When your body is going through something as difficult as cancer therapy, it becomes increasingly important to keep it as strong as possible throughout treatment, according to Dr. Lorenzo Cohen and Alison Jefferies, M.Ed., co-authors of the book “Anticancer Living: Transform Your Life and Health with the Mix of Six.”

In turn, this amplifies the importance of recognizing the average person’s exposure to harmful chemicals and substances through everyday products. However, the pair go on to say that there are ways that patients can lower their exposure to these harmful chemicals through small, yet meaningful changes.

“We live in a world that’s awash with different chemicals — everything that we can be exposed to through the air, through water and, of course, through things that we put on or in our bodies.” explained Cohen, who works at The University of Texas MD Anderson Cancer Center, in Houston, and is a member of the CURE advisory board.

Cohen continued by saying: "These chemicals modify how our endocrine system works, how our hormones function, and many cancers — prostate, breast, ovarian, endometrial — are linked to hormonal imbalances. Doing whatever we can to clean up what we can control is critically important, especially when the body is already carrying the burden of cancer or cancer treatment."

Jefferies emphasized that knowing and understanding your environment is the first step to making informed, proactive steps to living a healthier life during treatment. That said, it is important to recognize that not every product sold in stores is automatically safe just because it is on shelves. This shines a light on the precautionary principle, which encompasses avoiding unvetted products unless you know they are safe. This can help patients be more aware of what they breathe, apply, and consume at home, controlling their exposure. 

Jefferies explains, “You do have a lot of control \[of] what you put in your body, what you put on your body, and in your own home, what you breathe in. We do have a lot of different ways that we can reduce the burden on our bodies, and when we have a cancer diagnosis, we really want to reduce the burden that our body carries of things that are not health sustaining. 

"If we’re in treatment, we want all our body’s energy to go toward being successful in receiving that [treatment], in healing and getting better. Reducing the burden of chemicals that your body carries is a great place to start.”

There are also more exciting ways to ensure that you are reacting in a precautionary to your surroundings, Cohen said, referencing the impact that house plants have on the environment.

Overall, there are just a few steps that can be taken to help patients with cancer make more informed choices in reducing the toxic burden they may face, in order to help their body be as strong as possible while undergoing cancer treatment.

“Don’t get overwhelmed by this area. It’s the smallest of steps that lead to big changes. [You can] think [about this] in three ways: what you inhale, what you ingest and what you absorb. Start slow and harness your community to help support you make these changes,” Cohen and Jefferies conclude.

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Articles

Maintaining strength during cancer therapy is crucial, and reducing exposure to harmful chemicals can aid this process. Everyday products often contain chemicals that disrupt hormonal balance, potentially exacerbating cancer risks. Understanding one's environment and applying the precautionary principle can help patients make informed choices about what they breathe, apply, and consume. Simple steps, such as using house plants, can reduce toxic burdens. Patients should focus on what they inhale, ingest, and absorb, starting with small changes and leveraging community support to enhance their treatment outcomes.

Dr. Lorenzo Cohen and Alison Jefferies discuss small yet meaningful changes that patients can make to their home environment to foster a sense of wellness.

Meaningful Changes to Reduce Environmental Toxicities

Katie Ortman Doble was 31 years old when she was diagnosed with ocular melanoma, a rare type of cancer that originates in the eye, in May 2013. Since the cancer was contained to her eye, she underwent plaque therapy, a type of radiation therapy, and a biopsy to assess the disease further.

“I received a phone call a few weeks later letting me know that my cells were the best-case scenario,” Doble, now 43 and living in Denver, tells CURE. “They were classified as 1A, which meant there was a less than 2% chance that they would ever spread. So, I thought that was it.”

Her doctor advised Doble to undergo imaging every six months. Doble had clear images in April 2014. But in November 2014, imaging showed that there were at least 12 suspicious lesions on her liver. A biopsy needed to be done immediately.

The biopsy confirmed that she had stage 4 incurable cancer, and her oncologist told her she had 16 months to live. With limited options based on her disease’s genetic makeup, Doble’s father helped her find a clinical trial to participate in. This led Doble, her father and her fiancé across the United States to participate in multiple clinical trials and traditional therapies from January 2015 to mid 2018. She was eliminated from each trial due to side effects or tumor growth, but liver embolization, which is only Food and Drug Administration (FDA)-approved for metastatic colon cancer, stabilized her liver for several years.

After tumor growth in her liver was noticed in June 2020, she was connected with a doctor at the University of Pittsburgh Medical Center’s Hillman Cancer Center, who was conducting a trial in tumor-infiltrating lymphocyte (TIL) therapy.

“The way that the doctor described it was that he was essentially going to wipe out my immune system with chemotherapy, like you would wipe out a computer, then you reinstall the programs. He was then going

to reinstall this cancer that was taken out of my body and programmed like a robot to go back in and attack itself,” Doble says.

Doble underwent tumor banking in July 2020. The TILs were manufactured, and she underwent preparatory lymphodepleting chemotherapy, TIL infusion and high-dose interleukin-2 (IL-2) in September 2020.

“Every scan that I had, we were seeing really, really good results,” Doble says. “My doctor — he kept calling it a bumper crop of cells, like I had one of the largest batches of cells he’d ever grown before.”

Some tumors were disappearing, Doble adds, but one tumor on her liver kept growing. So, in September 2021, she and her husband flew back to Pittsburgh to have half of her liver removed.

“I woke up from that surgery, [my husband] Nick was sitting in the corner, and he was like, ‘He got it all. You have no evidence of disease,’” Doble recalls. 

“It was a miracle day. I have had no evidence of disease for over three years now.”

Amtagvi (lifileucel) was the first TIL therapy approved by the FDA, in February 2024, for the treatment of patients with advanced melanoma whose disease progressed on or after anti-PD-1/PD-L1 therapy and targeted therapy.

“In the past, we only had immunotherapy and targeted therapy as standard options for these patients,” Dr. Sunandana Chandra, associate professor of medicine at Northwestern University Feinberg School of Medicine in Chicago, says in an interview with CURE. “Now we have not only another option, but an option that is very different from the existing approved regimens for metastatic melanoma.”

Chandra adds that this new treatment still has benefits and risks associated with it.

“The upside with TIL therapy is that it’s this novel, first-in-its-class approval [for] metastatic melanoma, where we’re using the patient’s own immune cells against the cancer,” she says. “The downside of TIL therapy is that it’s a rigorous regimen. It requires a huge commitment

from the patient. It is only able to be given in a very limited number of sites across the country.”

Another barrier to TIL therapy is the cost. According to a post on the National Cancer Institute’s website, the manufacturer of Amtagvi noted that a single treatment would cost $515,000, although the company said that financial assistance programs will be established for patients.

“[TIL therapy] is a therapy that, if it is effective, it’s a one-time treatment,” says Dr. Adam J. Schoenfeld, thoracic medical oncologist, and cellular therapist and early drug development specialist at Memorial Sloan Kettering Cancer Center in New York. “So, you don’t have to have repeated treatments down the road.”

Patients who may be eligible for TIL therapy are those with advanced melanoma whose disease either progressed on or responded poorly by way of side effects to PD-1 antibody-based therapy, predominately Opdivo (nivolumab) or Keytruda (pembrolizumab). Given the rigor of TIL therapy, patients whose tumors have BRAF mutations are required to have disease progression after targeted inhibitor therapy prior to TIL therapy since targeted inhibitor therapy is less rigorous for patients.

Performance status is another assessment that is taken into consideration when determining whether a patient is a candidate for TIL therapy. This status factors in how functional a person is in their daily life, strength, time spent out of bed or a chair, and daily activities, among other factors. Care teams also assess each organ’s function — particularly the kidneys, heart and lungs.

Once a patient is considered eligible to undergo TIL therapy, the first step is surgery, during which a piece of the tumor is removed to obtain the material needed to make the T cells.

After tumor resection, the patient can return home, and the manufacturing period begins for the TIL product, which is done in an off-site facility. During this time, a patient may undergo bridging therapy or another treatment.

“In the lab, that tumor specimen that was obtained from the patient is then essentially chopped up, and the patient’s own T cells are extracted from it,” Chandra says. “Those T cells have been grown in the lab [and] — about three to four weeks later — are ready to be infused back into the patient.”

Before the TIL cells are infused, the patient undergoes lymphodepleting chemotherapy for five to seven days.

“Normally, we think about chemotherapy as a way to kill rapidly growing cancer cells,” Schoenfeld says. “But here, we’re actually using chemotherapy as a way to reset the clock on your immune system and create space for the TIL to grow when we infuse the TIL.”

After the lymphodepleting chemotherapy is completed, the patient receives the
TIL infusion in the hospital through a vein. During this time, experts say that patients receive up to a trillion T cells that were grown in the laboratory. A patient undergoing TIL is then closely monitored by their care team.

Following that, the patient is treated with high-dose IL-2, boosting the immune system in cancer therapy. This regimen is administered for up to six doses and may take a few days to complete.

“This [IL-2] is what is used to grow the TIL,” Dr. Amod Sarnaik, professor of cutaneous oncology and immunology at Moffitt Cancer Center and the University of South Florida in Tampa, Florida, tells CURE. “So, the thought is that if you just give the TIL without the [IL-2] ... that abrupt withdrawal may cause some problems for the TIL because they’re used to being grown in the high concentration of the [IL-2].”

This entire process, from tumor harvesting to completion of high-dose IL-2, experts say, can take between six and eight weeks. Toward the end of the process, usually after receiving high-dose IL-2, a patient can be discharged home if deemed appropriate. The patient then undergoes subsequent scans in an outpatient setting for care teams to determine whether the TIL therapy had an effect on the cancer.

Jamie Troil Goldfarb, now a 47-year-old living in Takoma Park, Maryland, with her husband and 14-year-old son, was diagnosed with stage 2B melanoma in 2007. The 32-year-old, at that time, underwent surgery to remove it, and a sentinel lymph node biopsy showed clear results. After Goldfarb experienced several infections, her oncologist called the surgeon and urged him to investigate further to see whether a suture was left behind. During that surgery in December 2009, it was discovered that she had stage 3 melanoma, for which a wait-and-watch approach was suggested.

In January 2011, three months after Goldfarb gave birth to her son, Kai, her oncologist recommended she undergo a scan before she returned to work from maternity leave. That is when she learned that the cancer had metastasized to her liver and pancreas, marking her disease as stage 4, and her care team gave her a 15% chance of survival.

With her experience in patient recruitment for a company that conducted clinical trials, she knew immediately to look for options. She found a study assessing TIL therapy in melanoma, for which she was eligible.

Compared with the FDA-approved regimen with Amtagvi, Goldfarb received four full rounds of IL-2 before receiving the lymphodepleting chemotherapy and then the TIL infusion in September 2011. This TIL infusion was somewhat different from Amtagvi, as researchers took Goldfarb’s cancer cells and genetically engineered them to express IL-12 upon contact with the tumor.

Initially, months after the infusion, scans showed that her tumor was growing, which led the research team to consider other treatment options, although Goldfarb was not ready to do that. “I was very emotionally [invested in] this really intense clinical trial for TIL and then being cured,” she recalls.

In January 2012, her scans started to show that the tumors were shrinking.

“All of the tumors shrank over the next two years until I had no evidence of disease, and it’s been 12 years now, completely disease-free,” Goldfarb says. “My diagnosing physician told me that he would do everything in his power to buy me six months with the baby, and [Kai] just turned 14 last week.”

Most of the side effects of this regimen may be associated with the lymphodepleting chemotherapy before the TIL infusion and the high-dose IL-2 after the infusion.

“I got a rash from the chemotherapy, and I couldn’t take steroids,” Doble recalls. “That was really uncomfortable. The TIL experience, it was a 22-minute infusion. It was totally uneventful. And then once the IL-2 hit, that’s when it kind of went downhill. ... [My doctor] was thrilled that I felt like s---. He’d come in and he’d be like, ‘This is good, Katie. This is so good because it means you’re responding.’”

Side effects associated with Amtagvi, according to the FDA, include fever, chills, tachycardia (abnormally fast heart rate), fatigue, febrile neutropenia (fever with a low level of certain white blood cells), diarrhea, rash, edema (swelling from fluid buildup in tissues), low blood pressure, infection, hair loss, shortness of breath and abnormally low oxygen levels.

“The TILs are designed to attack the tumor, but remember, the tumor came from our own cells, so the tumor and normal tissues sometimes share similar targets,” Sarnaik says.

Goldfarb mentions that she got vitiligo as a potential result of the TIL therapy, but other than that, she did not experience any other long-term side effects.

“I got [vitiligo] as an initial side effect around my neck,” she says. “And then five years ago, it [spread]. ... So now it’s everywhere, which is fine. ... I’d rather have vitiligo than cancer.”

With the high-dose IL-2, experts say that side effects can be “somewhat profound in the short term,” Schoenfeld says. This response, he adds, is because IL-2 stimulates the immune system, so it may cause shaking chills, fever, capillary leak syndrome (when fluid leaks outside of blood vessels and into legs and arms), and fluid around the lungs, causing shortness of breath.

Experts say that after a month or couple months after receiving TIL, patients typically regain their strength.

Melanoma was one of the first cancers to be assessed in TIL therapy trials because of how heavily mutated it can present, experts say. Researchers are currently seeing whether TIL therapy can derive similar success in cancers that are also heavily mutated, such as lung cancer.

Studies are also focusing on the potential of TIL therapy in cancers caused by viruses, such as cervical cancer and head and neck cancer. Experts note that cancers with unstable DNA repair mechanisms, such as colorectal cancer, may also see success with TIL therapy. Research is also aimed at assessing TIL therapy in patients with aggressive cancers with minimal treatment options, such as gastrointestinal malignancies and sarcoma.

In addition to assessing the potential benefit of TIL therapy in other cancer types, researchers are aiming to see how TIL therapy itself
can be improved and expanded. For example, researchers are seeing whether there are more effective ways to manufacture TIL, such as identifying TILs that could be expanded or engineering TILs to make them more active. Additionally, researchers are investigating whether there is a way to manufacture TILs so they have other properties to potentially eliminate the need for chemotherapy before or high-dose IL-2 after the treatment.

Goldfarb says she “screams the praises of TIL every chance I get.”

“Every time [my son, Kai,] has a birthday, I think about how lucky I am that I get to see it,” she says.

For more news on cancer updates, research and education,

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Ocular melanoma patient Katie Ortman Doble's journey highlights the potential of tumor-infiltrating lymphocyte (TIL) therapy in treating advanced melanoma. Despite initial setbacks, Doble achieved no evidence of disease after undergoing TIL therapy, which involves using a patient's own immune cells to target cancer. The FDA approved Amtagvi (lifileucel) as the first TIL therapy for advanced melanoma in 2024. While promising, TIL therapy is rigorous, costly, and limited to select sites. Research is ongoing to expand TIL therapy's application to other cancer types and improve its efficacy.

TIL therapy is on the rise in melanoma, with potential for other tumor types.

Empowering the Immune System

Cancer is nonpartisan. It touches everyone — cutting across religion, race, ethnicity, sexual orientation and socioeconomic status. As a community, we fight to prevent, diagnose, treat, cure and grieve this “Emperor of All Maladies.” There is, and will continue to be, tremendous hope and opportunity in the field of oncology, fruits reaped by the long-standing commitment and investment in scientific discovery.

The funding landscape for cancer research is complex, with multiple stakeholders invested in improving outcomes. There is an intricate woven mix of federal, state and private resources set up to study and fight cancer. The National Institutes of Health (NIH) and the National Cancer Institute (NCI) are by far the largest federally funded mechanisms that exist to combat cancer. You and I, taxpayers, are the largest funders of health and research in the United States.

In 1971 the National Cancer Act, an amendment to the Public Health Service Act of 1944, led to the establishment of the NCI, officially declaring our “war on cancer.” The act granted broad authority to the director of the NCI and significantly increased funding to academic research institutions. Private institutions, foundations and pharmaceutical companies also play a critical role in this battle and, together with federal funding, have led to significant improvements in outcomes and overall survival for people diagnosed with cancer. NIH and NCI funding contributed to 99% of therapies approved between 2014 and 2019, and ongoing advances will likely contribute to the future of cancer care in America and globally.

The fiscal year 2026 budget proposes a \$17.5 billion cut to the NIH, including the NCI, amounting to a 37% cut in funding. We cannot accept this! Our community of scientists, clinicians, patients and caregivers cannot allow a climate of fear and budget cuts to slow down discovery. In a recent powerful letter to the American people, scientists spanning the political spectrum representing the nation’s top medical and scientific researchers, including Nobel laureates elected members of the National Academies of Sciences and Medicine, wrote that “… the voice of science must not be silenced. We all benefit from science, and we all stand to lose if the nation’s research enterprise is destroyed.” Cutting funding for critical cancer research, including clinical trials, would destroy this great enterprise that is baked into the fabric of our country. Rapid changes and cuts to the infrastructure of the Food and Drug Administration risk slowing down the approval of novel therapies for patients in waiting. We need to act rationally and swiftly to urge our elected officials to change course and continue to fund the critical work that will continue to lead to discovery and cure.

As I sit with a young woman who newly diagnosed with stage 4 lung cancer, she asks me if there is hope: “How will our current landscape of budget cuts, fear and skepticism affect my outcome?” I tell her that I don’t know, but I promise her that we will do everything in our power as a community to allow her to live well and with a focus on quality and dignity of life.

For the readership of CURE, please understand that basic science research may be under fire, but the practice of oncology has not changed. Clinics are functioning as usual. Clinical trials are functioning as usual. Treatment, progress and cure are still within reach.

Martin Luther King Jr. said, “The arc of the moral universe is long, but it bends towards justice,” so too is scientific progress — the discoveries of tomorrow are fundamentally entrenched in the investments we make today. Despite the current landscape of research funding, there is a tremendous amount of hope and ongoing opportunity for progress today.

Cancer affects all demographics, and the fight against it involves prevention, diagnosis, treatment, and research. The funding landscape for cancer research is complex, involving federal, state, and private resources, with the NIH and NCI being major contributors. The proposed 2026 budget cuts to the NIH threaten progress in cancer research and treatment. Despite these challenges, the oncology community remains committed to advancing care and maintaining hope for patients. The practice of oncology continues, with clinics and clinical trials operating as usual, emphasizing the importance of sustained investment in scientific discovery.

Cancer is nonpartisan. It touches everyone — cutting across religion, race, ethnicity, sexual orientation and socioeconomic status.

Funding for Cancer Research: Hope in a State of Fear

A significant development in the treatment of advanced melanoma has recently emerged: tumor-infiltrating lymphocyte (TIL) therapy, a novel approach harnessing the power of a patient’s own immune system. In 2024, a first-of-its-kind drug was approved by the Food and Drug Administration (FDA) for patients whose cancer has progressed after other treatments.

In this issue of *CURE*, we highlight the details of this groundbreaking treatment, explaining how it differs from traditional immunotherapy and targeted therapies. You’ll learn about the steps involved, from tumor removal and T-cell manufacturing to the infusion process and the role of high-dose interleukin-2 in boosting the immune response, as well as crucial postinfusion care.

While TIL therapy presents a promising new avenue, it’s important for patients to understand both its potential benefits and its challenges. A key advantage is that it’s designed as a one-time treatment, potentially offering a lasting response without the need for continuous therapy. However, the treatment is rigorous, requires a substantial time commitment and is currently available only at a limited number of medical centers. Additionally, the cost of TIL therapy is significant, although financial assistance programs are being explored.

You’ll hear from experts who dive into this exciting advancement, as it offers a personalized and potentially impactful approach for patients who have limited options. Further, as research continues, this innovative strategy may hold promise for other cancers as well, expanding the arsenal of tools available in cancer care.

Also in this issue, we recognize our 2025 Extraordinary Healer® award winner, Kaifan Zhao, AGACNP-BC, PMHNP-BC, for his dedication to making a difference in the lives of patients and their loved ones. The event, held during the 50th Annual Oncology Nursing Society Congress, also featured a keynote lecture from journalist, podcaster and author Amy Robach. “You are walking with \[patients with cancer] during the scariest time of their lives,” she said. “They are afraid for their lives. They are afraid to think about tomorrow. They’re fighting for tomorrow, and you are there as their backbone, as their support, as their light,” she said.

If you are inspired by the testaments shared by our Extraordinary Healer finalists, essay nominations for the 2026 award ceremony are now open on curetoday.com. It is with your nominations that we can recognize the amazing feats of our oncology nursing community.

Staying informed is a powerful tool in your cancer journey. For the very latest updates in oncology, including breaking news on FDA approvals and expert perspectives on key cancer information, turn to curetoday.com.

We are dedicated to ensuring you have the information you need to navigate your cancer experience with clarity. Within these pages and on our website, you’ll find both personal narratives that resonate and expert opinions that provide context. We hope this information serves you well and offers encouragement. Thank you for your continued readership.

Tumor-infiltrating lymphocyte (TIL) therapy represents a significant advancement in advanced melanoma treatment, utilizing a patient's immune system. The FDA approved a pioneering drug in 2024 for patients with treatment-resistant cancer. TIL therapy, distinct from traditional immunotherapy, involves tumor removal, T-cell manufacturing, and infusion, with high-dose interleukin-2 enhancing immune response. Despite its promise, TIL therapy is rigorous, costly, and limited in availability. The approach offers a personalized treatment option, with potential applications in other cancers. The issue also highlights the 2025 Extraordinary Healer® award and encourages essay nominations.

A significant development in the treatment of advanced melanoma has recently emerged: tumor-infiltrating lymphocyte (TIL) therapy.

CURE Summer 2025

Meaningful Changes to Reduce Environmental Toxicities

Empowering the Immune System

Funding for Cancer Research: Hope in a State of Fear

A New Frontier in Melanoma Treatment

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