Janet: Lung Cancer Survivor

As a preschool teacher, it was not unusual for Janet to experience back pain now and then. It wasn’t until a Christmas shopping trip in 2006 that she suspected something more than a work related strain may be to blame. After reaching for something on a bottom shelf, she noticed she had trouble standing back up, and thought she may have a slipped disc; lung cancer was not one of the causes that entered her mind.

At the recommendation of her primary care physician, Janet received an MRI to find out what might be causing the problem. She was shocked to learn that she had stage IV lung cancer; it had spread to her brain and spine. It was three days before Christmas and she was told she would need to be admitted to the hospital immediately to begin treatment; however, under the impression that she would not live to see another Christmas, she left to be with her family. When she returned, she started treatment with radiation therapy.

Never having smoked before, Janet thought there must be a mistake and spent several months in denial of her disease. “I never realized there is such a large percentage of people that have never smoked, and still get lung cancer. Several of my close family members had cancer so I thought it may be a cause for concern in the future, but not lung cancer. When I heard the diagnosis my whole world went black and a part of me wanted to just die right there,” Janet explained.

After hearing the treatment plan she was to undergo, she decided it would be wise to get a second opinion, even though time was a factor. At the advice of her sister, Janet met with Scott Gettinger, MD, Assistant Professor of Medical Oncology at Yale Cancer Center. Dr. Gettinger tested her biopsy for an Epidermal Growth Factor Receptor (EGFR) mutation and learned that she does carry the mutation, meaning a different treatment plan needed to be put into action.

Tarceva is a targeted therapy that is generally used after standard chemotherapy has failed. It targets the EGFR in order to block tumor cell growth in the body. Janet commented that Dr. Gettinger was the first doctor that mentioned targeted therapies to her. She did not even realize that there were different types of therapy available. Janet has been taking Tarceva orally for three and a half years and her recent tests have all come back free of disease progression. She does experience side effects such as fatigue, rashes, and diarrhea. She went back to work for a year and a half, but it became too exhausting and she wanted to save her energy to visit her children. Despite these side effects, she is able to live a happy and fulfilling life.

“When I was first diagnosed I was told that I would not see my son graduate high school. He graduates from college next May and I plan to be the loudest mother there. I volunteer two days a week at a rescue farm, go to the beach every day, and travel to visit my daughters in New York City and Boston. I want people to see that I am here, four years later, no evidence of active disease and living a happy life,” Janet said. “It is possible.”

Janet commented that having cancer of any kind is never easy, but hope is one of those most important things to arm yourself with when faced with it. She credits Tarceva with giving her hope for more time, hope for a good quality of life, and the hope that there will be a cure somewhere down the road. She also credits her success to the fact that Dr. Gettinger specializes in lung cancer. To her it made a huge difference that he sees and cares for lung cancer patients on a daily basis and treats his patients like individuals.

“If Tarceva stops working down the line, which it may, I know that Dr. Gettinger has a Plan B and a Plan C for me,” explained Janet. “Tarceva has bought me time, and new research is constantly being done and new drugs developed. It’s comforting to know that Dr. Gettinger is prepared to help me continue fighting, to the best of his ability, for as long as it takes.”

One of the biggest challenges for Janet is the guilt she feels thinking about her children and their experience dealing with her diagnosis. She commented that people look at her and wonder why she is not able to work; she does not look like she has cancer. To help cope with these, and other issues, she recently joined the Lung Cancer Support Group at Smilow Cancer Hospital at Yale-New Haven, led by Irene Scanlon, LCSW and Linda David, RN. Even though Janet has a wonderful support system in her family, it is important for her to talk with people who have been through what she has, and are dealing with the same side effects and issues.

Janet continues to struggle with the effects of her cancer diagnosis. She makes sure to appreciate everything now, as it is constantly in the back of her mind that it may be the last time she sees or does something. Her advice to others is to not listen to the timeline given, but to make your own and enjoy each day. Janet and her husband have been together since she was sixteen years old, and she makes sure to tell her children how important it is to find someone that is their best friend and will be there by their side through anything, as she did.

“I have been given a gift to be able to spend quality time with my family. Targeted therapies are having so much success recently and it is important for people to know that they are out there, and that more research is needed in this area. It may not be a well known fact, but lung cancer kills more people than breast, colon, and prostate cancers combined, yet still only receives a small fraction of the research dollars,” Janet said. “When you receive a diagnosis of cancer, especially lung cancer, you think there is no way you can make it, but I am still here, I am surviving.”