Advanced Medical Treatment Leads to Remarkable Success for Stage IV Kidney Cancer Patient

At 55 years old, Griselda Castillo was a picture of health who rarely got sick. But in November of 2020, a persistent cough led her to finally see a doctor. After a short examination, the doctor ordered X-rays, which she was able to get that same day. Before she even arrived home from the appointment, however, she received a phone call with news she never could have imagined: Griselda had cancerous nodules throughout her lungs.

She was referred to an oncologist for further testing, which revealed that her cancer had originated with a large, 15-cm tumor in her kidney that had metastasized to her lungs and in some of her lymph nodes, with an official diagnosis of metastatic renal cell carcinoma. “I was diagnosed with Stage IV kidney cancer,” Griselda said. “It was a shock, and it was made more difficult by the fact that I was still grieving my son, who I had lost earlier that year.”

The plan was to begin treatment as soon as possible, but before she could start her recommended chemotherapy regimen, Griselda contracted COVID-19.

“I got very sick very quickly,” she recalled. “I couldn’t eat, and I became extremely weak.”

By January 8, she was rushed to Memorial Hermann Texas Medical Center, where she stayed for twelve days, fighting for her life. She was unconscious for the first three days and nearly needed intubation multiple times. But thanks to her own faith and determined medical team, she survived against the odds.

Back home, Griselda needed to address her cancer. Unsatisfied with her initial care, she sought help from Putao Cen, MD, an oncologist affiliated with Memorial Hermann Cancer Center-Texas Medical Center, who started her on an immunotherapy treatment called Nivolumab, combined with a targeted oral cancer drug called Cabozantinib, a tyrosine kinase inhibitor (TKI). Griselda was on this combination for eight months, then Dr. Cen switched her to another combination— Pembrolizumab immunotherapy with an oral TKI drug called Lenvatinib—when this newer combination got FDA approved for better response rate and tolerance.

“The combinations represent a powerful strategy in cancer treatment by leveraging both immunotherapy and targeted therapy, said Dr. Cen. “Nivolumab or Pembrolizumab, both immunotherapy drugs, work by blocking the PD-1 receptor on T-cells, thereby preventing cancer cells from evading the immune system and allowing the body to better recognize and attack the tumor. Cabozantinib or Lenvatinib, both tyrosine kinase inhibitors, target multiple receptors involved in cancer cell growth and the formation of blood vessels that supply the tumor, inhibiting both tumor growth and survival.”

When used together, Dr. Cen added, these drugs enhance overall treatment efficacy, offering a targeted approach that is significantly improving patient outcomes, even for those in advanced stages.

The immunotherapy treatment and oral chemotherapy combination worked wonders for Griselda. Within two months, 80% of the nodules in her lungs disappeared, and the tumor in her kidney began to shrink.

Despite the painful side effects that come from cancer treatment, Griselda remained determined. Over eight months, her tumor shrank to 9 cm. In the fall of 2021, she was finally ready for surgery and was referred to Tung Shu, MD, a urological surgeon affiliated with Memorial Hermann-Texas Medical Center. On November 9, 2021, he performed a successful minimally invasive surgery, removing her left kidney and the tumor with it. Her recovery was quick, with minimal pain, and she left the hospital in just a few days.

After surgery, Griselda continued treatment with a lower dose combination of Pembrolizumab and Lenvatinib, and her health improved steadily. The nodules in her lungs continued to decrease, and her treatment intervals extended.

Today, Griselda is nearly cancer-free. Each CT scan brings positive news, and she continues her low-dose medical therapy to help prevent recurrence.

“Thanks to the advancement in surgical technique, surgical equipment, and post-operative care provided at Memorial Hermann-TMC, Griselda recovered from the surgery quickly and was able to resume her immunotherapy within two weeks after surgery. This is compared to the typical six to eight weeks that it takes to resume medical therapy with traditional surgical options,” Dr. Shu said. “Medical therapy is the most important part of the overall treatment for patients like Griselda, so these advanced surgical techniques are allowing us to prioritize that, which tends to lead to better outcomes.”

Griselda credits her survival to advanced medicine and her faith.

“I am here today because I was put in the right hands, and I never gave up,” she said. “I never miss a pill or an appointment. I miss my son every day, but I still have a lot to live for, and it just wasn’t my time.”