Bill Holley had a dangerous squamous cell tumor on the back of his left hand, but you would never know it today.
And he didn’t have surgery.
Holley, 80, a retired chemist who lives in Ellington, said, “I have to believe it’s rather remarkable. It’s gone.”
What eliminated Holley’s tumor was immunotherapy over the course of about a year.
“It started off, Bill thought he had a wart on top of his hand and it kept getting bigger and bigger,” said Jonell Holley, his wife of 57 years. “And I said, ‘You know, you really need to go to your dermatologist.’”
Bill Holley, as a redhead, has had a lot of sunburn and a number of skin cancers, Jonell Holley said.
“Anyway, this thing on his hand kept growing, and I thought it was more than a wart,” Holley said. His longtime dermatologist agreed and took a small biopsy “from such a small corner on the very edge,” which came back negative, she said.
Fortunately, the couple got a second opinion.
“I don’t think she even took a biopsy,” Holley said of the second doctor. “I think she knew right away it was a really bad cancer, sent it to UConn in Farmington and they did all kinds of tests, but it was a really bad squamous cancer and he had one or two lymph nodes involved in his armpit. And Bill and I couldn’t wait to get the thing taken off.”
It took some time to get a surgery date, but four days before surgery, Dr. Upendra Hegde, co-director of the Cutaneous Oncology and Melanoma Program at UConn Health, “very patiently asked us to hold off on the surgery and try immunotherapy because they’ve been getting very positive results from the immunotherapy and Bill might not even need surgery,” Holley said.
“So we thought, well, you know, we’ll try it,” she said.
Bill Holley’s memory isn’t good, but his wife said the tumor had covered two-thirds of his left hand and it was raised.
“For months. I had been washing it gently and covering it like I was told to do,” she said.
Every three weeks, the Holleys drove to Farmington for the treatment. “So that was our Farmington day,” Holley said.
“And the cancer started to get smaller and smaller,” she said. “At first, Bill didn’t believe it. He thought I was seeing things. And I said no, no, it’s getting smaller. And within a couple of months, Bill could see it was starting to get smaller.”
Eventually, the tumor was gone, without so much as a scar. What’s even more impressive is that Bill Holley could have ended up with his hand or even part of his arm amputated. That’s how serious squamous cell cancer is in older people.
“Cancer is more common in older people,” Hegde said. “It’s a known statistic that 60% of all cancers occur in people 65 years and above. And what is implicated is a waning immune system. Because as we get older … every organ gets older, our immune system also becomes older and weakened.”
In Holley’s case, “that tumor was growing in such a way that it was just infiltrating down the tendons of the hand,” Hegde said. “So initially, he ignored it and then … it grew very, very fast.”
Hegde treated Holley with cemiplimab, marketed as Libtayo, which binds to a protein on the surface of the T cells, which are part of the immune system, and it “removes the brakes” on the T cells, he said.
“In the olden days, we always didn’t know how to treat older patients with cancer,” Hegde said. “Because there were no good treatments available for them. And so for squamous cell cancer, for basal cancer, for melanoma. Now, with the advent in scientific advances, this kind of drug that remove the brakes of the T cells are made available and they work very nicely.”
Hegde said families are not always willing to undergo immunotherapy because they don’t understand how they work or because they are concerned about side effects.
“And so we really have to help them to understand how this drug works, what to look for, their side effects, but when they work so briskly and so well, it really improves the quality of life and survival,” he said.
He said he has treated 19 patients with cemiplimab at UConn Health. “Out of 19 patients, 12 patients had amazing response,” he said.
Ed Stannard can be reached at [email protected].