My Story: Judith Toscano
Prior to my diagnosis of Bronchoalveolar Carcinoma (BAC) lung cancer in January of 2001, I was confident that cancer was behind me. I was free to pursue my career as a clinical social worker, a career that had defined and fulfilled me for thirty years, and to strengthen my relationships with family and friends that had nourished and supported me for fifty-six years. Fifteen years earlier, I was first diagnosed with Bowen’s disease, a form of skin cancer, and in 1991 I underwent surgery for cervical cancer. Six months later, I was diagnosed with breast cancer, and had multiple re-occurrences and multiple resections. I continued to smoke throughout this time never allowing myself to entertain the thought that these episodes of cancer might be related to smoking.
In 1996, I decided to quit smoking. There were no threats from doctors, family or friends, as they had long since given up on encouraging me to quit. I was simply done after smoking for thirty-two years. Five years later, having no overt symptoms, I elected to have a CT scan seeking reassurance that I had quit in time...that I got in under the wire. Initially, the results were inconclusive with the radiologist noting unusual “wisps” that were suspected to be artifacts or remnants of an infection. The doctors reassured me, favoring me with 80 to 90% odds of survival, yet it did not quell this dread I had, sensing it was indeed cancer. I was resolute in seeking a definitive answer although my doctors continued to reassure me. I was finally referred to a pulmonary specialist, a kindly doctor, who also reassured me, but took a different stance, stating my anxiety was well founded given my frequent bouts with cancers, and recommended anti-anxiety medication. Turning down Zanax, I insisted upon a biopsy after the second CT scan remained inconclusive. The pulmonary specialist reluctantly referred me to a thoracic surgeon. The surgeon reviewed my scans and immediately lowered my odds to a 50% chance of survival, fearing a relatively rare form of lung cancer, BAC, which appears to be more prevalent among women.
I underwent a biopsy that confirmed the surgeon’s BAC diagnosis. As much as I had prepared myself for these results, I was not emotionally ready to hear them. I am a fighter, yet my surgeon had taken away the tools that seemed necessary to me to fight the disease when he advised that surgery and radiation were not options given this type of cancer, and that chemotherapy would be of little benefit and not worth the side effects. He recommended only Gefitinib (Iressa), which at that time remained in clinical trials. Although he suggested that surgery was not an option originally, he reconsidered, and was able to preform a left upper lobectomy removing much of the cancer from the left lung.
By the time I reached my current oncologist, I had no hope, and was turning away family and friends. This second oncologist, however, offered measured hope predicating it on whether or not the BAC was slow growing. As long as my nodules remained small (continuing to be approximately four to five mm), the treatment would be to watch and wait, monitoring me every three months, thus allowing me to live and plan for the future in short time capsules. The results of CT, PET scans and blood work would determine my course of treatment for each three month time period during the next 2 years. I bless this man for insisting that I return to work, although at the time I thought he was insane for insisting a terminally ill woman return to work. However, he has instilled within in me a glimmer of hope that at the time my disease does progress, there may be more answers.
Given hope, I attempted to seek greater understanding, and searched the Internet. I found little information, let alone answers about BAC. I felt alone and frustrated, like I was on uncharted waters. Shockingly, unlike my other cancers, I found it difficult to find answers and support. Although the information available was sparse, I found research on the use of Celebrex in Stage I Lung Cancer, which my oncologist agreed to treat me with, although I am Stage IV. Some research in Canada was looking into the benefit of Chinese Herbs which put me on the path with a Chinese physician who I continue to see weekly, receiving herbs and acupuncture treatment. Approximately 2 years ago I walked through the doors of CURVES, a fitness center with an exercise program for women. This exercise program has vastly improved my stamina and breathing, and equally my confidence and hope.
Pink ribbons make me wistful. I long for the attention and research dollars that lung cancer so deserves. I understand the benefit of early detection, particularly since I benefited from it when I had breast cancer, but am frustrated that for lung cancer, my early detection may have been too late. Unlike breast cancer, there appears to be discomfort in talking about lung cancer let alone fighting it. Whether the discomfort is due its general poor prognosis or its association with smoking, I am not sure. I know that regardless, it should make no difference. If the prognosis is poor, all the more reason for greater research dollars, and if it is due to smoking, all the more reason for public outcry. I am grateful that my cancer was caught early, and that I continue to remain stable, offering me time and opportunities to live life to its fullest. I hope that in my life-time that the clear ribbon no longer symbolizes invisibility but rather clarity.