Beating four different types of cancer within four years, Marnie Cervenka, a wife and mother of two, describes herself as the “luckiest unlucky person you’ll ever meet.” The Texas native, who is now “cancer-free,” went through throat cancer, breast cancer, skin cancer and lung cancer, which was advanced at stage 3.
Cervenka credits MD Anderson Cancer Center and her care teams to the “reason I’m still here today. “People come from all over the world to be treated there,” she wrote in a piece for the hospital’s site. “And, since I live in Austin, it’s practically in my backyard.” And just to clarify, we fully credit the MD Anderson content folks who published this story for the web, which we saw and loved!
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A Throat Cancer Diagnosis
Throat cancer was Marnie’s first diagnosis, which was found in 2016 off a routine health screening — the sole reason for the visit being that she and her husband would lose the funds in their flexible spending accounts, so in they went. Her doctor “found something weird in her neck” and sent Marnie for a CT scan. RELATED: Famous Comedian, 63, Noticed ‘Large Abnormality’ On Neck While Shaving, Turned Out To Be Throat CancerThe following week, Marnie, 50 at the time, was suddenly meeting with her medical oncologists after they found throat cancer at the base of her tongue.
“First, they confirmed my diagnosis. Then, they recommended radiation therapy, followed by surgery to remove a couple of lymph nodes and chemotherapy.”
Back-to-Back Skin Cancer and Breast Cancer
Upon Marnie’s completion of throat cancer treatment, dermatologist Dr. Saira George at MD Anderson found her basal cell carcinoma, which is the most common type of skin cancer. Dr. George biopsied the spot on her cheek and it came back cancerous. “Surgery and 17 stitches got rid of it.”
The next day she was diagnosed with breast cancer from a routine mammogram. Thankfully, “that was caught at a very early stage, too, so all I needed was a lumpectomy and proton therapy.”
A lumpectomy is the surgical removal of cancer tissue from the breast. Proton therapy is a specific type of radiation using proton beam therapy instead of X-ray radiation.
An Advanced Stage Lung Cancer Diagnosis
While Marnie was thankful her other three cancers were discovered early, she was “unluckiest” with her fourth diagnosis.
“The lung cancer diagnosis was the real shocker. I am a lifelong non-smoker,” Marnie wrote. Unfortunately, this is a common misconception by many.
The former Austin Energy employee was at MD Anderson for a routine follow-up in March, and on a fluke, her doctor suggested a chest X-ray since Marnie “wasn’t hydrated enough” to administer the IV with CT scan contrast. “That revealed a suspicious area in my right lung.”
Marnie underwent a PET scan for further confirmation, but she needed a lung biopsy to make the diagnosis official. Then, suddenly, the pandemic hit. Like a multitude others in similar holding patterns, Marnie couldn’t get in for her biopsy for a few months.
“I was diagnosed with stage III adenocarcinoma of the lungs.” Adenocarcinoma of the lungs, according to the American Cancer Society, is the most common type of cancer in non-smokers. By the time of Marnie’s official diagnosis, the cancer had already spread to her sternum, which is the breastbone, and her lymph nodes.
Getting Diagnosed with Lung Cancer
She went on to have intense chemotherapy treatment and suffered some complications, one with her port, which had failed, and she also developed a blood clot throughout the process. Marnie then had surgery “to remove about two-thirds of my right lung.”
Fortunately, she was able to get on osimertinib (Tagrisso), an oral targeted therapy, “which had just been approved the month before for the treatment of lung cancers with the EGFR mutation.”
RELATED: For Lung Cancer Patients With The EGFR Mutation: The Benefit of The Drug TAGRISSO Plus Chemotherapy
After all she endured from the challenging disease, Marnie achieved “no evidence of disease” (NED) in October 2020.
“To me, that’s one of the most beautiful phrases in the English language.”
“When it was approved by the Food and Drug Administration (FDA) in December 2020, the five-year survival rate for stage III lung cancer was only about 33%. It’s up to 89% now. And I got that drug almost as soon as it became available because MD Anderson is on the cutting edge.”
“It’s a center for excellence and No. 1 in the nation for cancer treatment. I can’t imagine going anywhere else.”
The Gamechanger Targeted Oral Therapy for Lung Cancer
The targeted therapy osimertinib (brand name TAGRISSO) changed the game for EGFR-positive lung cancer patients when it was approved by the Food and Drug Administration about half a decade ago. Now, for those who have advanced or metastatic EGFR-positive lung cancer, there may be an additional treatment option that has the potential to prolong your life.
RELATED: How Does Molecular Testing Help Determine the Best Lung Cancer Treatment Option?
AstraZeneca made a recent announcement with updates from a clinical trial which demonstrated an improved progression-free survival of 9 months in patients with locally advanced and metastatic EGFR-mutated lung cancer, when using TAGRISSO in combination with chemotherapy versus using TAGRISSO alone.
For lung cancer patients with an EGFR mutation, “TAGRISSO is the best drug in the metastatic setting,” Dr. Roy Herbst, told SurvivorNet.
Learning About TAGRISSO Plus Chemotherapy
Dr. Herbst is a nationally recognized lung cancer researcher who serves as deputy director and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital. He sees some potential benefit in the data from the recent study.
“The time of progression is longer and the primary endpoint of the trial was met,” Dr. Herbst shared, yet he remains skeptical about whether the combination therapy will have a long-term benefit on this patient population. In baseball terms he says: “I think it’s a single or a double. It’s not a home run at all.”
RELATED: In Certain Types of Lung Cancer, Targeted Drug Tagrisso Slashed Recurrence Rates, Study Says
Arun Krishna, the US Commercial Lead for Lung Cancer at AstraZeneca says this recent announcement provides a new potentially beneficial alternative for many of those who are already qualified for TAGRISSO alone.
“Patients with a positive EGFR mutation, they always had an option for TAGRISSO as a monotherapy. This was approved more than five years ago,” Krishna told SurvivorNet.
“In the US this is now a new option, which is a combination of TAGRISSO plus chemotherapy showing benefit for patients in the metastatic stage,” he added. “So these are patients who’ve been diagnosed with either locally advanced, which are Stage 3B-3C or Stage 4 disease.”
What is EFGR-Mutated Lung Cancer?
In addition to the lung cancer stage, doctors look at the cancer cells themselves by doing something called molecular testing on your tumor biopsy or using a blood sample. The test results can determine additional information about the makeup of your cancer, which is used to make treatment decisions. The type of mutation can vary depending on the cancer type. In lung cancer a common DNA mutation is epidermal growth factor receptor, or EGFR.
Mutations That Matter in Lung Cancer and the Treatments Available for Them
EGFR is like a switch on the cell that when activated tells the cell to grow. When EGFR mutates it is constantly turned on, which means the cell grows too much. This can result in cancer growth. If your lung cancer has a mutation in EGFR, it is called an EGFR-mutated lung cancer or EGFR-positive lung cancer, which is a specific subtype. This can affect treatment options and also tells us how the cancer typically behaves.
The rate of EGFR-mutated lung cancer can vary depending on the population, but it typically comprises 15-20% of North American and European patients. It can be almost 50% in Asian populations.
Lung Cancer: The Basics
Treating lung cancer can be particularly challenging since symptoms often remain undetectable until the cancer has already spread to other organs.
Doctors categorize lung cancer into two primary types based on their behavior and treatment approach:
- Non-small cell lung cancer (NSCLC) — This is the more frequent type, accounting for approximately 85% of cases. NSCLC grows at a slower pace compared to other types and is treated differently.
- Small cell lung cancer (SCLC) — Although less common, SCLC tends to exhibit rapid growth when compared to NSCLC. Consequently, it requires a distinct treatment approach.
Questions to Ask Your Doctor
- How aggressive should my lung cancer treatment be?
- Am I eligible for immunotherapy therapy for lung cancer? Am I more, or less, likely to respond to this treatment?
- Do I have any genetic mutation that would change the course of my treatment?
- How long does it take to get my NGS (Next-Generation Sequencing) testing results?
- Do you need both the tissue sample and blood samples for NGS testing?
- Is there a clinical trial that would be relevant for me?
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