Treating Stage IV Lung Cancer With a Pill

Your Health | 6 years ago

Treating Stage IV Lung Cancer With a Pill

Through new targeted therapies, Susan fights cancer with a pill – while keeping up with her schedule of exercise and travel.
Christmas was coming, and Susan knew what she wanted.

A few weeks prior – on November 26, 2014, the day before Thanksgiving – Susan learned she had Stage IV lung cancer. It was a diagnosis that came without a cure, and one that came with quite a shock. But her oncologist, Edward Kim, MD, chairman of solid tumor oncology at Levine Cancer Institute, gave her reason to hope: He told her there was a chance she could fight lung cancer with a pill. The next step was to learn the genetic makeup of her tumor with a biomarker test.

When the phone rang six days before Christmas, Susan received her gift.

“I will never forget the most precious Christmas present that I have ever received,” Susan says. “The biomarker tests confirmed that I could be treated with a pill instead of normal chemotherapy.”

Big Advancements in Targeted Therapies

Not all lung cancers are the same; neither are their treatments. Some tumors contain genetic mutations that can be matched with drugs that target those specific abnormalities. These targeted therapies allow some lung cancers to be treated with a pill, a treatment that comes with fewer side effects and greater convenience than chemotherapy. About a quarter of lung cancer patients are eligible for such targeted therapies. 

Susan’s biomarker tests confirmed that her tumor had the ALK-positive mutation, which meant she could fight lung cancer with a drug called crizotinib – no chemotherapy, no radiation, just a pill twice a day. 

With the drug, Susan managed Stage IV lung cancer while keeping up with her active lifestyle, which is no small feat. Susan may insist that she’s just the average 77-year-old grandmother, but her schedule begs to differ. During the week, she swims an hour each day; on weekends, she takes walks through her neighborhood and she gardens in her yard. Susan loves to travel as well, and she has grandchildren in Michigan and England who give her four reasons to do so.

But in March 2016, her energy suddenly waned. Susan became so weak that her husband had to lift her from the bathtub. The drug stopped working, and her disease began to grow again.

“The unfortunate thing is that not all therapies work forever,” says Dr. Kim. Susan was admitted into the hospital, and Dr. Kim created a new treatment plan for her. He found another targeted therapy, alectinib, that would allow her to continue to fight cancer with a pill. 

“Two weeks later, she was back to normal,” Dr. Kim says. “It’s been almost a year and a half since she began her new treatment, and she’s had almost no sign of disease. Susan’s back to her usual self; feisty and stubborn as ever.”

Treatment Beyond the Tumors

During the year and a half since she began her new treatment, Dr. Kim meets with Susan every three months to monitor her disease. If her lung cancer begins to grow again, they’ll review her next treatment options – perhaps another targeted therapy or a clinical trial.

While Dr. Kim manages her cancer, he and the staff at Levine Cancer Institute have empowered Susan to take an active approach in maximizing her health. The goal is for patients to remain as strong as possible during cancer treatments, focusing on diet and fitness.

In addition to maintaining her exercise routine, Susan joined the Healthy Cooking Club at Levine Cancer Institute. This monthly club offers samples and discussions of recipes that provide the nutrition cancer patients need during and after treatment. The club recipes have become staples in Susan’s diet. Levine Cancer Institute also offers five additional nutrition classes each month taught by Pat Fogarty, LCI’s wellness oncology dietitian.

“I am focused on eating the healthiest, most nutritious diet that I can compile, exercise as often as I can and rest frequently when I am tired,” Susan says. 

Managing Adversity, Maintaining Hope

Between the alectinib, exercise and her healthy diet, Susan continues to enjoy an active lifestyle even while having Stage IV lung cancer. She’s back in the pool and back on her walks. She’s even got two fresh stamps in her passport from Scotland and Greece. Through it all, Susan has learned not to worry about things she cannot control but to appreciate each day as it comes. If she has a complaint, it’s about people who treat her as a sick person. She’s just an ordinary, 77-year-old grandmother, she insists.

It’s been three years since Susan’s “most precious Christmas present.” Since then, she has grown close with Dr. Kim and his staff, and she has grown optimistic in her fight against lung cancer.

“I enjoy interacting with Dr. Kim and all of the members of his team. Their optimism and cheerful approach to my treatment is always a source of comfort and hope,” Susan says. “Lung cancer is not necessarily a death sentence. It’s an adversity that can be managed.”