I have been a registered nurse for almost 5 decades and was completely unprepared to hear the words “You have stage IV lung cancer.” I think receiving the diagnosis was especially shocking because the symptoms I began experiencing in the summer of 2015, including some unusual weight gain, shortness of breath, fatigue, and a mild cough, sort of crept up on me. Despite these symptoms, I felt well enough to work a full shift, treating patients at an infectious disease clinic the day before my diagnosis. But by the next day, I was finding it so difficult to breathe that my husband had to drive me to the emergency room.
A computed tomography (CT) scan of my lungs and abdomen showed a mass in my upper left lung and in my liver, and there was excess fluid around my heart. I was immediately admitted into the intensive care unit, where I had a pericardial tap to remove the fluid around my heart and a biopsy of the mass in my lung. The results from the tissue biopsy showed I had stage IV ALK-positive non–small cell lung cancer (NSCLC) adenocarcinoma. I had never heard of ALK-positive lung cancer and wasn’t sure what that meant for my prognosis, but I feared I wouldn’t be around long enough to see Christmas.
Benefiting From Advances in Lung Cancer
A few weeks after my diagnosis, I met with an oncologist who told me that if I had to pick a cancer, this was the right one to have because advanced ALK-positive NSCLC is highly sensitive to ALK tyrosine kinase inhibitors. My oncologist recommended a clinical trial investigating the tyrosine kinase inhibitor ceritinib. After just a few weeks on the drug, the tumor in my liver disappeared, and just a small mass remained in my left lung.
Concerned that the malignancy would eventually spread to other organs, in August 2016, I had a left lung lobectomy. I remain in the clinical trial, and although no one has declared I am “cancer-free,” regular routine CT scans show no evidence of disease.
Dealing With Dual Crises
At the height of the COVID-19 pandemic this spring, I had another scare when my shortness of breath returned with a vengeance, and I was unable to have a diagnostic test. Since I was relatively certain I hadn’t been exposed to the coronavirus, I feared the symptom signaled a return of the cancer. My oncologist ordered a chest x-ray and another CT scan of my lungs, but because hospitals in my state were so overwhelmed treating patients with COVID-19, they were not performing outpatient services, and I was unable to have the tests.
“Contending with the threat of the COVID-19 pandemic and the fear of a cancer recurrence has made me determined to live life to the fullest.”— Maureen Markham
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My oncologist then sent a referral for a CT scan to a local radiology center, but it was denied because it stated I had “shortness of breath,” a hallmark of the coronavirus. Several weeks later, I was finally able to get an appointment for a CT scan with a radiologist in my hospital, and the results were clear for both COVID-19 and cancer.
Living Life to the Fullest
Contending with the threat of the COVID-19 pandemic and the fear of a cancer recurrence has made me determined to live life to the fullest. During my 48-year career as a nurse, I was so preoccupied with taking care of my patients—and happy to do so—I neglected my own life. When you are healthy, death seems far off into the distant future. It took cancer, and to some extent the COVID-19 pandemic, to make me realize that every day is a gift and not to be taken for granted.
In the past, when I received an invitation to meet friends for dinner or go to a movie, my work came first, and I usually declined. Today, I’m determined to say “yes” to life, and no invitation is too mundane for me to accept.
Once cancer enters your life, you are never the same. Mortality is no longer in the abstract, and I can see the end of my life. Until that happens, I’m going to live every day as if it were my last.
Ms. Markham lives in Bloomfield, New Jersey.
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.