In 2017, I noticed a roadside billboard touting the benefits of low-dose computed tomography (CT) imaging for lung cancer screening. The message probably saved my life. The public service campaign, called Saved by the Scan from the American Lung Association, included an Internet address where I could take a lung cancer risk assessment quiz to help determine whether I was eligible for CT screening. I had recently quit a 40-year cigarette habit and knew my risk for lung cancer was high.
Denise Lee
After taking the quiz, I talked to my primary care physician, who said I didn’t qualify for the CT scan because I was only 54, 1 year shy of the age eligibility requirement for the test. (Editor’s Note: In 2021, the U.S. Preventive Services Task Force changed its age recommendation for low-dose CT screening for high-risk individuals from age 55 to age 50.1 The following year, the Centers for Medicare & Medicaid Services also lowered its age requirement for high-risk individuals to age 50.2)
Finally, I convinced my doctor to prescribe the CT scan. Then, I had to convince myself to go through with the test. I was terrified of what it might find. The next day, I got a call from a pulmonologist telling me I had a suspicious mass on my left upper lobe and would need additional diagnostic tests. I underwent a full-body positron-emission tomography scan, magnetic resonance imaging of my brain, and tissue biopsy of the mass in my lung.
The initial diagnosis was stage IIB non–small cell lung cancer (NSCLC). Fortunately, following surgical removal of my left lobe and 17 lymph nodes, which were negative for malignancy, the cancer stage was downgraded to IB. However, the news wasn’t all good. Because the tumor was classified as grade III poorly differentiated, and a high percentage of cells were found to express PD-L1, my oncologist suggested I undergo adjuvant chemotherapy.
Being Part of the Solution
He recommended four rounds of a combination regimen of cisplatin and pemetrexed, which was successful in putting me in remission. He then asked if I’d like to participate in the ALCHEMIST Trial (ClinicalTrials.gov identifier NCT02194738), which is studying genetic testing in screening patients with stage IB–IIIA NSCLC to help physicians determine the best treatment for patients who have certain genetic changes to prevent cancer recurrence after surgical resection and chemotherapy.
Although I didn’t know a lot about clinical trials, I knew that for new cancer therapies to be approved by the U.S. Food and Drug Administration, they must go through this type of rigorous investigation. Even if the treatment isn’t successful in preventing a recurrence, I thought if the study could help other patients diagnosed with lung cancer, I was happy to be part of this important work and enrolled in the trial.
I was randomly assigned to receive nivolumab and undergo CT imaging scans every 6 months. So far, the tests show no evidence of disease. If my health status remains unchanged, in February 2023, I will reach my 5-year anniversary of being cancer-free.
Removing the Stigma of Cigarette Smoking and Cancer
When first diagnosed with lung cancer, I kept the news to myself. I was afraid people would think I deserved the disease because I had been a smoker. But isolating yourself is the worst thing a lung cancer survivor can do.
I was fortunate to find a mentor through the American Lung Association who was also a NSCLC survivor and former smoker. Being able to connect with someone with my similar smoking and disease history was incredibly helpful and comforting. She helped remove the shame I felt and offered me a lifeline when I badly needed one. Today, I’m paying her good deed forward by mentoring other lung cancer survivors and advocating for early-detection cancer screenings. The experience is rewarding and has given me a new life purpose.
Living My Best Life
Having cancer has taught me some invaluable lessons, including the importance of living in the present and not squandering time worrying about things that may never happen. I realize cancer recurrence is a possibility, but knowing I’m being closely monitored for such an occurrence takes away some of the fear.
I also know that advances in therapies for lung cancer are happening at an ever-increasing pace. Having that knowledge keeps me hopeful about not just my future, but the future of other lung cancer survivors as well.
I do not know what the future holds for me, but instead of living in fear and trepidation, I choose to live my life optimistically and with gratitude. I’m thankful for the support I receive from my medical team, friends, and family as well as for the opportunity to be of service to others going through a cancer diagnosis.
When my oncologist declared me cancer-free, he told me to go live my best life. That’s just what I intend to do.
REFERENCES
1. U.S. Preventive Services Task Force: Final Recommendation Statement: Lung Cancer: Screening. March 9, 2021. Available at www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Accessed November 29, 2022.
2. Centers for Medicare & Medicaid Services: CMS expands coverage of lung cancer screening with low dose computed tomography. February 10, 2022. Available at www.cms.gov/newsroom/press-releases/cms-expands-coverage-lung-cancer-screening-low-dose-computed-tomography. Accessed November 29, 2022.
Ms. Lee lives in Freemont, California.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
