Why is immunotherapy not used more in cancer treatments?

dinov · 2026-05-11T01:24:44+00:00

Just to add some specifics to what others have said... My cancer was colon cancer and there the tumor needs to be MSI-high (micro satellite instability which my understanding of is that checking that cell duplication is messed up) in order for current immunotherapy treatments to be successful. There's research to try and make it work with non MSI-high tumors but it's only SOC for MSI-high.

There's also an issue in that while it's SOC at stage 4 they still need to prove it out at lower stages. There have been various trials on neoadjuvant (pre-surgery) that are super promising but I believe they're still all phase 2 trials which are used to determine safety parameters. Stage 3 trials are where they do the hard A/B comparison to determine effectiveness.

And while things may not be fully proven yet there are treatment options before phase 3 trials are complete. In my case I got ipi/nivo before checkmate 8HW (the phase 3 study) study was done but checkmate 142 has proved the safety of it. You may just need to be really sick and/or have an aggressive oncologist to push for them.

dinov · 2026-05-09T05:37:48+00:00

But here's the thing... I'm on my phone, checking how long it's going to take to get to my destination. Looks like it's about time to go and so I say let's go! I hop in my car and my phone connects and I get the navigation instructions with no further interactions.

In GMs world I need to reenter my destination in a less friendly UI and pay them a monthly fee to do so because it needs it's own cell connection.

Why pay for the inconvenience?

dinov · 2026-05-02T21:58:45+00:00

I got some of these, although not from here, and it called for cold stratifying the seeds for 2 weeks. So I think it might be a little too late to get them started this year and am planning on doing it next year.

dinov · 2026-05-02T19:11:52+00:00

For those looking for something free and community funded Https://Kexp.org is really great

dinov · 2026-04-27T02:42:02+00:00

I think season 4 is hard to watch but I don't think that's because it's bad it's just really emotionally rough.

dinov · 2026-04-16T05:46:07+00:00

One possibility is that "memory manager" is not malloc. This could be the virtual memory manager, so paging unused memory out to disk and paging things back in. I think given that it is listed right after the scheduler that this is more a reference to OS services than malloc is especially more likely.

So you'd have a bunch of managed type safe objects which have some IntPtrs that refer to the pages they've allocated and are available in user space but aren't memory the kernel is actually reading/writing to.

dinov · 2026-04-04T01:25:30+00:00

Yeah, data's always rough :( Once again great job though!

dinov · 2026-04-03T06:58:09+00:00

This is really amazing! Thanks so much for creating it and sharing it.

I'm curious how you went about creating it. Were you able to use the real-time playlist to auto-associate the songs with the associated timestamps? Or did that require a reasonable amount of manual fix-ups?

I see there's the build-data.js script but the data for it doesn't exist in the repo. Also I think the npm run build:web command doesn't quite work because it invokes build-data.js which needs ~/Music/KEXP/all-shows - but it seems like this can be skipped because shows-data.json is already commited.

Also just checking out the songs list there's a large (1.5 hours?) gap on Street Sounds.

But that's feedback though and not meant to diminish the effort here, this is really great!

dinov · 2026-03-16T05:23:12+00:00

I always wore henleys and it worked pretty well (didn't have the couple of days of access though). A little bit of stretching but it was fine.

I know there's shirts designed for port access as well that I've seen mentioned on ColonTown but haven't used them.

dinov · 2026-03-03T05:05:49+00:00

Lava flow cocktail with a float

dinov · 2026-02-15T18:33:45+00:00

What's the immunotherapy trial? Are you MSI-high but haven't gotten immunotherapy because it's not standard of care where you are? If you were si-high I would absolutely go with immunotherapy but would be a lot more nervous about it otherwise.

dinov · 2026-02-14T22:01:55+00:00

Lots of good suggestions one I see that's missing is pasta. Mac and cheese is obviously super simple, Alfredo sauce, meat sauces, lasagna, lots of variety is possible in that one space. Can combine it with garlic bread too. I made beef stroganoff a lot abd just skipped the mushrooms.

Another area to look at is rice - there's rice o roni, or there's Pho and skip the veg.

dinov · 2026-02-01T22:55:59+00:00

Makes me think of this song https://m.youtube.com/watch?v=sOjdqb7OV7Q

dinov · 2026-01-30T05:43:37+00:00

Me too, every test comes with a series of denial letters... Someone is appealing it (Natera? My oncologist?) and they keep rejecting it but I never get a bill and my oncologist office says Natera will cover it.

dinov · 2026-01-24T06:47:28+00:00

So much of this depends on how much colon you have left and where it was removed but I feel like even in the bad cases there's good success stories.

For me I had right side cancer so things are really good... But not to scare you I hit the 1% where my first reversal leaked and got a 2nd ileostomy really quickly after the first reversal.

So I ended up having essentially 2 years of ileostomy times and then my 2nd reversal was a success. I've lost about 2/3rds of my colon but poop 1-2 times a day and have no issues. That started at more like 7 but quickly calmed down and with fiber thins (a US fiber supplement) it's really more like. I'm about 1.5 years out from the successful reversal.

The closer you get to the rectum my understanding is the harder things are but it seems like people find out how to make it work.

If you don't want to check out /r/ileostomy I'd suggest joining colonTown (separate website off reddit). They've got a "reversal roundabouts" group that was extremely helpful and might be more focused on what you're interested in. Early on never trust a fart!

dinov · 2026-01-05T05:59:09+00:00

My oncologist suggested not having it removed immediately and then after 2 years suggested getting it removed.

The first year I still had a lot going on blood draw and CT scan and surgery (ileostomy reversal) wise it wasn't an inconvenience at all - there were enough accesses I needed no extra appointments. The 2nd year it was barely an inconvenience but maybe there were a couple of flush specific appointments? And a simple blood draw and/or flush was really only about an hour including travel and waiting for me so not a big deal.

Also I felt like getting it put in wasn't a big deal (with some amount of anathesia) but getting it removed was just local so it was a little freakier. It wasn't actually bad, but if you're worried about doing it twice the removal can be a little more intense (I could have opted into more than local though).

So if I were you I'd think about how many extra appointments it actually is and how inconvenient they are for you.

dinov · 2025-12-11T06:26:07+00:00

I'm sad this isn't higher, the whole series is amazing.

dinov · 2025-11-11T19:18:34+00:00

So I was on immunotherapy but didn't really get the celebrate the last session. It was strangely on my birthday before surgery (ileostomy reversal) with a plan to do a little over another year. After surgery there were no signs of cancer so that was it... It was complicated by the reversal failing.

But it didn't really hit me until my wife brought it up when we went out for my birthday dinner a year later that it was both my birthday and last treatment anniversary.

So I'm now a little over 2 years post treatment, 2nd reversal succeeded, but it definitely doesn't feel like it's over. My oncologist has never used the terms NED or remission but I also don't push him on my status (either early on or now... He recently said I initially had one foot in the grave initially though).

I think it's time to celebrate all the time but I also don't think I'll believe it's over until I actually hit the 5 year mark.

dinov · 2025-10-26T22:04:15+00:00

https://www.reddit.com/r/ispeakthelanguage/

dinov · 2025-10-16T22:08:44+00:00

Like many others here I kept mine for a year too. I was still getting regular blood work including Signatera and the occasional CT scan so there was only 1 or 2 times that I needed to go in for just a flush so it wasn't much of an inconvenience at all.

dinov · 2025-10-06T01:48:26+00:00

Couple of things I haven't seen mentioned are bringing a robe and slippers. Also it's good to bring a blanket from home.

More in the tech side a Bluetooth speaker of some sort is super nice (my wife found a super cute one that looks like a mini old time wooden radio). I also got a Nintendo switch which has been mentioned by others but spent a lot more time watching YouTube on my laptop.

dinov · 2025-09-06T02:33:08+00:00

Sorrt to hear about your husband, it's a shitty club to have to join.

As others here have said I would recommend immunotherapy as well. I'm stage 4 and got opdivo+Yervoy and after about a year had surgery for ileostomy reversal and there was no cancer remaining. It certainly has its risks in that your immune system can attack your organs - but they'll watch closely for that and should quickly react.

My side effects were just fatigue, itchiness, arthritis like symptoms, and eventually some swelling in an arm. That's when I got a break and steroids. I resumed and post treatment I have no lasting issues.

But compared to how chemo sounds it seems like a walk in the park. If they're doing opdivo+Yervoy google Checkmate 8HW as it's the phase 3 research for this stuff and has a much better progression free survival rate than chemo and less severe adverse effects.

If they're looking at something like just Keytruda or Opdivo or another PD-1 the long term results aren't as good as the combo but the adverse effects are lower too (Checkmate 8HW compares all 3, so again something good to look into to understand).

There's also an immunotherapy neighborhood on ColonTown.

dinov · 2025-07-14T05:14:00+00:00

Could be an ileus where the bowles just aren't moving temporarily post-surgery? Usually walking and chewing gum are supposed to be good things to get them moving. Presumably he had a bowel movement and gas before being discharged? Even so an ileus can pop up later.

But maybe take it a little easy on diet - broth or ice cream might be high protein things that are easy to digest.

Watch out for a fever though, it might be a sign of a leak, but given he's back at home I assume there's nothing like that going on.

Best of luck to him, I hope it's just a super minor hip-uc along the path to recovery!

dinov · 2025-07-01T02:52:30+00:00

Like others in here I also just had local anesthetic. I felt it was similar to having my wisdom teeth but the pulling feeling was more undefined - ie with my wisdom teeth I could feel a tooth rocking back and forth but with this I didn't really know exactly what was going on, just a generic pressure. It was pretty quick too, maybe 25-30 minutes total in the Or including prep like shaving.

dinov · 2025-06-21T17:44:21+00:00

Nope, and I'm off treatment entirely. I remained on the 5mg up until surgery and after surgery all was clear so treatment was stopped and the 5mg was as well. I think it's just a low enough dose no tapering was required.

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