What are the signs of lung cancer? Nonsmoker diagnosed with disease fights stigma

November is Lung Cancer Awareness Month.

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/ Source: TODAY
By Kate Snow and Carter McKay

Jill Feldman doesn’t smoke, but she’s been vigilant about getting screened for lung cancer ever since the disease decimated her family.

At 13, she lost two grandparents to it within weeks of each other. Just months later, her father was diagnosed, too, after complaining of a bad cough. He was only 41 when he died.

When she was in her 20s, her mom also developed lung cancer and passed away, followed by a close aunt — five loved ones gone in just over a decade.

Then at 39, Feldman got the news she was dreading.

"Imagine how you would feel if you were diagnosed with the same disease that you literally watched kill both your mom and your dad,” she told TODAY.

Every year, more men and women die from lung cancer than of colon, breast and prostate cancers combined. It's often detected late — when the cancer has already spread — and the five-year survival rate is just 19% percent.

But thanks to two surgeries and targeted therapy for her specific kind of lung cancer, Feldman is living with the disease more than a decade later — proof that advances in treatment have changed everything.

Feldman has had two surgeries and targeted therapy for her specific kind of lung cancerTODAY

Targeted treatment

Feldman's cancer is incurable, but it's contained to her chest. The goal is to treat it as a chronic disease for as long as possible, she noted. Her targeted therapy is in the form a pill she’ll take every day until the cancer develops a resistance to the drug.

Such therapies mean some lung cancers are no longer a death sentence, said Dr. Helena Yu, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York.

She displayed CT scan images from another patient that showed lung tumors mostly disappeared after three months of treatment. Combining treatments has turned out to be more effective than relying on one approach, she said.

Lung cancer has decimated Jill Feldman's family. She's lost two grandparents, her father, mother and an aunt to the disease. Courtesy of Jill Feldman

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Researchers now know that all lung cancer is not the same: there are different types, plus gene mutations that can trigger the disease. Doctors can categorize it by genetic makeup to come up with a personalized treatment for each patient’s disease; however, the proportion of people with lung cancer who are eligible for targeted therapy is still “pretty low” — about 25%, Yu said.

There are also markers that tell doctors whether patients would be a good fit for immunotherapy, so molecular testing is key to determine what type of cancer a patient has, she added.

Research is critical, but funding doesn't come easy. While lung cancer kills more men and women than colorectal, breast and prostate cancer combined, only 6% of federal research dollars go to the disease.

“It's really the survivors of cancer who are the biggest fundraisers, and I think historically we haven't had as many survivors that have lung cancer," Yu said.

“There's a stigma that is associated with lung cancer, where people think, ‘If somebody never smoked, they would never get the lung cancer.’”

Dealing with the stigma

When Feldman was diagnosed, the No. 1 question people asked her was how long she had smoked. It frustrated the nonsmoker.

“Any other cancer, people say, ‘I am so sorry. What can I do to help?’ With lung cancer, you are immediately put on the defensive,” she noted.

One out of seven people who get lung cancer have never smoked a cigarette, Yu said.

Someone in the U.S. will be diagnosed with lung cancer every 2 minutes and 20 seconds, according to the American Lung Association. Feldman and other patients argue at that rate, it shouldn't matter if a person smoked or not — everyone deserves to find a cure to this disease.

Feldman has made it her mission to reduce the stigma around lung cancer and change people's perceptions of it.

She's the former president of LUNGevity, an organization devoted to funding scientific research, and a co-founder of an advocacy group for her type of cancer. Being able to connect with others who’ve had the same experience is a “lifeline” and makes a world of difference, she said.

She and her husband of 24 years have four kids. Her diagnosis still weighs heavily on the family.

Feldman and her family.TODAY

In the last three years, the U.S. Food and Drug Administration has approved more lung cancer treatments than in the last three decades and that brings hope.

“I never used to use the word ‘hope’ in the same sentence with lung cancer because in my experience, there wasn't any. But there is hope now. It's real hope," Feldman said.

So real that she decided to tattoo the word on her arm as a permanent reminder.

Feldman shows her "Hope" tattoo.TODAY

The best chance to fight lung cancer is to catch it early

Early detection is still difficult because the symptoms can be mistaken for other common illnesses like pneumonia.

The American Lung Association says warning signs include:

  • A cough that doesn't go away and gets worse over time
  • hoarseness
  • constant chest pain
  • shortness of breath or wheezing
  • frequent lung infections such as bronchitis or pneumonia
  • coughing up blood

There's no good way to scan for lung cancer early because the imaging can often detect false positives, leading to unnecessary invasive procedures and causing more harm than good. The goal is to offer a simple blood test in the future, but that doesn't exist yet, Yu said.

For now, the best advice is to get screened for lung cancer every year if you have a history of heavy smoking and are 55 or older.