Sanger Institute has analyzed the genomes of 16 mammal species – ranging from mice, rats, and rabbits to horses, tigers, and giraffes – in order to shed more light on the role of these genetic changes in ageing.

They found that, despite huge variations in lifespan and size, different animal species tend to end their natural life with surprisingly similar numbers of somatic mutations. However, the results suggest that the longer the lifespan of a species, the slower the rate at which the mutations occur, thus lending support to the hypothesis that somatic mutations may play a crucial role in ageing.

“To find a similar pattern of genetic changes in animals as different from one another as a mouse and a tiger was surprising. But the most exciting aspect of the study has to be finding that lifespan is inversely proportional to the somatic mutation rate,” said study lead author Alex Cagan, a postdoctoral researcher on somatic evolution at the Wellcome Institute.

“This suggests that somatic mutations may play a role in ageing, although alternative explanations may be possible. Over the next few years, it will be fascinating to extend these studies into even more diverse species, such as insects or plants.”

“Animals often live much longer in zoos than they do in the wild, so our vets’ time is often spent dealing with conditions related to old age. The genetic changes identified in this study suggest that diseases of old age will be similar across a wide range of mammals, whether old age begins at seven months or 70 years, and will help us keep these animals happy and healthy in their later years,” added study co-author Simon Spiro, a wildlife veterinary pathologist at the Zoological Society of London.

Nevertheless, understanding the exact causes of ageing remains an unsolved question. Although somatic mutations appear to play a fundamental role in ageing, other processes such as protein aggregation and epigenetic changes are also likely to contribute to the molecular damage in our cells and tissues that is a well-known marker of old age. Further research is needed to compare the rates of all of these processes across species with different lifespans.

By Andrei Ionescu

Source: Mutations in animals shed new light on the process of aging • Earth.com

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By Catherine Barnette

Mutations can occur during the life of an animal (acquired—affecting only a single cell) or can be inherited from a parent (present in all of the body’s cells). When a cell is affected by a mutation, all cells arising from that cell are likely to carry the mutation. In the case of an acquired mutation, this may be only a small number of cells. In the case of a reproductive cell, the mutation will affect all of the offspring’s cells.

The effects of mutations depend on the size and location of the mutation. Much of an animal’s genetic code consists of what is called non-coding DNA. These non-coding regions do not contain genes that code for protein production. Mutations in this area may have no effect on the animal or its offspring.

If an acquired mutation occurs in a coding region of DNA, the effects will vary depending on the mutation. Perhaps the most concerning effect of an acquired mutation is the formation of cancer. For example, solar radiation damage can lead to cell mutations that may result in squamous cell carcinoma or other cancers.

Inherited mutations are mutations that occurred in a parent animal’s reproductive cells. These mutations are part of the genetic code that is found in every one of the offspring’s cells. For this reason, inherited mutations can have significant effects if found in vital, coding regions of the DNA.

A marker is a specific segment of DNA with known characteristics. While the specific sequences may vary between individual, there is enough consistency in the genetic code at that particular site on the genome to allow comparison between individuals. Markers are often located in non-coding areas of the DNA where a specific base pattern repeats many times and these repeating segments are known and mapped.

When a mutation occurs in a marker region, the mutation can be easily identified because the normal pattern of the repeating segment is known. Even if the marker region is located in non-coding DNA and the mutation has no visible effects, analyzing the marker region will allow scientists to see that a mutation has occurred.

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What Old Dogs Can Teach Us About Aging

For many of us, our dogs are our constant companions. Whether collie or retriever, purebred or mutt, dogs climb mountains with us, travel on airplanes with us, and eat the scraps off our plate.  

And as we get older, so do they. In fact, dogs experience a lot of the same age-related changes that humans do, from greying hair and creaky joints to more serious conditions like cancer or cognitive decline. Today, scientists are learning how comparing different dog breeds can give us new insights into the aging process — for both our canine companions and their owners. 

Old Dogs, New Tricks

One major project currently underway is the Dog Aging Project. Headquartered at the University of Washington, the project is working with dogowners across the country, gathering info about their pets’ lives, lifespans and medical ailments.  The project has more than 32,000 dogs already enrolled, though co-director Daniel Promislow says it’s kind of just getting started. “Over this past year, we’ve sort of launched into the next phase, which is pretty exciting,” says Promislow. One key development:

Building out their logistics network, like where to store computer data and physical samples and how to make that data easy to sort through. The second development? Time.  The scientists behind the project hope that this wealth of data could soon be used to see which health problems are commonly found together, and even figure out how long problem may lead to another.

 “Once we move into this longitudinal phase, which we’re now doing, we can identify how something that happens early in a dog’s life eventually impact his health late in life. That’s the real power of discovery,” says Promislow. “Years in the future, a veterinarian could enter some information about the clinical history of a dog and know that a particular diagnosis was more or less likely.” 

They’re also collecting DNA samples from the dogs, which could help reveal the underlying genetic causes of disease. Beyond that, dogs in particular present a rare opportunity for researchers thanks to the artificial selection pressures that have shaped them.

It’s All in the Genes

Exactly when and where dogs were first domesticated is a matter of debate, but scientists think it was at least 14,000 years ago. Since that fateful day, breeders have shaped our canine companions by repeatedly choosing for specific traits like intelligence, attitude, or speed. The signs of this artificial selection and in-breeding are visible in dogs genetics or, more specifically, the amount of variation in their genetics.

“Across all dogs, it’s about the same as us genetically,” says Promislow. “But within a single breed it’s like having a whole bunch of full siblings. Or even closer.” This means that specific breeds of dogs may have traits built into their genes.

Variation in a gene known as IGF1, for instance, accounts for nearly half of all size differences between breeds.  What does this actually mean for researchers, though? Essentially, if a particular problem shows up frequently in a given breed, it may be due to something in that breed’s genes.

The IGF1 gene has been implicated as influencing both size and lifespan, possibly helping explain why large dogs tend to die younger than small ones, though it’s still being researched. Meanwhile, variants in a gene called SLC2A9 may be behind the high rate of urinary problems in Dalmatians, whereas a gene region called CDKN2A/B could contribute to the high rate of certain cancers in Bernese Mountain Dogs.  

Looking at cancer in particular helped kickstart another major project, the Golden Retriever Lifetime Study, says geneticist Janet Patterson-Kane, the project’s principal investigator.

The research team has recruited a one-time cohort of over 3,000 golden retrievers and have been going since 2012. By looking at just one specific breed, they can zero in on the effects of individual genes.  Plus, the fact that researchers are studying one breed helps them see things beyond just genetics, as well.

Because the dogs are quite similar genetically, you may be more likey to tease out the influence of something environmental or dietary to their health, says Patterson-Kane. “There’s a power in taking dogs that are quite similar to each other, and then you’re looking at the factors acting upon that,” says Patterson-Kane. 

Lessons for Humans

What’s more, studying how dogs age could help us not only help our pets, but ourselves, too. The SLC2A9 gene that causes Dalmatian urinary problems also exists in humans, for example, and could be the target of future research.  And with regards to environmental exposure, because our canine companions get exposed to a lot of what humans do — like home pesticides, second-hand smoke, or even asbestos — and suffer the same problems humans do, a dog’s health may serve as warnings for their owners.

 Studies suggest that a pet dog contracting a type of lung cancer called mesothelioma could be an early warning sign of asbestos exposure for the humans in the household.  Both The Dog Aging Project and The Golden Retriever Lifetime Study are still ongoing, though the researchers behind the latter say they’re now coming to the end of many of their enrollee dogs’ natural lifespan. “We are losing a lot of dogs right now.

It’s just one of those sobering things,” says Patterson-Kane. “But those samples from those dogs are a legacy to those dog’s lives. And after they’re gone, we’re still going to be getting those samples out looking at that data.” The hope is that more researchers, not just veterinarians but also people in other fields, will be able to use the group’s data. 

The Dog Aging Project, meanwhile, is continuing to recruit new dogs. “The Dog Aging Project welcomes dogs of all ages, from puppies to geriatric dogs,” says Promislow, adding that the research project takes dogs from all around the country. “What better way to discover the cool things that science can do then, by doing it through this dog who you love and who’s a part of the family?”

By James Gaines

Source: What Old Dogs Can Teach Us About Aging | Discover Magazine

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Cancer Without Chemotherapy A Totally Different World

Dr. Seema Doshi was shocked and terrified when she found a lump in her breast that was eventually confirmed to be cancerous. “That rocked my world,” said Dr. Doshi, a dermatologist in private practice in the Boston suburb of Franklin who was 46 at the time of her diagnosis. “I thought, ‘That’s it. I will have to do chemotherapy.’”

She was wrong.

Dr. Doshi was the beneficiary of a quiet revolution in breast cancer treatment, a slow chipping away at the number of people for whom chemotherapy is recommended. Chemotherapy for decades was considered “the rule, the dogma,” for treating breast cancer and other cancers, said Dr. Gabriel Hortobagyi, a breast cancer specialist at MD Anderson Cancer Center in Houston. But data from a variety of sources offers some confirmation of what many oncologists say anecdotally — the method is on the wane for many cancer patients.

Genetic tests can now reveal whether chemotherapy would be beneficial. For many there are better options with an ever-expanding array of drugs, including estrogen blockers and drugs that destroy cancers by attacking specific proteins on the surface of tumors. And there is a growing willingness among oncologists to scale back unhelpful treatments.

The result spares thousands each year from the dreaded chemotherapy treatment, with its accompanying hair loss, nausea, fatigue, and potential to cause permanent damage to the heart and to nerves in the hands and feet.

The diminution of chemotherapy treatment is happening for some other cancers, too, including lung cancer, the most common cause of cancer deaths among men and women in the United States, killing about 132,000 Americans each year. Breast cancer is the second leading cause of cancer deaths among women, killing 43,000.

Still, the opportunity to avoid chemotherapy is not evenly distributed, and is often dependent on where the person is treated and by whom.

But for some patients who are lucky enough to visit certain cancer treatment centers, the course of therapy has changed. Now, even when chemotherapy is indicated, doctors often give fewer drugs for less time.

“It’s a totally different world,” said Dr. Lisa Carey, a breast cancer specialist at the University of North Carolina.

Dr. Robert Vonderheide, a lung cancer specialist who heads the University of Pennsylvania’s Abramson Cancer Center, remembers his early days on the job, about 20 years ago.

“The big discussion was, Do you give patients two different types of chemotherapy or three?” he said. There was even a clinical trial to see whether four types of chemotherapy would be better.

“Now we are walking in to see even patients with advanced lung cancer and telling them, ‘No chemo,’” Dr. Vonderheide said.

The breast cancer treatment guidelines issued by the National Cancer Institute 30 years ago were harsh: chemotherapy for about 95 percent of patients with breast cancer.

The change began 15 years ago, when the first targeted drug for breast cancer, Herceptin, was approved as an initial treatment for about 30 percent of patients who have a particular protein on their tumor surface. It was given with chemotherapy and reduced the chance of a recurrence by half and the risk of dying from breast cancer by a third, “almost regardless of how much and what type of chemotherapy was used,” Dr. Hortobagyi said.

In a few studies, Herceptin and another targeted drug were even given without chemotherapy, and provided substantial benefit, he added.

That, Dr. Hortobagyi said, “started to break the dogma” that chemotherapy was essential. But changing cancer therapies was not easy. “It is very scary,” to give fewer drugs, Dr. Hortobagyi said.

“It is so much easier to pile on treatment on top of treatment,” he continued, “with the promise that ‘if we add this it might improve your outcome.’”

But as years went by, more and more oncologists came around, encouraged by new research and new drugs.

The change in chemotherapy use is reflected in a variety of data collected over the years. A study of nearly 3,000 women treated from 2013 to 2015 found that in those years, chemotherapy use in early-stage breast cancer declined to 14 percent, from 26 percent. For those with evidence of cancer in their lymph nodes, chemotherapy was used in 64 percent of patients, down from 81 percent.

More recent data, compiled by Dr. Jeanne Mandelblatt, a professor of medicine and oncology at Georgetown, and her colleagues, but not yet published, included 572 women who were 60 or older and enrolled in a federal study at 13 medical centers. Overall, 35 percent of older women received chemotherapy in 2012. That number fell to 19 percent by the end of 2019.

Cheaper and faster genetic sequencing has played an important role in this change. The technology made it easier for doctors to test tumors to see if they would respond to targeted drugs. Genetic tests that looked at arrays of proteins on cancer cells accurately predicted who would benefit from chemotherapy and who would not.

There are now at least 14 new targeted breast cancer drugs on the market — three were approved just last year — with dozens more in clinical trials and hundreds in initial development.

Some patients have reaped benefits beyond avoiding chemotherapy. The median survival for women with metastatic breast cancer who are eligible for Herceptin went from 20 months in the early 1990s, to about 57 months now, with further improvements expected as new drugs become available. For women with tumors that are fed by estrogen, the median survival increased from about 24 months in the 1970s to almost 64 months today.

Now some are in remission 10 or even 15 years after their initial treatment, Dr. Hortobagyi said.

“At breast cancer meetings, a light bulb went off. ‘Hey, maybe we are curing these patients,’” Dr. Hortobagyi said.

Dr. Doshi’s oncologist, Dr. Eric Winer of the Dana-Farber Cancer Institute, gave her good news: A genetic test of her tumor indicated she would not get any significant benefit from chemotherapy. Hormonal therapy to deprive her cancer of the estrogen that fed it would suffice.

But as much as Dr. Doshi dreaded chemotherapy, she worried about forgoing it. What if her cancer recurred? Would chemotherapy, awful as it is, improve her outcome?

She got a second opinion.

The doctor she consulted advised a “very aggressive” treatment, Dr. Doshi said — a full lymph node dissection followed by chemotherapy.

She had multiple conversations with Dr. Winer, who ended up discussing her case with four other specialists, all of whom recommended against chemotherapy.

Finally, Dr. Doshi said, “my husband said I should just pick a horse and run with it.” She trusted Dr. Winer.

Her struggles mirror what oncologists themselves go through. It can take courage to back off from chemotherapy.

One of the most difficult situations, Dr. Winer said, is when a patient has far more advanced disease than Dr. Doshi did — hers had spread to three lymph nodes but no further — and is not a candidate for one of the targeted treatments. If such a patient has already had several types of chemotherapy, more is unlikely to help. That means there is no treatment.

It falls to Dr. Winer to tell the patient the devastating news.

Dr. Susan Domchek, a breast cancer specialist at the University of Pennsylvania, can relate to those struggles.

“It is the nature of being an oncologist to be perpetually worried that you are either overtreating or undertreating a patient,” she said.

“Some cases keep me up at night,” she said, “specifically the cases where the risks and benefits of chemotherapy are close, yet the stakes still feel so high.”

When Dr. Roy Herbst of Yale started in oncology about 25 years ago, nearly every lung cancer patient with advanced disease got chemotherapy.

With chemotherapy, he said, “patients would be sure to have one thing: side effects.” Yet despite treatment, most tumors continued to grow and spread. Less than half his patients would be alive a year later. The five-year survival rate was just 5 to 10 percent.

Those dismal statistics barely budged until 2010, when targeted therapies began to emerge. There are now nine such drugs for lung cancer patients, three of which were approved since May of this year. About a quarter of lung cancer patients can be treated with these drugs alone, and more than half who began treatment with a targeted drug five years ago are still alive. The five-year survival rate for patients with advanced lung cancer is now approaching 30 percent.

But the drugs eventually stop working for most, said Dr. Bruce Johnson, a lung cancer specialist at Dana-Farber. At that point many start on chemotherapy, the only option left.

Another type of lung cancer treatment was developed about five years ago — immunotherapy, which uses drugs to help the immune system attack cancer. Two-thirds of patients from an unpublished study at Dana-Farber were not eligible for targeted therapies but half of them were eligible for immunotherapy alone, and others get it along with chemotherapy.

Immunotherapy is given for two years. With it, life expectancy has almost doubled, said Dr. Charu Aggarwal, a lung cancer specialist at the University of Pennsylvania.

Now, said Dr. David Jackman of Dana-Farber, chemotherapy as the sole initial treatment for lung cancer, is shrinking, at least at that cancer treatment center, which is at the forefront of research. When he examined data from his medical center he found that, since 2019, only about 12 percent of patients at Dana-Farber got chemotherapy alone, Dr. Jackman said. Another 21 percent had a targeted therapy as their initial treatment, and among the remaining patients, 85 percent received immunotherapy alone or with chemotherapy.

In contrast, in 2015, only 39 out of 239 patients received a targeted therapy as their initial treatment. The rest got chemotherapy.

Dr. Aggarwal said she was starting to witness something surprising — some who had received immunotherapy are still alive, doing well, and have no sign of cancer five years or more after their initial treatment.

She said: “I started out saying to patients, ‘I will treat you with palliative intent. This is not curative.’”

Now some of those same patients are sitting in her clinic wondering if their disease is gone for good.

Chong H. Hammond’s symptoms were ambiguous — a loss of appetite and her weight had dropped to 92 pounds.

“I did not want to look at myself in the mirror,” she said.

It took from October 2020 until this March before doctors figured it out. She had metastatic lung cancer.

Then Dr. Timothy Burns, a lung cancer specialist at the University of Pittsburgh, discovered that Mrs. Hammond, who is 71 and lives in Gibsonia, Pa., had a tumor with two unusual mutations.

Although a drug for patients with Mrs. Hammond’s mutations has not been tested, Dr. Burns is an investigator in a clinical trial involving patients like her.

He offered her the drug osimertinib, which is given as a pill. This allowed her to avoid chemotherapy.

Ten days later she began feeling better and started eating again. She had energy to take walks. She was no longer out of breath.

Dr. Burns said her lung tumors are mostly gone and tumors elsewhere have shrunk.

If Mrs. Hammond had gotten chemotherapy, her life expectancy would be a year or a little more, Dr. Burns said. Now, with the drug, it is 38.6 months.

Dr. Burns is amazed by how lung cancer treatment has changed.

“It’s been remarkable,” he said. “We still quote the one-year survival but now we are talking about survival for two, three, four or even five years. I even have patients on the first targeted drugs that are on them for six or even seven years.”

Mark Catlin, who is being treated at Dana-Farber, is one of those patients.

On March 8, 2014, Mr. Catlin, who has never smoked, noticed a baseball-size lump under his arm. “The doctors told me to hope for anything but lung,” he said.

But lung it was. It had already spread under his arm and elsewhere.

Oncologists in Appleton, Wis., where he lives, wanted to start chemotherapy.

“I was not a fan,” Mr. Catlin said. His son, who lives in the Boston area, suggested he go to Dana-Farber.

There, he was told he could take a targeted therapy but that it would most likely stop working after a couple of years. He is 70 now, and still taking the therapy seven years later — two pills a day, with no side effects.

He rides a bike 15 to 25 miles every day or runs four to five miles. His drug, crizotinib, made by Pfizer, has a list price of $20,000 a month. Mr. Catlin’s co-payment is $1,000 a month. But, he says, “it’s keeping me alive.” “It’s almost surreal,” Mr. Catlin said.

Gina Kolata

By:

Source: Cancer Without Chemotherapy: ‘A Totally Different World’ – The New York Times

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