‘This Is Us’ Actor and Lung Cancer Survivor Gerald McRaney, 78, Explains ‘Love Scene’ With Actress Delta Burke, 69, Ignited a Decades-Long Relationship As the Couple Celebrates 36 Years of Marriage

The couple married in 1989 and recently renewed their vows in an intimate backyard ceremony surrounded by close friends, children, and grandchildren. For McRaney, joy is found in the quiet moments—emails, dogs, and Burke by his side.

“I know it’s simple, but just being in the bedroom with my wife and our two dogs… that brings me joy,” he said.

But two decades ago, McRaney’s life took an unexpected turn. While on a hunting trip in New Zealand, he twisted his knee. He brushed it off, but Burke urged him to see a doctor. That insistence led to a pre-op physical—and a life-saving discovery.

“By absolute chance, one of the radiologists spotted a tiny, tiny spot on my right lung,” McRaney explained to “Future of Personal Health.”

Further testing at MD Anderson Cancer Center confirmed early-stage lung cancer.

Lung cancer symptoms often go unnoticed, with signs like fatigue, shortness of breath, and persistent coughing easily mistaken for everyday ailments.

Thoracic surgeon Dr. Joseph Friedberg emphasizes that lung cancer often develops silently, without noticeable symptoms in its early stages.

“It’s completely asymptomatic,” he told SurvivorNet. “It doesn’t cause problems until it spreads—if it reaches the bones, it might cause pain; if it reaches the brain, it could trigger something dramatic, like a seizure.”

In many cases, the first clue comes by chance—such as a shadow spotted on a chest X-ray during a routine insurance physical. That subtle finding, Dr. Friedberg notes, can be the critical signal to investigate further and catch the disease before it advances.

Treatment options vary depending on the cancer’s stage and location, ranging from surgery and chemotherapy to radiation and targeted therapies.

Upon diagnosing a lung cancer patient, thoracic oncologists like Dr. Geoffrey Oxnard say they carefully review other pieces of data to get a complete understanding of the cancer.

“Has the biopsy specimen been reviewed by an expert pathologist? Do we know what kind of lung cancer this is? Is this a small cell carcinoma, more aggressive, generally seen in smokers? A non-small cell carcinoma? Or a variety of histology is that we tend to break down these days into squamous-type, skin-type carcinoma, or adenocarcinoma, gland-type carcinoma,” Dr. Oxnard explains to SurvivorNet.

Getting answers to these questions helps lung cancer doctors better understand how the cancer functions and how to treat it effectively.

WATCH: Diagnosing Lung Cancer and Determining Treatment

“Surgery to remove the cancer is considered the gold standard for stage one lung cancer, says Dr. Friedberg.

Although stage 2 lung cancer can involve a lymph node, these lymph nodes are close to the involved lung and are called hilar lymph nodes, making them removable with surgery. In certain circumstances, treatments like chemotherapy, targeted agents, or immunotherapy may be used before (neoadjuvant) or after (adjuvant) the tumor is removed with surgery.

For advanced lung cancer patients where the cancer has spread to other organs, treatment depends on several factors.

• The type of lung cancer you have, for example, small cell carcinoma, tends to spread quickly but is responsive to chemotherapy
• Your overall health condition, for example, if you have other serious illnesses like heart disease or diabetes mellitus
• How well your body responds to certain types of treatment

“The way we plan Stage 4 lung cancer today is using precision therapy,” Dr. Oxnard told SurvivorNet. “It’s the idea of moving away from just chemotherapy for all into finding the right medicine for the right patient.”

These advances involve testing your cancer for the presence of genetic mutations or molecular features, which might be targeted for relatively new medications. For some people, these medications are extending life in remarkable ways.

Surgeons removed the middle lobe of his right lung, and shortly afterward, McRaney began the road to recovery, with his brother helping him rebuild stamina through daily walks in the park.

“If I had waited another six months or a year, I would probably be dead now,” he said. “Delta saved my life.”

McRaney’s biggest fear wasn’t the diagnosis—it was missing out on the life he loved, especially time with Burke. Her quiet support, even the simple act of rubbing the scar on his back, brought comfort during his most vulnerable moments.

Today, McRaney is cancer-free and grateful. He urges others to stay vigilant with annual check-ups, noting that he had skipped his check-up the year before his diagnosis.

“Had I gone in sooner, it might’ve been caught even earlier,” he said.

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,” Dr. Friedberg says.

“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 the 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 is also 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 the 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 (a treatment method where the immune system is re-engineered to target cancer cells and kill them), may be 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.

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.

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 treatments I need?

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