I’ve seen the tremendous research advances in treatment that have allowed patients like me to surpass survival expectations.— Tomma Hargraves
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The only clue that I was harboring a life-threatening cancer came as I was driving to a golf lesson in the fall of 2006, and I casually rubbed the left side of neck and felt a tiny bump. Although I wasn’t alarmed at the time, I did point out the mass to my primary care physician when I met with him a couple of weeks later for my routine physical exam. He wasn’t concerned about the mass either but suggested I see a surgeon to have it removed and biopsied to be cautious. Otherwise, he assured me, except for some weight loss, which I had attributed to my new exercise program, I appeared to be in excellent health.
Even when he called me a few days later to say the tissue biopsy showed I had non–small cell lung cancer (NSCLC), he prefaced the bad news by saying he didn’t think the findings were accurate because I was otherwise so healthy and had no symptoms of such a serious cancer. Then, he ordered a computed tomography (CT) scan that same day, and the findings were definitive—and devastating. Unbelievably, there was a tumor in my upper right lung and tumors in many lymph nodes in my mediastinum and in both sides of my neck. I had stage IIIb -NSCLC. I later learned the cancer carried the epidermal growth factor receptor (EGFR) mutation.
Within a few days, I went from being a seemingly healthy, physically fit woman with potentially many decades ahead to a life-and-death struggle with metastatic lung cancer, and I knew my odds weren’t good.
Managing Metastatic Lung Cancer
A search on the Internet revealed the 5-year survival rate for my type of advanced cancer was just 35%.1 After meeting with three oncologists, who offered differing approaches to treatment, I decided to participate in a clinical trial that the third oncologist recommended, which was being launched at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center. The trial was investigating a staggered protocol of a triplet-combination of high-dose chemotherapy, followed by 7 weeks of high-dose radiation and reduced doses of the combination chemotherapy, and then several months of erlotinib.
The radiation caused 3 weeks of intense esophagitis and permanent lung damage, which makes me susceptible to pneumonia, but the treatment was successful in putting me in complete remission for 3 years. Fortunately, because I was still enrolled in the clinical trial, I was monitored closely; when the cancer recurred in my neck and brain in 2009, the tumors were easily treated with additional chemotherapy and radiosurgery. I have been in remission ever since, but I don’t consider myself cured of cancer. I think of my cancer as being under control, and I am grateful for that.
Redefining Cancer Survivorship
I’m sad to say that most of the patients enrolled in the clinical trial did not experience the outcome I did. I don’t know why my tumor responded so well to the treatment and theirs did not, and I have survivor’s guilt knowing that so many patients with late-stage NSCLC do not get to be long-term survivors like me.
In October 2020, if all continues to go well, I will celebrate 14 years as a cancer survivor, and cancer survivor is how I now define myself. As a speech therapist, until I retired 5 years ago, I know the rewards that come from public service. I am continuing that commitment as a patient lay navigator at UNC Lineberger Comprehensive Cancer Center, the hospital I believe saved my life and where I help newly diagnosed patients cope with cancer. I also raise funding for research in NSCLC, and the work is rewarding.
Cancer has given me a new life purpose and an obligation to pay my good fortune forward to others. I’ve seen the tremendous research advances in treatment that have allowed patients like me to surpass survival expectations. And I know that, in the future, long-term survivorship, even for late-stage cancers, will become the norm and not the exception.
Ms. Hargraves lives in Raleigh, North Carolina.
1. American Cancer Society: Lung cancer survival rates. Available at www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/survival-rates.html. Accessed January 31, 2020.
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.