Immunotherapy Gives Hodgkin Lymphoma Patient a Second Chance

May 26, 2017 | by Samantha Bonar

Mark Paolera Mark Paolera, Hodgkin lymphoma survivor
Four years ago, Mark Paolera, now 39, was busy enjoying a typical active California lifestyle, including mountain biking, hiking and deep-sea fishing.
 
The San Diegan loved lifting weights and going out for a beer with friends and family, exploring the San Diego food scene (“Taco Tuesday is a holiday to me”), going on road trips “and other fun stuff.” 
 
He was also occupied with growing his business, an ecofriendly cleaning company that specializes in window cleaning called Green Earth Window Services. After years of trying, he had found a way of making a living that “allowed me to be outside and also make people smile.” After a few years in business, “I finally felt I was on my way to being a success,” he said. 
 
But for a few years he had been having “an odd feeling in my chest, but nothing very painful.” By November 2013 his symptoms had worsened and included coughing, night sweats and lumps in his neck. After a battery of tests, Paolera was diagnosed with Stage 2 Hodgkin lymphoma in May 2014. By June, he was receiving chemotherapy in an attempt to shrink a large mass in his chest.
 
“I knew there was something wrong, but when I heard they suspected lymphoma based on the X-ray and bloodwork, I felt deflated,” Paolera recalled. “I was scared of the treatments and also scared of the disease, which felt like a two-headed dragon coming at me from both directions, breathing fire. I cried for a bit, then collected myself and took the first steps in my journey.”
 
After two months of chemo, Paolera was told his lymphoma was in remission. He finished his treatment and started working in the field on some days with his crew. “Things were looking up,” he said.
 
Unfortunately, a follow-up scan in November 2014 showed his cancer had returned.
 
A stem cell transplant was Paolera’s next option. A week before his transplant process began in January of 2015, Paolera’s father died of a massive heart attack. “I was in bad shape, but knew I had to fight,” he said. He stuck to his fitness regime and was still doing trail runs up until the day he was admitted to the hospital for his stem cell transplant in May 2015. 
 
Recovering from the transplant was a “battle,” and Paolera was hospitalized for three weeks. On
Day 30, a PET scan showed he was again in remission. By July 2015, he was on a maintenance treatment, receiving chemotherapy infusions every 21 days to reduce the chance of relapse.
 
But another scan in November of 2015 revealed that the Hodgkin lymphoma was back, this time in Paolera’s lung. 
 
Frustrated by the options available at the time, Paolera decided to seek out clinical trials, which is how he ended up at City of Hope.
 
“My mom and I drove to City of Hope on a rainy day in January of 2016,” he said. “As I entered the hospital, I felt I had a chance again.” 
 
Paolera was told that the trial he was interested in was closed. But his City of Hope doctor, Robert Chen, M.D., a hematologist and oncologist and assistant professor in the Department of Hematology & Hematopoietic Cell Transplantation, explained that there was another option.
 
“He gave me more confidence and reassurance than I had felt in a long time,” Paolera said.
 
At City of Hope, Paolera began receiving immunotherapy, a form of cancer treatment that focuses on harnessing the power of a patient’s own immune system to fight the disease. It worked for a while, but then stopped being effective.
 
But great news was in the offing: nivolumab, an immunotherapy drug that was the subject of the clinical trial that Paolera had initially been interested in, had been approved by the Food and Drug Administration. Chen placed Paolera on the drug and after just three treatments, his cancer was once again declared in remission, in November of 2016. “I was literally in shock,” Paolera said. A scan last month showed he is still in remission.  
 
“I don't know what my future holds, and sometimes it scares me,” he said. “But today I am happy, healthy and I have hope — thanks to the amazing staff, doctors, nurses and selfless volunteers at City of Hope. I'm still running my business, lifting weights, hiking, biking and living.
 
“I've learned that life is a day-to-day event and things can change in a blink,” he added. “Cancer has made me slow down a few steps and think longer before I speak. My goals are to be a light in the lymphoma community, continue to appreciate my family and friends and to keep loving, living and learning. I would tell anyone in the fight to keep as active as they can, and to simply not give up.”
 

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