A Lung Cancer Diagnosis

November 2018: I have posted about my different diagnoses throughout this blog. It's been a while since I've posted about being diagnosed with lung cancer.

It all started three years ago in August 2015.  I was in the first years of a serious relationship with my boyfriend, Jeremy.  We were passed that milestone moment when you realize your significant other is your forever person.  We were planning our future together and talking about getting married.

It was also the beginning of my career as a letter carrier.  By choice, I was on walking routes. I was walking approximately 35-40 miles a week.  I would walk anywhere from 6 to 12+ miles a day. Carrying mail was more than a job. It was my career and my passion.

I would run at least one 5k (3.1 miles) a week after work with my runner's club.  I was enjoying running for the first time in my life. There were times I'd run two or three 5k's in a week.  Running wasn't just the annual 5k for charity any more.

As active and healthy as I was, I had a persistent cough and some random breathing issues.  There were a few times between late 2014 and July 2015 that I felt a heaviness in my chest, something similar to bronchitis. Each time there seemed to be an acceptable explanation (post nasal drip, virus) to justify the breathing problems.   It didn't seem too serious at the time.

When breathing issues interfered with exercising and running, I decided to get things checked out. I went to  a doctor for my breathing problems.  I had a chest x-ray. The result...a mass in my right lung.  Further testing revealed a devastating diagnosis.

We heard the words, “inoperable”, “incurable”, “terminal”.  What seemed to be minor turned out to be inoperable, incurable, stage iv lung cancer.  It was late stage, stage 4, non small cell lung cancer. At the time of diagnosis, lung cancer had already spread throughout both lungs and to my spine.  

I asked:

• How long to I have to live?
• How did I get lung cancer?
• What do I do now?

Statistics said I had a 3 to 5% chance of living one year.  Lung cancer in young healthy adults, especially women, was on the rise.  My lung cancer is caused by the EGFR gene mutation. It’s not genetic or something I inherited from my parents. It’s genomic, something in my DNA has changed and mutated.

The mutation meant I would have targeted therapy treatment instead of iv chemo.

Days before we heard, “incurable” and “terminal”.  Now we heard something promising. I had a chance at living a normal life.  It’s almost like, “normal life” echoed as it came out of my nurse navigator’s mouth.

Over the years my treatments have been targeted therapies and radiation treatments to my lung and spine.  I take a chemo pill once a day that targets the mutation that is driving my cancer.

I was able to stay at work and continued living my active otherwise healthy life. Things were as normal as they could be with quarterly PET scans thrown in to monitor disease progression. Or in my case, we watched tumors and nodules shrink and disappear. the targeted therapy did it's job. I was No Evidence of Disease within 8 months.

Our moment of relief lasted 6 months. Then the nodules and tumors returned in my lungs. We monitored that growth for 10 months. In the mean time I had a bronchoscopy biopsy to test for a new mutation. I switched targeted therapies because I tested positive for the t790m mutation.

Life is back to normal, for now. Well, as normal as it can be with quarterly scans and blood labs thrown in to monitor for disease progression.

x

One Year Ago Today...July 9, 2015

This is the first in a series of, "One Year Ago Today" posts.

One year ago today, on July 9, 2015, I met the man that ultimately saved my life.  One year ago today was my first appointment with my (then first and new) primary care physician, Dr. C. David Bird.

I explained to him I was having some shortness of breath and a persistent cough. I told him of my intermittent breathing problems and my brief, two appointment, history of going to two different urgent care type facilities and being told told, both times, (Dec 2014, June 2015) that my lungs sounded clear, when obviously to me they didn't feel clear.

At my Dr. Bird appointment I had an xray. That xray showed something in my upper lobe of my right lung. Dr. Bird said, although it may be the cause of my breathing problems, an xray wasn't enough to go on. He ordered a follow up CT Scan. The rest is history.

Why is it important to have a primary care physician? For me more frequent check ups, with one doctor, may have meant an earlier detection, possibly before a stage iv, inoperable, lung cancer diagnosis.

December 2014, I went to an urgent care type facility with what I thought was bronchitis. I was told my lungs sounded clear and my cough was from post nasal drip. Now, at the time I did have a terrible head cold. But at the appointment I made it a point to tell them that I coughed constantly, even without the head cold. I remember saying, "Jeremy says I cough all the time." No xray, no additional questions about my cough, no follow up suggested. I was given sinus meds to clear my head and sent on my way, like every other person with a head cold and post nasal drip that winter.

Fast forward to June 2015. Again, I thought I had bronchitis. I went to a different urgent care type facility. I told this Dr. that I felt like I had bronchitis and I coughed blood one time. I was told my lungs sounded clear and I had the tail end of a virus that was going around. No xray, no additional questions about my coughing blood, no follow up suggested. It really was one time, one cough, but I COUGHED BLOOD! I was given cough medicine and sent on my way, like every other person with that virus last summer.

It's so frustrating to think about stage iv lung cancer having the same symptoms of other, easy to fix, ailments.  It's also frustrating to think about the in and out exam offices and the lack of attention to individual patients. Or is it the lack of lung cancer education in the medical community altogether?

I owe my life to Dr. Bird.  Dr. Bird, a physician that listened to me and followed through until we knew exactly what we were dealing with.

One year ago today my life changed completely. It was just a few weeks later I would find out exactly how much it was going to change.

Side Effects or Something Else?

With a higher dose of my targeted treatment pill, Tarceva, I experienced all over muscle aches and pains.  The dose was lowered.  Most of those pains went away.

Lately, I've been concerned with some muscle tightness.  I started doing morning stretches after my last back pain issue. Since I was going to stretch my back every day, I thought I would be good to stretch the rest of my body too.

I realized I'm having issues with more than just my lower back.  Most all my body is tight. There has been no improvement in flexibility after several weeks of daily stretches.  I contacted my oncologist last Friday.  He suggested I hold off on my chemo pill for a few days to see if things improve.  Today is Monday.  I haven't taken a pill since Thursday.

I didn't think it would be too scary to not take my chemo pill for the last few days. I knew I would still have some in my system. I didn't think the cancer would return within a couple days.  But my energy levels were down.  I was also reluctant to carry on with normal activities for a couple days.

I called the oncologist today with my update.  Three days with no pill.  Three days with very little to no change.  So the plan is to go back to my regular dosage tonight.

Maybe I'm just that out of shape.  Maybe the stress on my body has effected me more than I realized.  Maybe this isn't lung cancer or treatment related.

The Rain in May Stays Mainly on the Brain

The forecast is calling for rain this week. That makes me think of May 2015. It rained 28 days in May last year. We don't get rain like that in Colorado Springs. It was so humid. I was having a hard time breathing.

That's the bad thing about lung cancer. The symptoms are often very similar to other symptoms. My lungs felt so heavy last May. I didn't think too much about it at the time because of our unusual, wet, humid, weather.

I now know it wasn't the weather causing my breathing problems. It was, yet to be diagnosed, lung cancer.

When it rains, and I'm at work, it triggers that memory of my bogged down lungs.

I've been deleting emails from the urgent care type facility that I went to in December 2014. Every time I see their emails it triggers the memory of going to their location, thinking I had bronchitis, and being told my lungs sounded clear. I was told my congestion was caused by post nasal drip. I explained that I cough all the time, even without a head cold.  I was given a list of over counter medications and the appointment was over.

This last week I decided to look at an email so I could unsubscribe from the repeated emails. That's when found the email was a survey.  How was your service? Let's just say I gave them an earful with the limited amount of characters I had to notify them that my post nasal drip cough was later diagnosed as stage iv lung cancer. I haven't received a reply yet.