Don Stranathan: What Does Precision Medicine Mean for You?

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Topics include: Patient Stories and Treatments

Scientific progress can now tell us, down to a molecular level, what form a cancer is taking, and with this knowledge patients are then empowered to seek treatment that is appropriate for their condition. Tune in to hear from lung cancer survivor Don Stranathan’s own experience with a targeted approach to care that used his own health data to route his course of treatment. He also discusses what other methods are available through precision medicine that use practices tailored to a patient’s distinctive genetics, environment and lifestyle. 

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello.  Andrew Schorr on location in Palo Alto, California, in one of the medical education buildings for Stanford Medical School, and we're at the Stanford Medicine X Conference.  I'm with my friend Don Stranathan, who lives not too far. 

Don Stranathan:

Santa Rosa.  Couple hours. 

Andrew Schorr:

Yeah, not too far, in the Bay Area, and we've known Don for a while.  Some people in the lung cancer community consider the Don the godfather in lung cancer.  You've been living nine years now with stage IV lung cancer. 

Don Stranathan:

Right. 

Andrew Schorr:

And Don is with us and with Esther and our friend Sarah Kerruish.  We're about to do a panel discussion at this conference about precision medicine for me, what does that mean?  Well, Don and I have both had genetic profile tests for our cancers.  Don, do you feel that that's played a role in extending your life? 

Don Stranathan:

Definitely.  Because I was on a—I was actually on a targeted therapy for six years, and back when I was diagnosed in 2009 they weren't doing genomic sequencing on the tumors, so they just gave me the pill, and they assumed that I was EGFR because I responded to it. 

So in 2015 when I had progression, a new tumor in my left lung, they—I reached out to Foundation Medicine and had multiplex sequencing done on my tumor and found out, you know, I just got lucky all those years.  I never had the EGFR mutation and found out I didn't have any driver mutations at all.  So it actually made me, with that knowledge, I was a very good candidate for immunotherapy, and I've been on immunotherapy now for over two years.  I was on an Opdivo, nivolumab, and I just switched to atezolizumab (Tecentriq), Genentech's new chemotherapy because about a month ago I was having a hard time breathing, and I had three liters of fluid pulled out of my pericardial sac. 

Andrew Schorr:

Wow. 

Don Stranathan:

And again, and this is something new, Foundation Medicine is actually testing the pericardial fluid because there were malignant cells in the fluid, so they not only test tissue and blood now they're testing the pericardial…

Andrew Schorr:

…fluid. 

Don Stranathan:

Yes, definitely. 

Andrew Schorr:

So the name of the game for other patients in this age of science progress and seeing which therapy either approved or experimental lines up with what you got, you and your doctor need these sophisticated tests that are becoming available to see what is your version of that cancer, not just on day one but later, too.

Don Stranathan:

Right. 

Andrew Schorr:

Because it changes over time. 

Don Stranathan:

Right.  Tumors can mutate.  I have friends that had driver mutations like EGFR or no EGFL-R, and then seven years later they developed the alpha mutation, so what I tell people that are newly diagnosed, you know, a lot of the hospitals test for the standard mutations like EGFR-L, ROS1, but they don't go into detail.  They don't do what like my friend Bonnie Oddario always says, you've got to do a deep dive.  And they, Foundation and Garden, check for over 315 different mutations…

Andrew Schorr:

And the newest MP something, M70 and M—what's that other? 

Don Stranathan:

Well, there was an article I posted.  I posted a lot of my journey on Facebook and Twitter, but there was a new mutation they're finding.  It was a small panel, but they tested people with the MPN-2 and -4 mutation and found out that people that have that mutation that had been exposed to immunotherapy actually can have hyper-progression. 

Andrew Schorr:

Wow. 

Don Stranathan:

So it's important that information, you know, that you know what's driving your cancer.  Like my friend Matt always talks about if you don't know who is driving the bus you're in trouble, so you've got to know as much—you know, edge—information is power. 

Andrew Schorr:

Just talking about our friend Matt Ellefson, who is also a long-term survivor.  At one point I went to see my doctor at UC San Diego the other day, and I brought up this term "precision medicine."  And she was saying, well, Andrew, we need more precision in precision medicine.  But as we live longer as cancer patients, science is moving forward too.  So we're identifying new genes, we're developing new medicines, new medicines are in trials, and they're learning what may line up with what. 

So your job—and this is what we're speaking about here at Stanford is the job of the healthcare consumer affected by cancer now is to really push to make sure that you get the ample testing and now at the genetic level so that you and your doctor know what is your specific situation.  Did I get it right? 

Don Stranathan:

Correct. 

Andrew Schorr:

Okay.  So that's our message.  Don's message.  It's keeping him alive, it's helped me with my leukemia and myelofibrosis so I get the right treatment, and we wish you the same.  Thanks for being with us.  On location in sunny Palo Alto, California, at the Stanford University and the Medicine X Conference, I'm Andrew Schorr with Don Stranathan.  And as he said, knowledge not only is power but can be the best medicine of all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on October 25, 2017