Recognizing the Subtle Symptoms of Lung Cancer
- Keshia Liburd, 38, was misdiagnosed twice before her advanced lung cancer was discovered. It was initially mistaken while she experienced dental pain and pneumonia, delaying critical treatment until an X-ray revealed the true diagnosis: stage 4 lung cancer.
- Despite enduring multiple rounds of chemotherapy, radiotherapy, and immunotherapy, Liburd remains determined to survive and is fundraising for new treatment options to stay present for her three children.
- Lung cancer is commonly already in stage 4 when it is first diagnosed because its symptoms are hard to detect in the early stages of the disease. A persistent cough, fatigue, and shortness of breath are common but not easily distinguishable from more benign conditions.
- Treating lung cancer depends on the cancer’s location and how advanced it is. Surgery may be ideal for early-stage lung cancer because it’s localized to the lung.
- More advanced lung cancer has spread beyond the lungs, and chemotherapy and immunotherapy (which uses the immune system to fight cancer cells) may be more optimal.
“I was told there was nothing wrong,” Liburd told The Independent, recalling her initial visit to the dentist. But the pain didn’t subside. Instead, it escalated, and soon she began experiencing chest pain. A trip to the doctor led to another misdiagnosis.
Liburd, who acknowledges she was a smoker, learned her cancer had already reached stage 3. It quickly advanced to stage 4, spreading to her lungs, liver, and brain.
The impact has been profound—not just physically, but cognitively and emotionally.
“It’s impacting everything, really. Her memory has been impacted as well, because of the brain cancer,” said Liburd’s cousin, Kirsty Watson.
Determined to fight, Liburd has undergone an aggressive treatment regimen.
“I’ve endured three different types of chemotherapy, 30 rounds of radiotherapy, and three rounds of standard immunotherapy. I’m now on my 4th round of chemotherapy. We’re doing everything we can,” she shared in a GoFundMe post.
The toll—both emotional and financial—has been immense. As she explores new treatment options, Liburd is seeking support through a GoFundMe page set up to help cover mounting medical expenses.
“I’m not ready to give up,” she said. “I need to be here for my children — to guide them, love them, and watch them grow.”
Helping Patients Understand Lung Cancer Risks
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.
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.
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.
Advancements In Lung Cancer Treatment
Lung cancer treatment is still evolving, offering the promise of hope for people living with this type of cancer. Research presented at the 2024 American Society of Clinical Oncology (ASCO) showed that (generic name: durvalumab) (brand name: Imfinzi), a type of immunotherapy drug, could reduce the risk of death for patients with limited-stage small cell lung cancer (LS-SCLC) by 27-percent.
The study demonstrated that the use of Imfinzi improved overall survival and progression-free survival (the time a patient lives without their disease getting worse) in patients.
“SCLC is one of the most aggressive types of lung cancer. The ADRIATIC trial is a landmark study and provides a new standard of care with the addition of immunotherapy for patients with early-stage SCLC who are being treated with the goal of curing their cancer,” said Dr. Lauren Byers, thoracic section chief in the Department of Thoracic-Head & Neck Medical Oncology at the University of Texas MD Anderson Cancer Center in Houston.
Dr. Byers pointed out that Imfinzi helped patients live for years compared to many other treatment approaches where the benefits were measured in months.
WATCH: Understanding Immunotherapy in Lung Cancer.
Another treatment option that has shown great promise is the drug Rybrevant, which is approved by the U.S. Food and Drug Administration for non-small lung cancer (NSCLC) and has a specific genetic mutation your doctor can identify through testing.
“When a patient comes in, we immediately sequence the tumor. We are doing panels that might include three, four, or 500 genes, the ones that are most likely. Some sort of next-generation approach is the best standard of care these days – it has to be done,” Dr. Herbst explains.
The active ingredient in Rybrevant is amivantamab-vmjw. It belongs to a class of drugs known as biologics, which are made from living cells.
The drug works like a guided missile, finding and sticking to the bad cancer cells. It targets and attaches to two specific proteins in cancer cells, disrupting their growth signals and activating the immune system to fight the cancer.
Once it finds its target, it blocks signals the cells need to grow and spread. This stops the cancer from worsening and helps patients feel better for longer.
Rybrevant is different from older cancer treatments because it is a targeted drug therapy. It doesn’t just attack all rapidly dividing cells like traditional chemotherapy does. Instead, it goes after the cancer cells with the mutation it was designed to treat while avoiding the healthy surrounding cells. This means it can be more effective and might have fewer side effects than other treatments.
WATCH: Imfinzi offering hope to patients.
Lorlatinib and crizotinib are other lung cancer treatments known as tyrosine kinase inhibitors. These drugs target ALK, a signaling protein inappropriately present in the tumors of about five percent of patients with NCSLC.
“It is encouraging that the upfront benefits of lorlatinib over crizotinib continue for several years in more than half the patients. It also is encouraging that patients receiving lorlatinib had much fewer incidences of brain metastasis, which can be devastating,” Dr. Leslie Busby, an oncologist at Rocky Mountain Cancer Centers, told SurvivorNet.
Five-year PFS, or the percentage of patients who lived five years without any evidence of cancer growth or death, was 60% among patients who received lorlatinib compared to only 8% among patients who received crizotinib—an absolute difference greater than 50%.
Coping With Chemotherapy Lung Cancer Treatment
Lung cancer often doesn’t cause symptoms until it has already spread outside the lungs. Doctors may suspect lung cancer after seeing a shadow on a routine chest X-ray that requires further evaluation.
Once a lung cancer diagnosis is confirmed, it’s important to find out whether the cancer has spread. Depending on the part of the body being scanned, additional scans may include a CT scan, PET scan, or MRI.
The PET/CT scan combines two imaging tests in one. CT stands for computed tomography. It uses X-rays to take pictures of the body from many different angles.
PET is an acronym for positron emission tomography. It uses a radioactive form of sugar that cancer cells absorb more than healthy cells, helping to distinguish healthy cells from cancer. A PET scan can help determine the extent of the cancer’s spread and its stage before treatment.
WATCH: Understanding PET and CT Scans.
A scan of the chest, abdomen, pelvis, and brain to see if the cancer has started to spread outside of the lung.
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. However, if cancer has spread to the lymph nodes, a combination of radiation (use of X-ray-like beams focused on cancer cells to kill them) with chemotherapy, followed by immunotherapy (treatment method where the immune system is re-engineered to target cancer cells and kill them), maybe the best option.
Once the cancer has spread outside of the lungs, chemotherapy and/or targeted drugs are used to control its growth as much as possible.
Surgery is more optimal for early-stage lung cancer, meaning the cancer has not spread beyond the lungs. For more advanced stages of lung cancer, adding chemotherapy and other treatment methods may be ideal.
Chemotherapy and Lung Cancer
Chemotherapy is often recommended in patients with high-risk features such as tumors > 4cm or in poorly differentiated tumors. There are other factors your clinical team will also consider when deciding whether chemotherapy is right for you.
Chemotherapy alone used to be the mainstay of treatment for stage 4 lung cancer. It is often used with other treatment options, such as immunotherapy, radiation therapy, or targeted medications. Chemotherapy is important in stage 4 cancer because often, more localized treatment options, like focused radiation or surgery, are no longer possible due to the extent of the disease and how much it has spread to other parts of the body (also called metastasis).
WATCH: How targeted therapies can be used for advanced lung cancer.
Systemic treatment of the body with chemotherapy is helpful to slow the progression of further growth of the primary cancer, prevent future metastasis, and relieve symptoms associated with existing tumors. However, chemotherapy works by killing all cell types, healthy or cancerous, that are multiplying quickly, so it does have significant side effects for the healthy tissue – the pain point Marian Derrico has struggled with.
Some patients may also be considered for other therapies, including the targeted agent osimertinib and the immunotherapy drug atezolizumab. These drugs are very different from chemotherapy and are often much better tolerated. However, to receive these drugs, the tumor must test positive for certain biomarkers that allow these drugs to be effective. Genetic testing helps distinguish specific biomarkers in cancerous tumors and determine effective treatments.
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