For more than a year before my diagnosis of stage IA non–small cell lung cancer (NSCLC), in 2020, I had been self-treating a relentless chronic cough and a slight feeling of tightness in my chest. The symptoms were similar to asthma, so I began using albuterol inhalers. When they stopped working, I switched to a nebulizer machine to help ease my breathing, which provided only temporary relief.
When the COVID-19 pandemic hit early in 2020, I was working in the emergency room of a large community hospital and worried that my underlying lung problem could put me at greater risk of contracting a serious case of the coronavirus. By mid-summer, the tightness in my chest was a constant presence, and my breathing grew worse. I knew I could no longer self-treat my symptoms and made an appointment with my primary care provider, who ordered a chest x-ray and a pulmonary function test to determine whether I had restrictive airway disease or asthma.
I was relieved when both tests came back negative for any sign of a lung condition, but there still was no explanation for why I continued to have a persistent cough and tightness in my chest. I decided to have a consultation with a pulmonologist and asked for a computed tomography (CT) scan of my chest. And that’s what finally determined the source of my problems: I had a nearly 2-cm mass on the upper lobe of my right lung. A biopsy of the mass confirmed that I had NSCLC.
Preparing My Children for My Cancer Diagnosis
The diagnosis was shocking and terrifying. I have never smoked, and, as a physician, I’ve always looked after my health. How could this be happening to me, I wondered. I didn’t realize that an estimated 57% of Asian American women diagnosed with lung cancer have never smoked, compared with about 15% of women of other ethnicities.1
Adding to my distress was the fact that, at the time, I was raising three young children. Explaining my cancer diagnosis to them was very difficult, and I worried about how the diagnosis would affect their lives.
After the biopsy report, I underwent a series of CT and positron-emission tomography scans to make sure the cancer had not spread. Once it was confirmed that the cancer was localized, I met with a thoracic surgeon to discuss the next steps. He said because the size of the tumor was right at the 2-cm border, I was eligible for either a wedge resection or a lobectomy, but his recommendation was complete removal of my right upper lobe. After doing my own research, I concurred with his recommendation.
During surgery, the thoracic lymph nodes were resected and found to be clear of any malignancy. The surgery was successful, and no further treatment was indicated. I have been cancer-free for the past 4 years.
Although a biomarker study of the tumor isn’t required for early-stage lung cancer, I requested genomic testing of my tumor, which found an alteration in the EGFR protein. This information will be helpful if a recurrence occurs in the future.
Understanding the Increased Risk of Lung Cancer in Asian Women Who Have Never Smoked
My recovery from the lobectomy was long. But through regular rigorous exercise, my overall lung function and capacity are excellent, and the persistent cough and tightness in my chest have eased.
My experience with cancer has led me to become a fierce advocate for health education and to raise awareness among physicians and members of the Asian community, especially women, of the risk of lung cancer in never smokers. To better understand the underlying causes of why we are at greater risk of developing lung cancer, I have enrolled in the Female Asia Never Smokers (FANS) study at the University of California, San Francisco (https://fansstudy.ucsf.edu/home). I also encourage my family members, friends, and patients to enroll in the FANS study and to pursue screening tests if they have any chronic lung problems.
Becoming a Better Person, Parent, and Physician
Having cancer has given me a greater appreciation for the simple joys in life, including spending more time with my family, hiking, and traveling. It’s also given me a greater awareness of what my patients go through after receiving a cancer diagnosis. I understand the fear they have and try to arm them with information and resources to ease their concerns. Cancer has made me a more compassionate person and a better physician.
REFERENCE
1. Winn S: Study aims to understand lung cancer in non-smoking Asian American women. UC Davis Health, May 19, 2023. Available at https://health.ucdavis.edu/news/headlines/study-aims-to-understand-lung-cancer-in-non-smoking-asian-american-women-/2023/05. Accessed January 7, 2025.
Dr. Ho, 49, lives in Pleasanton, California. She is a medical emergency physician at Kaiser Permanente Fremont Medical Center and San Leandro Medical Center in 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.
