Jill Feldman with radiation oncologist Gaurav Marwaha, MD, left, and medical oncologist Philip Bonomi, MD.
By Jill Feldman
I have been fighting lung cancer indirectly, and now directly, for 36 years, and most of it has been an uphill battle. I lost my dad and two grandparents to lung cancer when I was 13, and then my mom and aunt, Dede, died of lung cancer when I was in my 20s. I was shocked and upset that in the 14 years between my dad being diagnosed with lung cancer and my mom being diagnosed, there was not a single advancement in lung cancer treatment, despite it being the No. 1 cancer killer. My family and I felt helpless and hopeless, and while there wasn’t any research on hereditary lung cancer, I knew our familial lung cancer wasn’t just a coincidence.
I did what I could to get educated, be an advocate for myself and my family and to help advance a cause that many were not aware of and/or not interested in. While doing so, in 2009, I was diagnosed with lung cancer at 39 years old. My kids were 6, 8, 10 and 12 — and their only association with the disease was death. They were scared, and my greatest fear was becoming a reality. I was following in my family’s footsteps, and there wasn’t any promising research that convinced me the path would change.
For many years, the only distinction doctors could make was whether a person had small cell or non-small cell lung cancer, and patients had three treatment options: surgery, radiation and chemotherapy. It wasn’t even until the 1990s that combination chemotherapy regimens were approved. Still, there was debate whether it was even worth treating lung cancer because in many cases, the toxicity was worse than the disease, and the benefits from chemotherapy were marginal.
Immunotherapies have changed how we treat the disease
By Philip Bonomi, MD
One of the things I learned early on in medical school is never to forget that it’s a privilege when a patient puts his or her trust in you to take care of them. I have never taken that privilege lightly. My goal has always been to prolong meaningful life and relieve suffering for my patients. That’s been my personal mission statement throughout my career.
And those goals are not always easy when it comes to treating lung cancer. When I started out in medicine, some of the treatments we tried for lung cancer were simply not effective. There were not a lot of options for our patients and often the prognosis was poor.
But through my long career, I have seen that perseverance, believing in an idea and not giving up on it can pay off.
Enter immunotherapies. When I was in medical school in the late 1960s, we had high hopes for immunotherapy. We thought it was going to be very important for treating patients with cancer. But then, we saw one failed study after another over the next few decades.
Gina meets with medical oncologist Marta Batus, MD, and thoracic surgeon Christopher Seder, MD.
As a lifelong smoker, Gina knew the risks of smoking — but, like many people, she pushed these thoughts out of her mind.
“For years, my very dearest friend and I would sit on the phone together, have coffee and smoke cigarettes,” Gina remembers. “Then she was diagnosed with lung cancer and died from it. Even though I saw what she and her family went through, I was still in denial that anything could happen to me.”
Five years ago, at age 70, Gina got a wake-up call to start taking control of her health: She was diagnosed with breast cancer.
She had a mastectomy at Rush and was soon cancer-free. With a new lease on life, she began running, cut down to three cigarettes a day, and started listening to shamanic drum chants and doing positive-thinking exercises. She also continued her regular breast cancer follow-ups at Rush with medical oncologist Melody Cobleigh, MD, and nurse practitioner Teri Dougherty, NP.
Still, Gina’s smoking history and age put her at high risk for lung cancer. So at an appointment last summer, Dougherty talked to Gina about her risk factors and suggested that Gina was a good candidate for a lung cancer screening test — a low-dose CT scan that can detect lung cancer at its earliest stages, before symptoms arise and when it may be most curable.
When I was 13, I lost two of my grandparents to lung cancer, and six months later my dad died of lung cancer. Then in my 20s, both my mom and close aunt died of lung cancer.
Needless to say I was devastated and felt helpless, so I started doing advocacy work with LUNGevity Foundation, a national lung cancer organization. I also began getting scans every few years. All was good until 2009. I was 39 years old, had four small children and was president of LUNGevity, so there just aren’t words that can describe how I felt when I was diagnosed with lung cancer, the same disease that I literally watched kill both of my parents.
I have been in and out of treatment for the past 8 1/2 years. Lung cancer will be a lifelong roller coaster ride for me, but because of a better understanding of lung cancer biology, advancements in treatments, and my dedicated, passionate, collaborative care team, the cancer can be managed as a chronic disease, for now.
I started smoking at age 18. My dad was a smoker, and he quit so that none of his kids would smoke, but everybody in the family smoked anyway. We were on our own to decide when to quit. There were seven of us, and I was the sixth one to quit. I just got to a point where I thought, “There has got to be something better than this.”
I originally learned about the opportunity to have a lung cancer screening from my family doctor, Jeremy Pripstein, at my annual physical. He explained that the government had a program for a free screening for people who had smoked for a long time.
In my role as lung cancer screening coordinator at Rush, I have the pleasure of working on a program that has the ability to save lives by identifying lung cancer that otherwise would go undetected.
In doing so, I hope to spare my patients and their families the sadness and grief one experiences when diagnosed with advanced lung cancer. I know and understand lung cancer on a very personal level.
To understand my relationship with this disease, one has to learn a bit more about me. Here is my story.
I always wanted to be a nurse. When I graduated from high school, my family encouraged me to focus my career on business. I held positions in advertising and marketing. Looking back, I was always restless and never quite satisfied with my work.
‘Love, laughter, tears’
Fast forward many years to helping my mother, a widowed lifelong smoker, who recently downsized to a senior apartment. Tired and blaming the move for her unsteady gait, in the back of my mind, I wondered if she might have a brain tumor because of lung cancer. My worst fears came true when a few weeks later she was diagnosed with small cell lung cancer that already spread to her brain.
On Feb. 17, 2010, while I was teaching high school science in the Bronx, my mother was diagnosed with stage IV lung cancer. I quickly left everything — my teaching fellowship, my master’s degree program and my friends — and returned to Chicago to be with my family and my mom.
I always knew I was going to work in health care, but I wasn’t sure which route or specialty I was really interested in. While I saw my mother suffering, I came to a very big realization: There is nothing in the world harder than watching someone you love struggle for a breath. It was the most helpless feeling to not be able to alleviate any of that hardship.
After caring for her through her illness (my mother passed away about 10 months after she was diagnosed), I knew that I wanted to dedicate my life to helping people breathe and supporting their loved ones. In 2011, I entered the Master of Science in Respiratory Care Program at Rush, where my mother received wonderful care, so I could help people care for their heart and lungs.
I was diagnosed with a mass on my left lung approximately 6 centimeters in size. My primary care physician wanted me to move quickly and get a biopsy so he could decide what the best treatment would be.
I am a COPD patient with emphysema and really didn’t want a biopsy. I would rather they just went in a removed whatever was there. Some other history for me is that I was a smoker of about a pack a day for about 25 years, but have quit since 1995.
I decided to get a second opinion and was recommended by a friend and patient to Rush thoracic surgeon William Warren. My appointment was scheduled on Dec. 8, 2010, where I brought to him all of my films from previous scans and X-rays. When he entered the exam room, we talked a bit and he asked if I have the chills or feel flu-like symptoms. I told him “no, I feel fine.” I also mentioned my primary care physician recommended I move to get a biopsy.
Dr. Warren informed me I do not need a biopsy, he knows what it is and it is a form of cancer, and he feels it should be removed. He said “if it was me, I would get it done soon.” I was registered for the the surgery on the morning of Dec. 14. Continue reading →