– It was like a penicillin cure – news Vestland

This is the case: Oliver Njåstad was diagnosed with lymphoma, after experiencing pain and finding lumps in his temple, shoulder and rib. Despite prolonged chemotherapy, the cancer returned. Oliver became increasingly ill. Senior doctor Maria Winther Gunnes at Haukeland University Hospital suggested trying an immunotherapy with genetically modified immune cells (CAR-T), a treatment that has previously shown an effect on blood cancer. The treatment was expensive and this type of lymphoma has never before been tested in Norway. After ten days of intense monitoring and pain, Oliver declared himself well. Nine months later, Oliver is still cancer-free, and his story can potentially help other patients with a similar disease course. The first signs came on the football field. – I couldn’t run as fast anymore. I didn’t quite get it and was annoyed by it, says Oliver Njåstad. Then he felt small lumps in his temple, shoulder and rib. Then great pain. After many tests and examinations, Oliver was diagnosed with lymphoma. The very next day he had to come in and start treatment at the hospital. – I was quite frightened. It was a scary and disgusting feeling. I didn’t sleep that night. He felt small lumps in his temple and shoulder and rib. It turned out to be tumors. The pain got worse during the autumn three years ago. When chemotherapy didn’t work, doctors feared the worst. Photo: Synne Lykkebø Hafsaas / news Got sicker and sicker He received his very first chemotherapy treatment on his own thirteenth birthday. The treatment was prolonged. He had to undergo chemotherapy for a year and a half. He lost his hair and was “in and out” of the hospital. The chemotherapy seemed to work at first. And he was declared healthy. But after a short time the relapse came. Around Christmas time last year, Oliver was really unwell. He had large, black tumors in several places in his skeleton. He didn’t eat and lost a lot of weight. – I walked around with constant anxiety and restlessness. I had to step up the morphine because my knee hurt so much. I was lying the whole time. I could barely walk because I was in so much pain. He received stronger and different types of chemotherapy. But the body did not respond. He just got sicker and sicker. Oliver was diagnosed with lymphoma when he was twelve years old. When he relapsed after several rounds of chemotherapy, the doctors were left with few options. Then the superior tried an advanced immunotherapy, which had never been used on the form of cancer he had. Here he is at Haukeland University Hospital. Photo: Private – Not much to play at The doctors were firm. Recurrence is not common for this type of cancer. Nine out of ten recover. – For the few who relapse, there is not much to gamble on, explains senior physician Maria Winther Gunnes at the children’s department at Haukeland University Hospital. They gave Oliver new combinations of chemotherapy. It worked a little, but not well enough. The supervisor discussed various possibilities with colleagues in the Nordics, Germany and the USA. But they had no experience of how his disease behaved when it returned. – We received little concrete advice and tips when the disease responded so little to our standard treatment. We ended up taking a chance, says Gunnes. Senior doctor Maria Winter Gunnes at Haukeland University Hospital worked hard to find a treatment. She ended up taking a chance and tested a treatment that few had experience with. Photo: Synne Lykkebø Hafsaas / news Made an army The superior wanted to try an immunotherapy with genetically modified immune cells (CAR-T). A treatment that has had an effect on other related diseases, such as blood cancer. – There is an army of cancer-eating cells. They find the cancer cells and mostly leave healthy cells alone, she says. There was great uncertainty related to whether the CAR-T cells would reach the skeleton, where the disease was located. This is CAR-T treatment: The CAR-T immunotherapy involves taking blood from the patient and running it through a machine that extracts some of the patient’s immune cells (called T cells). In a laboratory, a gene is inserted into the T cells. This means that a receptor, a kind of link, is expressed on the surface. Millions of these immune cells are then made, which are specially trained to recognize a protein on the surface of the cancer cells in the individual patient. The cells are then put back into the body much like a blood transfusion and these cells attack the cancer cells. The problem was also that the treatment was expensive. In addition, it had never been tested for this type of lymphoma in Norway. The chief physician nevertheless got it approved by the professional director of Health Bergen. – We were very excited. It is a very experimental treatment in this setting, says Gunnes. But it was worth a try. Without another treatment, Oliver would not survive anyway. – It would have gone fairly quickly. The disease would be out of control, she says. Last autumn, Oliver relapsed after undergoing chemotherapy for a year and a half. The fifteen-year-old would not have survived without new treatment. – It would have gone fairly quickly. The disease would have been out of control, says senior physician Maria Winther Gunnes at Haukeland University Hospital. Photo: Private “Now I’m healthy” In January this year, Oliver was in such severe pain that he was in a wheelchair. The family barely managed to transport him to the Rikshospitalet in Oslo, where he was to receive treatment. It took one and a half minutes to insert the CAR-T cells into the body. – Oliver experienced intense pain where the cancer was: in the knee, pelvis and back, explains his mother, Hilde Økland. The doctors said it was a good sign. Then the cancer cells were attacked. Hilde Økland describes the last few years as extremely tough. She now wants more people to have access to the treatment her son received for lymphoma. – I have no words for how grateful I am, she says. Photo: Synne Lykkebø Hafsaas / news The son got a fever. He was monitored and given morphine day and night. Then a small miracle happened inside the small hospital room. After ten days he got up from his sick bed and said: “Now I am well.” The mother shows with a big mouth and wet eyes how she reacted. “What do you say?”, she asked her son. Oliver replied that he could go. He was no longer in pain. – It went so fast. It was like a course of penicillin. As if he had an infection and was given antibiotics and recovered, she says. Oliver was under investigation in January 2022. He later learned that he had lymphoma. He had to start treatment on the day.Oliver together with his father, Helge André Njåstad (Frp), who is elected to the Storting for Hordaland and chair of the justice committee. Here they are together after their son, after he was declared cancer-free for the first time. Oliver lost his hair when he received chemotherapy. The friends in the class got together and shaved off their hair with him. – I couldn’t wear a wig when everyone had “taken” their hair. It was a nice thing to do, he says. The tumors disappeared and the MRI images confirmed the feeling. The large, black, painful spots were completely gone. The doctors were prepared that the treatment might stop working after a while. For many, the effect is short-lived. Then you are in the same difficult situation as before the immunotherapy. That doesn’t seem to be the case here. After nine months, Oliver is completely healthy, with no signs of cancer. – I started looking at things with interest again. I could walk without pain and cut back on painkillers, says Oliver. The pictures show Oliver Njåstad’s feet before and after he received immunotherapy against lymphoma. The picture on the right shows the tumors around the knee before he received the treatment (th). The picture on the left shows the feet after the treatment. Photo: Privat But just ten years ago he probably wouldn’t have survived. – This is a sunshine story. This is something we didn’t have available just a few years ago. Then we wouldn’t have had any more tools left in the drawer, says Gunnes. From a wheelchair to a motorbike, Oliver had to build himself up and taper off the morphine. Then he felt like doing things again. – The first thing I did was go to the shop and buy myself a light motorcycle and motorcycle clothes, he says. After a couple of days he developed an appetite and was able to eat a whole steak by himself. – They could actually see from the blood tests afterwards that he had eaten meat, laughs the mother. It is almost a year since he received the treatment at Rikshospitalet. He still goes to check-ups at the hospital every month. After Oliver received the new treatment, he was suddenly able to walk without pain and reduce his medication. Now he has his everyday life back. Several days a week, he goes out in a boat and pulls lines around the island. Photo: Synne Lykkebø Hafsaas / news But otherwise he has a normal everyday life. He goes to school, meets friends and exercises almost every day. His goal is to run the Bergen City Marton next year. – I’m starting to get in pretty good shape. It’s an absolutely fantastic feeling to not be in pain, he says. See interview with Oliver and his mother below: Higher place in the hierarchy The type of cancer that Oliver got is not a “folk disease”, and the vast majority recover. Nevertheless, the miracle story can have meaning for others who get cancer. – It can help other patients with a similar course of illness. And that can lead to this type of treatment being given a higher place in the hierarchy, says Gunnes. She hopes that in the future more immunotherapy and less chemotherapy can be used in cancer treatment. And that the type of treatment can eventually be expanded to be effective for several diagnoses, such as brain tumors and neuroblastomas in children. – This shows that we constantly have to think new things and think a little further. Especially when we have come to change with standard treatment, she says. At the same time, she emphasizes that it is not certain that the treatment would work for everyone. Senior doctor Maria Winther Gunnes hopes the treatment Oliver received for lymphoma can help others with a similar disease. And that immunotherapy may be used more in the future. Photo: Synne Lykkebø Hafsaas / news This is what the Cancer Society thinks Photo: Petter Larsson / news Sigrid Bratlie, molecular biologist and strategic advisor at the Cancer Society, calls the treatment a “breakthrough” for patients who get the most serious forms of cancer. – This treatment is a fantastic revolution for cancer treatment. It is extra gratifying that this works on children, she says. The Norwegian Cancer Society expects the advanced immunotherapy to become available to more patients with blood and lymph cancer. She also hopes that it can be effective on other forms of cancer in the future. – Cancer patients should receive it earlier in the course of the disease, because we believe it is more gentle and effective than other cancer treatments, believes Bratlie. The challenge is that the treatment is technically advanced and expensive. The hospitals also have limited capacity to carry it out. – The treatment should definitely be used more. If not, this is a product you can buy if you have a big wallet, and we don’t want that in Norway, says Bratlie. Hello! Thank you very much for reading the matter! Thinking of something? Do you have something on your mind that I should write about? I would be very happy to receive an email. Published 24.11.2024, at 11.55



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