Defying the Odds With Small Cell Lung Cancer: Montessa Lee, 47, Is a Beacon of Hope

Initially, doctors suspected bronchitis or inflammation around her rib cage, which is common among someone working daily with children, such as Lee, an educator. But her symptoms persisted: “When I say chest pain, it was like stabbing chest pain. Still had shortness of breath, coughing.”

It wasn’t until she finally received a chest X-ray that the truth emerged: a tumor was covering nearly three-quarters of her lung.

Lee was diagnosed with small-cell lung cancer, a rare and aggressive disease with a five-year survival rate of just 5 to 10 percent, according to the National Cancer Institute.

There are two main types of lung cancer, which doctors group together based on how they act and how they’re treated:

• Non-small cell lung cancer (NSCLC) is the most common type and makes up about 85% of cases
• Small-cell lung cancer (SCLC) is less common, but it tends to grow faster than NSCLC and is treated very differently

“At the time of my diagnosis, it was still like a one-size-fits-all treatment approach,” Lee says. She underwent simultaneous chemotherapy and chest radiation, followed by prophylactic cranial radiation to prevent the cancer from spreading to her brain. The side effects were brutal. “I couldn’t swallow—not even saliva. And the fatigue… I cannot describe that level of fatigue.”

Lung cancer experts tell SurvivorNet that treatment varies depending on which type and stage of cancer you have. If the cancer is local — meaning just in the lungs — surgery may be an option. But if it has spread to the lymph nodes, a combination of radiation with chemotherapy, followed by immunotherapy, may be the best option.

Faith as a Lifeline

Despite the physical toll, Lee leaned into her faith.

“I’m a woman of faith, but I’m also a pessimistic person,” she admits. “But I heard the Lord whisper, ‘It is going to be something bad, but it’s not going to kill you. It’s going to be a healing testimony for somebody beyond yourself.’”

That whisper became the foundation for her memoir, “He Whispered Life,” a deeply personal account of her cancer journey.

“Maybe my memoir was more therapeutic for me as well,” she reflects. “But the oncologist who read my book, and people who have read it, said it was inspiring to them.”

WATCH: SurvivorNetTV Presents: ‘SN & You Turning To Faith’

A study published in Cancer highlights the powerful role of faith in the lives of cancer patients, revealing that 69% of those diagnosed with cancer reported praying for their health, compared to 45% of the general U.S. population.

Cancer psychologist Dr. Andrew Kneier helped co-author “Coping with Cancer: Ten Steps toward Emotional Well-Being.” He also co-authored a column published by Stanford Medicine with Rabbi Jeffery M. Silberman, director of spiritual care at Danbury Hospital in Connecticut.

Together, they emphasize the deep emotional and psychological support that faith provides to those battling illness.

According to Kneier and Silberman, spirituality offers a powerful coping mechanism, helping individuals navigate the uncertainty that comes with a cancer diagnosis.

“A person’s faith or spirituality provides a means for coping with illness and reaching a deeper kind of inner healing,” they explain.

Faith helps patients in multiple ways, including:

• Seeking answers to the difficult questions illness presents.
• Finding comfort in the midst of fear and pain.
• Gaining a sense of direction during an overwhelming and uncertain time.

Religious teachings, they argue, can serve as a guidepost, offering strength and resilience when navigating the emotional and physical challenges of cancer.

The Weight of Survival

Lee’s nearly 20-year journey hasn’t been without emotional scars.

“Survivor’s guilt is real,” she says. “I’ve lost a lot of people on this journey. Even though I was a psychology major undergrad, I don’t know if I really understood that survivor’s guilt is real—but it is.”

According to the medical journal Cureus, “Survivor’s guilt is the response to an event that some people experience when they survive a traumatic event or situation that others did not. This psychological phenomenon can be associated with post-traumatic stress disorder (PTSD), anxiety disorders, and complicated grief.”

There are times, she admits, when she has to step away from social media, where she often learns of fellow patients’ passing.

“Had I not been able to walk that strongly in the faith, I would have been depressed and just down and out,” she says. “I had to be reminded that he didn’t bring me this far to leave me now.”

WATCH: How Genetic Testing Can Help Determine the Right Form of Mental Health Treatment.

Research published in Epidemiology and Psychiatric Sciences found that “35 to 40 percent of cancer patients have a diagnosable psychiatric disorder,” and the number of people experiencing mental health challenges is “higher among cancer patients with advanced stages of cancer and in palliative care settings.”

Dr. Asher Aladjem, a board-certified psychiatrist at NYU Langone, tells SurvivorNet, “Anxiety is a protective and normal kind of symptom.”

“Sometimes the anxiety gets to the point that things stand in the way of the scan or whatever the test is, and people avoid it and run away from it. Treating the anxiety allows for the completion of the workup or the treatment or whatever the situation may be in a much more effective way,” Dr. Aladjem said.

Dr. Alagjem encourages patients to advocate for their mental health. He reminds us that even if mental health services are not offered while undergoing physical treatment for a diagnosis, patients can still ask their care team about them.

A Voice for Change

Today, Montessa continues her work in education, specializing in teaching children with autism. But she’s also become a passionate advocate for lung cancer awareness and research funding.

She’s led numerous conversations about the challenges of living with small-cell lung cancer and the advancements in treatment for this rare disease.

As part of her advocacy, she visits research labs to spotlight the transformative potential of cancer research. Her presence is a living testament to the hope that emerges when we invest in this vital field that touches countless lives.

“These university labs are on the cusp of potentially changing outcomes for patients,” Lee says. “But you have to fight for cancer research funding.”

And while her diagnosis once felt grim, she now sees a shift in the landscape. “There’s never been a better time to get small-cell lung cancer—and I’m smiling because, I mean, who says this, but it’s true,” she says. “I can’t even keep up with the FDA approvals and things coming out back-to-back, offering us patients hope.”

Understanding Lung Cancer and Why It’s Hard to Catch Early

Lung cancer forms when cancer cells develop in the tissues of the lung. It is the second most common form of cancer and the leading cause of cancer deaths in both men and women in the U.S., SurvivorNet experts say. It’s “completely asymptomatic,” says thoracic surgeon-in-chief at Temple University Health System Dr. Joseph Friedberg.

“It causes no issues until it has spread somewhere. So, if it spreads to the bones, it may cause pain. If it spreads to the brain, it may cause something not subtle, like a seizure,” Dr. Friedberg adds.

WATCH: Detecting lung cancer in the absence of symptoms.

Scans such as X-rays can help doctors determine if a shadow appears, which can prompt further testing for lung cancer.

Lung cancer often doesn’t cause symptoms until it has already spread outside the lungs, according to SurvivorNet’s experts.

Some people with lung cancer may experience symptoms such as:

• A cough that doesn’t go away, that gets worse, or that brings up bloody phlegm
• Shortness of breath
• Fatigue
• Chest pain
• Hoarse voice
• Appetite loss
• Weight loss

If you are experiencing these kinds of symptoms consistently, contact your doctor for further tests.

How Molecular Testing Helps Lung Cancer Patients

Lung cancer treatment has seen notable progress, partly because of molecular testing and profiling. This type of testing helps better understand specific genetic alterations and mutations that drive the growth, development, and progression of cancer cells. Some of these molecular characteristics can be targeted using precise and effective new therapies to improve patient outcomes. Ultimately, understanding the molecular profile of each person’s cancer allows oncologists to use customized and personalized treatments.

RELATED Next-Generation Sequencing in Lung Cancer

There are several next-generation sequencing (NGS) tests you may encounter, depending on where you are getting treatment and what you are getting treatment for. Here are some of the common ones currently on the market:

• FoundationOne®CDx looks at 324 genes in solid tumors and says results can take up to 12 days. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB) to help inform immunotherapy decisions.
• OmniSeq Insight provides comprehensive genomic and immune profiling for all solid tumors. It looks for 523 different genes. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB), as well as PD-L1 by immunohistochemistry (IHC).
• Cobas EGFR Mutation Test v2 identifies 42 mutations in exons 18, 19, 20, and 21 of the epidermal growth factor receptor (EGFR) gene. It is designed to test tissue and plasma specimens with a single kit, allowing labs to run tissue and plasma simultaneously on the same plate.

Questions for Your Doctor

If you find yourself diagnosed with lung cancer and are concerned about the long-term impacts, here are some questions you can ask your doctor.

• Has my cancer spread to other parts of the body?
• Based on my cancer stage, what are my treatment options?
• What are the side effects of my recommended treatment?
• Are there ways to help minimize the effects of treatment?
• How long will I be unable to work or carry out my daily activities?
• What financial resources are available to get the treatment

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