Roger Siddons was 68 years old when he received the call nobody wants. A week earlier, chest pain sent him to an emergency department near his home in Oshkosh. Doctors drained fluid from around his lungs and tested it. A few days later, he received a diagnosis. He had cancer.

“Just hearing those words was devastating,” Roger said. “I was in shock, not knowing what to do.”

A local oncologist told Roger he had either stage IV lung cancer or pleural mesothelioma, a rare cancer that forms in the thin tissue lining the internal organs. Fortunately, Roger had options and understood the importance of seeking a second opinion. He was referred to the Froedtert & MCW Thoracic Cancer Program and Jonathan Thompson, MD, MS, medical oncologist and MCW faculty member. Dr. Thompson confirmed the mesothelioma diagnosis and started Roger on a course of chemotherapy, but the results were discouraging. The tumors continued to grow and Roger was becoming sicker.

Due to Roger’s health at the time, surgery was not a consideration. But Dr. Thompson had another treatment in mind. Immunotherapy is a therapy that triggers a person’s immune system to find and eliminate cancer cells. Immunotherapy has shown promise in treating certain cancers like melanoma and small cell lung cancer. Dr. Thompson started Roger on a combination of two immunotherapy drugs — nivolumab and ipilimumab.

The first follow-up imaging scans showed mixed results, with some cancerous areas shrinking but new lymph node involvement.

"Due to our extensive experience using immunotherapy to treat people with mesothelioma, we were confident that because Roger was feeling so much better, we were getting the response we would expect,” Dr. Thompson said. “Sometimes, it looks like patients are getting worse, but if you give immunotherapy a little time, people can show signs of improvement.” 

That confidence paid off. About a year into treatment, tumors were shrinking or remaining stable, and Roger was feeling fine. There were a few bumps along the road. He was diagnosed with adrenal insufficiency, a condition that can occur when the immune system attacks adrenal glands and reduces cortisol production. 

“It is carefully managed with hydrocortisone, which mimics what the body produces,” said Catherine Zhang, MD, endocrinologist and MCW faculty member. 

Historically, mesothelioma has had a dire outlook. Dr. Thompson said that even with surgery, chemotherapy and radiation therapy, most people did not survive for more than a year. Now, people who respond positively to immunotherapy have good odds of living full lives. There is even a chance Roger's body will take over the task of fighting the cancer, and he will no longer need immunotherapy regularly. 

Froedtert & MCW cancer specialists can often access cutting-edge treatments that might not be widely available. Roger’s team is experienced in treating thoracic cancers, including rare types like mesothelioma, which gave his doctors the insight to continue treatment when Roger’s initial scans did not look promising. Roger said he has no doubt he is alive now because of that expertise. 

“The care I received was outstanding,” he said. “I don’t know if I would be in this position if it weren’t for the Froedtert & MCW Cancer Network.”