Cancer- and Tagrisso-versaries

June 14 marked three years since my Stage IV lung cancer diagnosis and on June 30, I will complete three years on Tagrisso targeted therapy. 

with my first Tagrisso pills (a sample from my oncologist), June 30, 2022

Every year as June approaches, I feel like I am reliving my own Stations of the Cross, recalling what happened each day as I walk toward the inevitable, gut-wrenching diagnosis: my GP telling me the x-ray showed “infiltration” and recommending a CT scan, getting the CT scan and the radiologist (and Leland) thinking I had TB, being sent to the LungenClinic, the doctor ruling out TB and telling me cancer was one of 3 possible explanations for my symptoms, but that it was "unlikely" because of my age, and so on.

Not long ago, a Stage IV lung cancer diagnosis was a sure, quick death sentence. A researcher who wrote an article commemorating the 20^th anniversary of the discovery the EGFR (epithelial growth factor receptor) mutation driving my cancer recalled that in 2004, “It was not uncommon for patients to be directly referred to hospice following the diagnosis of lung cancer.”  

But thanks to incredible scientific progress in targeted therapy and God’s mercy, I have experienced my own resurrection, with my lungs now clear enough to breath and be able to walk up a hill or climb several flights of stairs without feeling winded like I once did. And all without having to undergo radiation or chemo.

When I was first diagnosed – and even after I learned I was a candidate for targeted therapy – I had no idea if I would be alive in three years. I remember in late summer 2022 when Leland and I read the fine print on the Tagrisso promotional materials indicating that the median overall survival rate was 38.6 months (compared to 31.8 months for 2 other medications). We did the math and felt shocked to realize that 38 months was only a little more than 3 years. That seemed like a simultaneously great and terrible statistic.

So, approaching three years on Tagrisso feels like a victory, especially considering the hell we’ve been through. After being an outlier in all the wrong ways, I am hoping to be an outlier in the right direction for once – and I have growing confidence that I might be. What I have going for me is my age (most people with lung cancer and in the Tagrisso clinical trials are 65 or older) and lack of any other health problems. As I like to say, other than having lung cancer, I’m in perfect health! Thanks to targeted therapies and other new cancer treatments, thousands of people like me are living full lives while managing lung cancer as a chronic, incurable disease. This was unthinkable even 15 years ago.

But future scientific progress and cancer prevention and treatment, including lung cancer, are now in jeopardy. The Trump administration has proposed a 26.2% cut to the Department of Health and Human Services. This cut includes a whopping 37% cut to the National Institutes of Health and shuts down the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention. The CDC’s highly successful Office on Smoking and Health has already been eliminated, leading the American Lung Association to conclude that “the federal government has virtually abandoned its role to help tobacco users quit and prevent kids from starting.”

The Department of Defense eliminated all lung cancer research funding in 2025. “In a shocking move, the [DOD] slashed its cancer research budget, eliminating all support for lung cancer under the Congressionally Directed Medical Research Programs. The Lung Cancer Research Program, which once funded groundbreaking studies to improve survival and early detection, now receives $0 in FY25. These Department of Defense cancer research cuts jeopardize years of progress and put lives—especially those of veterans and non-smokers—at serious risk.”

Make no mistake: many people will die because of these cuts to cancer research and prevention – not to mention all the other cuts to health programs and the loosening of air pollution guidelines. The latest research suggests that air pollution is the leading culprit in the rising incidence of never-smokers with lung cancer: “outdoor air pollution is the second leading cause of all lung cancer cases after smoking.” If I had to bet on what caused my cancer, my money would be on air pollution. I spent my teenage years (1980s) in So Cal where the smog was so dense that we often couldn’t see the nearby San Bernardino mountains. And in El Salvador, where I lived for 6 months in 1993 and 8 months in 2001, the diesel smoke was so thick that my snot was blackish-grey when I blew my nose after running 10K in the city.

Many people don’t realize that lung cancer is by far the leading cause of cancer deaths in the USA and worldwide. Cutting off funding to prevent and treat it is cruel. Budgets are moral documents, and this proposed budget is immoral. As a cancer patient who is alive because of advancements in biomedical research, I take personally the destruction of the US research and public health infrastructure.