In September 2008, Pat Merwin walked out of the gym and collapsed. She was having a seizure. Pat was rushed to the emergency department at Long Beach Memorial where she received a CT scan of her brain that indicated she had two tumors. One of the tumors was quite large causing the entire right side of her body to become numb.
Pat was immediately admitted immediately to the hospital where and a biopsy of the tumor confirmed biopsy confirmed that both tumors were cancerous. Although the tumors were now in her brain, it became evident that they originated in her lung. Pat was diagnosed with had stage Stage IV adenocarcinoma, non-small cell lung cancer. But Yet, she had never smoked a day in her life.
It turns out that in progressed advanced stages of lung cancer, such as Pat’s, the disease can spread beyond the lung to other major organs in the body. By the time Pat was diagnosed, her cancer had spread to both lungs and her brain.
At 52, Pat kept an active lifestyle and considered herself to be in good health. Before her seizure, she didn’t experience any symptoms or pain. Having never smoked and with no history of exposure to second hand smoke, Pat found the idea of lung cancer to be surreal. “I had no reason in the world to think that at 52 years old I had lung cancer,” says Pat.
After a week in the hospital, Pat was referred to Robert A. Nagourney, MD, oncologist, MemorialCare Todd Cancer Institute, Long Beach Memorial. Dr. Nagourney conducts an innovative process called functional-profiling. This test is used to match available treatments to each individual according to their unique profile of sensitivity and resistance. The process begins with surgery to remove a portion of the tumor. Once the tumor is removed it’s sent back to Dr. Nagourney’s laboratory, Rational Therapeutics, where different chemotherapy drugs are tested on the tumor. This process helped determine which treatment Pat would respond to best; without having to put the drugs in her body first.
"When I first met Dr. Nagourney, he told me you’re not sick, you just have cancer and it’s my job is to keep you from getting sick. With luck we will treat this like a chronic illness and not a death sentence," said Pat.
After analysis, Dr. Nagourney decided against a standard chemotherapy protocol and instead chose a new targeted drug, a once-a-day pill called Tarceva®. This oral drug is part of a new wave of treatment called targeted therapy. As opposed to the traditional chemotherapy, this drug tackles specific mechanisms. In Pat’s case, the drug attacks the lung cancerous cells and and causes them to die. prevents the cells from mutating.
In addition to the once-a-day pill, Pat also was put on given a drug infusion chemotherapy, called Avastin®, which that she receives every other week. This particular treatment attacks the cancer blood vessels that feed the tumor there by so that the tumor doesn’t have depriving if of the chance to grow further.
Typically patients who have long- term chemotherapy treatment patients develop resistance to the drugs and a new course of treatment must be developed. It’s been four years since Pat’s diagnosis and she has yet to develop a resistance to her treatment.
"As long as it continues to work, I will take this drug forever," says Pat. "There is no way to know that I'm cancer free unless I stop taking my treatments, and that's not a risk I'm willing to take now."
Because of the innovative testing Dr. Nagourney conducted, Pat was given the best course of treatment to combat her specific cancer for her body the first time. Unlike so many other cancer patients, she was able to avoid the crippling symptoms often associated with chemotherapy and radiation treatments.
"Other than some mild fatigue, intestinal issues and dry skin I'm as active as I've ever been," says Pat. "I travel, snorkel and have thrown myself into volunteer work."
One of the many programs Pat volunteers for is the Beat the Odds program – a comprehensive survivorship program for patients and their families – led by Mariusz Wirga, MD, medical director, psychosocial oncology, MemorialCare Todd Cancer Institute, Long Beach Memorial. Dr. Wirga was instrumental in helping Pat cope with her diagnosis.
"Because there is such a negative stigma surrounding lung cancer many patients can feel isolated and it puts the burden of care on them," says Dr. Wirga. "Talking about their diagnosis and developing an understanding that there are people here to support them helps patients through the cancer journey."
The stigma comes from the belief that all people with lung cancer are smokers, but according to the Lung Cancer Alliance 60 percent of lung cancer cases are former smokers and 20 percent have never smoked – Pat being one of them.