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How I took charge of my disease: CAR T-cell therapy at Sheba Medical Center

Remission From CLL
By Sam Turel

It’s your health that’s on the line – don’t just leave it to others. Understand the issues, consider the options, seek professional advice, monitor your progress, and make well-informed decisions. Most importantly, select a top medical center that is experienced and reputed in treating your disease. For me, I decided Sheba Medical Center in Israel was the best place for treating my diffuse large b-cell lymphoma (DLBCL) and chronic lymphocytic leukemia (CLL), and it was the right decision.

My diagnosis

I went for a routine check-up in December 2003, and my annual blood test showed a rise in my WBC (white blood cell) count. But because I had no infection, no injury, and no symptoms
of disease, my doctor advised me to return for follow-up testing in three months. After a steady increase in WBC counts over the next 9 months, I was referred to a hemato-oncologist who conducted many tests, including blood and bone marrow analysis that led to a diagnosis of chronic lymphoproliferative disorder (CLPD).

Reacting to my diagnosis – “like a bolt from the blue”

At that point, I was still very active – living a full and robust life professionally and socially. I enjoyed a great balance between work, family, and sport. But the moment I heard the dreaded words “blood cancer and leukemia,” I fell into acute fear, despair, disappointment, and anxiety. It was like a shocking bolt from the blue had hit us. My wife, who was sitting beside me, was in disbelief.

When our friends and family heard about my diagnosis, they all offered sincere support in various ways. Some, out of the goodness of their heart, suggested alternative treatments, and some who believe in the occult, unabashedly offered to communicate with mystics who could help with extrasensory powers.

But that approach wasn’t right for us. My wife and I reacted with an intense desire to scientifically understand what caused the disease, to know what to expect and to figure out what we needed to do going forward. I wanted to take control of the problem and partner with my doctor to manage it as best as I could.

Initial Treatments for CLL and DLBCL

As the disease progressed, I began to slow down. Then, in 2009, I was diagnosed and treated for chronic lymphocytic leukemia (CLL). For the next seven years, I was in remission. However, in 2016, I suffered a relapse and was treated with targeted therapy to control CLL.

About two years later, my disease took a sudden turn for the worse. Swollen lymph nodes appeared in my neck region, and there was an unexplained transformation from CLL to diffuse large b-cell lymphoma (DLBCL; Richter Transformation). My doctors decided to administer six cycles of chemotherapy (R-CHOP regimen), but in less than six months, I suffered a relapse.

R-GDP therapy was given as salvage therapy, but it began to cause severe side effects after just one cycle. I reluctantly began the 2nd cycle, but my body wasn’t able to cope with the toxicity. That was when I began to research options outside of India.

Choosing Sheba for cancer treatment

I was aware of treatment options such as CAR T-cell therapy, and my neurosurgeon brother suggested getting treatment at Sheba Medical Center in Israel. We had explored other international hospitals, such as MD Anderson in Houston, TX. But there, they only had a program to treat DLBCL with CAR T-cell therapy, or a 2-year clinical trial to treat both DLBCL and CLL. The latter was an experimental program spread out over a long period that required temporary relocation to the United States.

In contrast, Sheba Medical Center had a program to treat both DLBCL and CLL with CAR T-cell therapy specially engineered at their on-site lab. The entire treatment would take 8-10 weeks, maximum. Additionally, the cost of the treatment in Israel was much more affordable than in the US.

My experience at Sheba

When I stepped onto the campus at Sheba, I was awed by the huge size of the complex and the extensive facilities of the Hemato-Oncology Division. Most impressive was the way my three medical specialists collaborated, considering all aspects of my case to collectively design the most effective treatment program.

The International Medical Tourism team worked closely with the consulting doctors and helped to facilitate every aspect of my treatment. I felt their deep commitment constantly. All in all, Sheba Medical Center is the most impressive hospital I have ever been to.

In complete remission

I was ecstatic to learn that I was in remission from DLBCL. Over the upcoming years, my condition will be systematically monitored to ensure the disease is cured and behind us. While the success of the treatment for CLL, the more benign and manageable disease, is still unknown, I am confident it will be successful too.

Now, I am excited to start enjoying life and do all that I planned to do in my retirement!

Sam Turel after successfully completed treatment with CAR T-Cell therapy, achieving Remission From CLL

October, 2020

I like to believe that I’m fully cured of cancer. I feel healthy, energetic, and fit – and I try to think positively. Of course, there’s always the fear of a relapse, but I firmly believe in the power of remaining mentally optimistic. Instead of focusing on fear of the future, I focus on fitness and relaxation. Meditation and prayers give me peace of mind, and a good healthy diet with regular exercise keeps me stress-free.

Sam Turel Remission From CLL, new information October 2020

Three months after I underwent CAR T-cell therapy at Sheba, my PET-CT scan showed complete remission. Now, my monthly blood test results are normal. So I haven’t gone for any check-ups since my return to India.

People always ask me about the side effects of the cancer treatments I received. When I arrived at Sheba for the first time in 2018, I was already suffering from side effects from failed treatments in India (R CHOP regimen and R-GDP therapy). These included neuropathy in my feet and legs, which I still have now. Also, as a result of those treatments, I experienced severe dehydration that damaged my kidneys. My blood pressure shot up, and I’m now receiving treatment from a nephrologist for chronic kidney disease and hypertension. Fortunately, there are signs of improvement and, over time, I hope to fully recover. As for any side effects from the CAR T-cell therapy I received at Sheba – I didn’t have any!

My approach to self-care is to rebuild and strengthen my immune system by eating well and exercising regularly. In light of the coronavirus pandemic, I am cautious of the risks and follow all hygiene protocols to stay safe. But I don’t feel inhibited – my positive attitude gives me the liberty and confidence to do whatever I wish. Of course, while I’d love to go skydiving or parasailing like I did when I was younger, my age gets in the way! I’d also love to take advantage of international travel, but the current environment is prohibitive, and I’m waiting for things to normalize.

I’ve learned a lot from my experiences with cancer, and I’d like to share some advice:

  • Be positive. Accept your diagnosis, understand the issues and seek professional advice.
  • Don’t leave your health to others. Be personally involved; monitor your progress at every stage and make well-informed decisions.
  • Choose the right medical center or professional doctor that is experienced and reputed in your disease, not necessarily the doctor who is friends with your relative or neighbor.
  • Before meeting with the doctor, prepare all your questions and concerns, and be ready to answer all the doctor’s questions truthfully.
  • Follow your doctor’s instructions meticulously, and keep him advised of your condition at all times. It’s okay to seek second opinions, but discuss them openly and candidly with your doctor.
  • Make sure you have adequate medical insurance to help with the financial expenses.
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