How acceptance and collaboration with a trusted doctor led to a tailored treatment plan for one person diagnosed with blood cancer.
Justin Fishman felt like his body was failing him. Over the past six months his back had started to hurt, his skin was itchy, and on most days he felt too exhausted to get out of bed. It was the summer of 2023, and Fishman was just 35 years old — too young, he thought, to feel like this. “I used to be able to stay out late with my friends at a bar, but now if I had even one drink I’d feel sick,” he remembers. “My back was in so much pain, and it was only getting worse. I thought maybe I’d injured myself without even knowing it.”
Trying to find some relief, Fishman made an appointment with an acupuncturist. “She felt my back, and immediately said, ‘Something’s wrong with you.’” The next morning, Fishman woke up and couldn’t move his legs. “That’s when I knew this wasn’t normal,” says Fishman. His wife Daria took him to the urgent care, where an X-ray showed he had a cracked pelvis.
“I remember they asked me, ‘Did you get into a motorcycle accident? Did you take an extreme fall? Pelvises don’t just break.’” Fishman explained that he hadn’t done anything out of the ordinary: he worked out and played with his dogs, but that was it. The urgent care doctor sent Fishman and Daria to the ER, where he underwent a battery of tests. The couple waited hours for the results before a doctor finally came in to speak with them. “He said, ‘It looks like you have cancer,’” Fishman recalls.
I’ll never forget that moment for as long as I live.
Fishman was diagnosed with diffuse large B-cell lymphoma, or DLBCL, an aggressive form of non-Hodgkin’s lymphoma – a common type of blood cancer. “I’d had such a normal life,” says Fishman, “And now it was totally derailed.”
Like many people with cancer, Fishman struggled to accept the loss of control that came with his diagnosis. All his life, he’d had a plan for his future and stuck to it: he’d wanted to marry Daria since they met as teenagers, and now they were married. He graduated from high school intending to work at his family’s courier business, and he’d built a successful career there. He and Daria were the proud pet parents of two dogs and two cats, just like they’d always wanted. But now, in just one day, his seemingly certain future was ripped out from under him.
“I couldn’t stop focusing on what this would mean for Daria,” says Fishman. “I just kept thinking, I have to get better, because I can’t leave her alone.” But Daria was ready to step up for her husband in his time of need: just months before she was supposed to earn a degree in marriage and family counseling, she postponed finishing her final semester to care for Fishman full-time. “That was tough to swallow,” says Fishman. “She wasn’t going to graduate with all the friends she’d made over the past four years.”
It was a huge sacrifice, and I worried she’d resent me. But I couldn’t do it on my own.
For two weeks, Daria stayed by Fishman’s side as he received inpatient treatment at the hospital. “That was terrifying,” he recalls. “I couldn’t go home, and I didn’t know what was going on. I’d always been a worried person, so it was difficult to have no idea what was going to happen to me and just trust that the medical team was doing their best.”
As Fishman grappled with ceding control of his future to his medical team, one person earned his complete trust: Alex Herrera, M.D., a hematologist-oncologist and chief of the Division of Lymphoma at City of Hope Cancer Center. “Daria and I had researched doctors, and I liked that Dr. Herrera was the head of his department,” says Fishman. “That meant he’d likely have the most experience, and access to the best research and the best trials. This was about my health, so I wanted what was best for me.”
After meeting Dr. Herrera, Fishman knew he’d made the right decision. “He was very reassuring, and it’s clear he got into this field to help people,” Fishman says. “He explained my cancer to me in a way that was approachable and understandable.”
I felt like we were making decisions about my treatment as a team. I learned to completely trust him, which allowed me to focus all my energy on getting better.
“Given the aggressiveness of DLBCL, early treatment is crucial to provide patients with the best chance at remission, especially knowing that approximately one in three of those diagnosed may see their cancer relapse or not respond to first-line treatment at all,” notes Dr. Herrera. “Clinical research is fundamental for exploring safe and effective therapies and advancing patient care, and continued research and innovation remain key to overcoming the challenges of this disease.”
While it had been almost 20 years since another option had become available for the initial treatment of DLBCL, Dr. Herrera informed Fishman of an addition to the treatment landscape: a medication called Polivy®, which is combined with other medicines (rituximab, cyclophosphamide, doxorubicin, and prednisone), as a first treatment for adults who have moderate to high risk DLBCL, not otherwise specified or high-grade B-cell lymphoma. “He presented the science to me, and then he spoke with my sister who works in the medical field so she could understand it, too,” says Fishman. Together, Dr. Herrera and Fishman decided that the Polivy regimen was the right course of action.
Based on the results of the clinical trial that Dr. Herrera participated in as the principal investigator at City of Hope, the Food and Drug Administration approved the Polivy (polatuzumab vedotin-piiq) regimen in April 2023 as a treatment for adults with previously untreated DLBCL. All medicines have side effects. In the clinical trial of Polivy, the most common side effects were nerve problems in the arms and legs, nausea, tiredness or lack of energy, diarrhea, constipation, hair loss, and redness and sores of the lining of the mouth, lips, throat, and digestive tract. Call your healthcare provider or get emergency help right away if you develop any signs or symptoms of serious side effects. More important safety information can be found below this article.
For six cycles, Fishman was treated with the Polivy regimen every three weeks. “My white blood cell count was so low that I was in a wheelchair,” says Fishman. “Daria helped me with everything from eating to bathing.”
She never complained, and she gave me permission to be honest about my emotions.
Slowly but surely, Fishman began to notice a difference. “My blood test results began improving,” he says. “I had a follow-up scan and my wife and I were told that everything looks good.” In February of 2024, seven months after being diagnosed, Fishman was officially declared to be in remission.*
“Being able to share this kind of news with patients is the best part of my job,” Dr. Herrera says. “It represents a profound milestone in their journey – a moment when we can collectively breathe a sigh of relief and celebrate a positive outcome.”
Just like when he first heard his cancer diagnosis, Fishman’s first thought when he learned he was in remission was of his wife. “Daria and I have been together for so long, and I couldn’t help but think we wouldn’t get to have more time together,” says Fishman. “Now I’m looking forward to creating additional memories with her.”
Fishman’s cancer experience has also helped him accept that life will never go exactly as planned.
“I know from experience there are things that will be beyond my control, and I’ve just got to accept that,” he says. “Once I decided to trust the experts, I could focus on healing and getting through treatment. I encourage others in a similar situation to do the same – collaborate with your doctor to find the best possible treatment plan for you. Now, I’m just looking forward to continuing to do the things I love — it’s that simple. I’m happy to be here today.”
To learn more about this type of blood cancer or for more information about Polivy, visit Polivy.com
The information in this story is specific to one patient’s experience and is not a substitute for consulting your own doctor. If you have diffuse large B-cell lymphoma, talk to your doctor about your individual symptoms and potential treatment options.
*In a large clinical trial of 879 people newly diagnosed with certain types of large B-cell lymphoma, Polivy plus R-CHP reduced the risk of people’s cancer worsening or returning by 27% compared with traditional chemoimmunotherapy (R-CHOP; a combination of Rituxan, cyclophosphamide, doxorubicin, vincristine and prednisone). There were no differences in response rates.
Polivy U.S. Indication
POLIVY is a prescription medicine used with other medicines (a rituximab product, cyclophosphamide, doxorubicin, and prednisone) as a first treatment for adults who have moderate to high risk diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) or high-grade B-cell lymphoma (HGBL).
Important Safety Information
Possible serious side effects
Everyone reacts differently to POLIVY therapy, so it’s important to know what the side effects are. Some people who have been treated with POLIVY have experienced serious to fatal side effects. Your doctor may stop or adjust your treatment if any serious side effects occur. Be sure to contact your healthcare team if there are any signs of these side effects.
• Nerve problems in your arms and legs: This may happen as early as after your first dose and may worsen with every dose. Your doctor will monitor for signs and symptoms, such as changes in your sense of touch, numbness or tingling in your hands or feet, nerve pain, burning sensation, any muscle weakness, or changes to your walking pattern
• Infusion-related reactions: You may experience fever, chills, rash, breathing problems, low blood pressure, or hives within 24 hours of your infusion
• Low blood cell counts: Treatment with POLIVY can cause severe low blood cell counts. Your doctor will monitor your blood counts throughout treatment with POLIVY
• Infections: If you have a fever of 100.4°F (38°C) or higher, chills, cough, or pain during urination, contact your healthcare team. Your doctor may also give you medication before giving you POLIVY, which may prevent some infections
• Rare and serious brain infections: Your doctor will monitor closely for signs and symptoms of these types of infections. Contact your doctor if you experience confusion, dizziness or loss of balance, trouble talking or walking, or vision changes
• Tumor lysis syndrome: Caused by the fast breakdown of cancer cells. Signs include nausea, vomiting, diarrhea, and lack of energy
• Potential harm to liver: Some signs include tiredness, weight loss, pain in the abdomen, dark urine, and yellowing of your skin or the white part of your eyes. You may be at higher risk if you already had liver problems or you are taking other medication
Side effects seen most often
The most common side effects during treatment were
• Nerve problems in arms and legs
• Nausea
• Tiredness or lack of energy
• Diarrhea
• Constipation
• Hair loss
• Redness and sores of the lining of the mouth, lips, throat, and digestive tract
POLIVY may lower your red or white blood cell counts and increase uric acid levels.
POLIVY may not be for everyone. Talk to your doctor if you are
• Pregnant or think you are pregnant: Data have shown that POLIVY may harm your unborn baby
• Planning to become pregnant: Women should avoid getting pregnant while taking POLIVY. Women should use effective contraception during treatment and for 3 months after their last POLIVY treatment. Men taking POLIVY should use effective contraception during treatment and for 5 months after their last POLIVY treatment
• Breastfeeding: Women should not breastfeed while taking POLIVY and for 2 months after the last dose
These may not be all the side effects. Talk to your healthcare provider for more information about the benefits and risks of POLIVY treatment.
You may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch. You may also report side effects to Genentech at (888) 835-2555.
Please see the full Prescribing Information and visit https://www.POLIVY.com for additional Important Safety Information.
