THIS PROGRAM IS FUNDED IN PART BY GRANTS FROM THE FOUNDATION FOR A HEALTHY KENTUCKY AND THE KENTUCKY MEDICAL ASSOCIATION THROUGH A GRANT FROM THE ANTHEM FOUNDATION.

>> Renee: UNTIL RECENTLY, THE NEWS ABOUT LUNG CANCER WAS UNIFORMLY BLEAK, BUT THE TIDE IS CHANGING.

IN THIS PROGRAM WE EXAMINE HOW EARLY DETECTION THROUGH LOW DOSE C.T.

SCANS AND TREATMENT MOW MODALITIES ARE HELPING SURVIVAL RATES AND HOW THE LUNG CANCER PATIENTS WHO NEVER SMOKED WHO ARE DESPERATE FOR OTHERS TO UNDERSTAND THAT WE ARE ALL AT RISK FOR LUNG CANCER.

>> MY @CMTHOT20 TAG IS ANYONE WITH LUNGS.

>> FIGHTING TO BREATHE, WHERE WE EXAMINE THE UNDERTOLD STORY OF LUNG DISEASE IN KENTUCKY, INCLUDING LUNG CANCER, C.O.P.D.

AND ASTHMA.

EXPLORE THE LATEST ADVANCEMENTS AND TREATMENTS AND MEET HEALTHCARE PROVIDERS AND ADVOCATES ACROSS THE STATE WHO ARE WORKING TIRELESSLY TO HELP US ALL BREATHE EASIER.

>> Renee: WELCOME TO ANOTHER INSTALLMENT OF FIGHTING TO BREATHE, KET'S THREE-PART SERIES ON THE UNDERTOLD STORY OF LUNG DISEASE IN KENTUCKY.

I'M RENEE SHAW.

IN THIS EPISODE, WE FOCUS ON LUNG CANCER AND NEW ADVANCES IN BOTH TREATMENT AND EARLY DIAGNOSIS.

WE BEGAN WITH MY INTERVIEW WITH Dr. TIM ANY MULL IT, A PROFESSOR OF THORACIC SURGERY AT THE UNIVERSITY OF KENTUCKY AND LEADING PROPONENT OF LOW DOSE C.T.

SCANS FOR EARLY DETECTION OF LUNG CANCER.

WHEN IT COMES TO LUNG CANCER IN THE STATE, WE ARE UP AGAINST A LOT, AREN'T WE IN KENTUCKY?

>> WE ARE.

>> PAINT THE PICTURE FOR US AND THE STATUS OF LUNG CANCER IN KENTUCKY.

>> LUNG CANCER IN KENTUCKY HAS HAS A DOMINANT FEATURE IN OUR CANCER LANDSCAPE.

THE BURDEN THAT WE HAVE IN OUR STATE IS LARGER THAN ANY OTHER STATE IN THE UNITED STATES.

BUT AT THE SAME TIME, I THINK WE ARE BEGINNING TO SEE SOME NEW OPPORTUNITIES AND SOME NEW EXPERIENCES TO BE ABLE TO SEE THAT BURDEN HOPEFULLY BEGIN TO CHANGE.

>> Renee: THERE IS CLEARLY A STIGMA SURROUNDED AND ASSOCIATED WITH LUNG CANCER.

TALK ABOUT THAT STIGMA AND THE NEGATIVE CONSEQUENCES IT CAN HAVE.

>> LUNG CANCER IS OFTEN ASSOCIATED WITH TOBACCO USE.

SEEN IN AREAS WITH LOWER EDUCATION, SEEN IN PATIENTS WITH LOWER INCOME.

IT OFTEN CARRIES WITH IT SOME SENSE OF A SENSE THAT THEY BROUGHT IT UPON THEMSELVES AND THAT BRINGS A WHOLE LOT OF GUILT THAT SAYS I KNEW I SHOULD HAVE QUIT AND THAT'S NOT REALLY FAIR TO THE PATIENTS BECAUSE THERE IS A LOT OF PEOPLE THAT ARE SMOKING THAT DON'T GET LUNG CANCER AND A LOT OF PEOPLE THAT HAVE QUIT SMOKING, MADE GOOD DECISIONS AND STILL COME UP WITH THE DIAGNOSIS OF LUNG CANCER MANY YEARS AFTER THEY MAY HAVE QUIT SO AGAIN, I THINK THAT ASSOCIATION WITH THE DISEASE THAT HAS HISTORICALLY HAD A VERY LETHAL DIAGNOSIS AND SO THERE IS A SENSE OF FATALISM THAT PATIENTS MAY SAY I'VE GOT LUNG CANCER, WHY BOTHER.

>> Renee: TO THAT POINT, THERE WAS A TIME WHEN LUNG CANCER WAS DIRE AND NO TREATMENT OPTIONS BUT TIMES HAVE CHANGED AND MEDICINE HAS CHANGED AND THERE ARE MORE OPTIONS NOW.

CAN YOU SPEAK TO THAT?

>> MOST LUNG CANCERS ARE DIAGNOSED AFTER THE PATIENTS ALREADY HAVE HAD A CANCER THAT FORKED IN THE LUNG, HAS GROWN AND HAS SPREAD TO SOME PLACE ELSE.

MANY YEARS AGO CHEST X-RAYS WERE STUDIED AND FOUND TO BE INEFFECTIVE FOR LUNG CANCERS WHEN THEY COULD MAKE A DIFFERENCE.

THEY STARTED TO STUDY A LOW DOSE C.T.

SCAN, RECEIVING LESS THAN THE DOSE OF NORMAL RADIATION EXPOSURE FROM A C.T.

SCAN AND IT ALLOWS US TO BE ABLE TO GET A SCAN OF THE LUNG, FIND A NODULE, FIND A SPOT IN THE LUNG THAT IS SMALL AND IF IT IS TOO SMALL, WE CAN REPEAT THE SCAN LATER AND SEE IF IT IS GETTING BIGGER.

IF IT IS LARGE ENOUGH, WE CAN THINK ABOUT DOING A BIOPSY OR CONFIRMING THAT THAT IS A CANCER AND GET THAT PATIENT IN FOR THE TREATMENT THEY NEED.

>> Renee: CURRENTLY THE TASK FORCE RECOMMENDS SCREENING FOR PEOPLE AGES 50 TO 80, TOBACCO EXPOSURE OF AT LEAST 20 PACK YEARS AND HAVE SMOKED WITHIN LAST 15 YEARS.

Dr. BULLET AND OTHERS AT THE KENTUCKY LEAD COLLABORATIVE LUNG CANCER AWARENESS DETECTION AND SURVIVORSHIP HAVE BEEN WORKING TO INCREASE USE OF THIS TOOL IN KENTUCKY.

WHAT PERCENTAGE OF PEOPLE WHO ARE ELIGIBLE FOR SCREENING ARE ACTUALLY BEING SCREENED?

IN THE COUNTRY, IT'S ABOUT FOUR OR 5% OF THE ELIGIBLE POPULATION BEING SCREENED AND THAT'S WHAT WE FEEL A SENSE OF URGENCY TO TRY TO GET MORE PEOPLE INTO THIS BUT IT'S TAKEN SOMETIME TO GET THIS INTO THE PRIMARY CARE OFFICE, TO GET THEM TO DO THIS.

THE EFFORTS HAVE BEEN VERY SUCCESSFUL IN KENTUCKY.

WE ARE IN THE THIRD OR FOURTH HIGHEST IN THE COUNTRY FOR LUNG CANCER SCREENING.

WE ARE AT ABOUT 13% NOW.

WE ARE CURRENTLY NUMBER TWO IN TOBACCO EXPOSURE AS A STATE AND SO WE CERTAINLY WOULD LIKE TO SEE US DRIVE DOWN OUR TOBACCO USE OVER TIME BUT AS I MENTIONED, EVEN IF EVERYBODY QUIT SMOKING NOW, WE WOULD STILL HAVE A RISK FOR THESE PATIENTS TO GET INTO LUNG CANCER-- TO DEVELOP LUNG CANCER SO IT'S REALLY IMPORTANT THAT WE GET THESE INTO LUNG CANCER SCREENING.

>> Renee: NOT JUST A ONE AND DONE.

IT'S RINSE AND REPEAT, RIGHT?

>> IT IS.

AGAIN, WE GET A SCAN AND LET'S SAY THERE IS NOT A NODULE THAT IS DETECTED, THERE STILL COULD BE A SMALL CANCER DEVELOPING OVER THE COURSE OF TIME AND SO YOU NEED TO GET A SCAN EVERY YEAR AND THAT'S REALLY THE ONLY WAY THAT WE HAVE SHOWN THE REAL BENEFIT FOR LUNG CANCER SCREENING IS WHEN PATIENTS COME BACK YEAR OVER YEAR.

>> Renee: AT ST. ELIZABETH HEALTHCARE IN NORTHERN KENTUCKY, PRIMARY CARE PHYSICIAN MIKE GIESKE AND THORACIC SURGEON ROYCE CALHOUN HAVE BUILT ONE OF THE MOST SUCCESSFUL LUNG CANCER SCREENING PROGRAMS IN THE STATE IF NOT THE ENTIRE COUNTRY AND REACHED THE IMPRESSIVE MILESTONE OF 20,000 SCREENINGS.

>> I HAVE BEEN IN PRIMARY CARE FOR 34 YEARS NOW AND I HAVE EXPERIENCED A LOT OF FRUSTRATION WITH LUNG CANCER AND HAVE SEEN THE DISMAL OUTCOMES.

WE FIND IT TOO LATE.

IF YOU CATCH IT EARLY, YOU CAN MAKE A GREAT DEAL OF DIFFERENCE.

WE ARE FINDING 56% OF THE CANCERS WE FIND THROUGH THE SCREENING PROGRAM IN STAGE 1 WHERE YOU CAN HAVE A GREATER THAN 90% CHANCE OF CURE, WE ARE FINDING ABOUT 69% OF THE LUNG CANCERS IN OUR SCREENING PROGRAM IN THE EARLY STAGES, STAGE 1 OR 2.

>> THE ST. ELIZABETH LUNG CANCER SCREENING PROGRAM IS BUILT ON SEVERAL CORE COMPONENTS: SHARED DECISION MAKING WITH THE PATIENTS, TOBACCO CESSATION COUNSELING, COMPREHENSIVE SCARE COORDINATION WITH NURSE NAVIGATORS AND A MULTIDISCIPLINARY NODULE REVIEW BOARD THAT EXAMINES EVERY NODULE AND MAKES CAREFUL RECOMMENDATIONS FOR FOLLOWUP.

>> IT WAS IMPORTANT TO ME THAT WE PUT TOGETHER A PROGRAMMATIC APPROACH BECAUSE ONE OF THE CONCERNS WITH LUNG CANCER SCREENING IS YOU ARE SCREENING CHEST WITH A CAT SCAN.

UNLIKE MAMMOGRAPHY JUST LOOKING AT THE BREAST OR COLONOSCOPY JUST GOING UP IN THE SKOAL ON, THERE IS A LOT OF STUFF IN THE CHEST.

YOU ARE GOING TO FIND CARDIAC DISEASE, ANEURYSMS, INNUMERABLE THINGS THAT COULD BE A PANDORA'S BOX.

THAT'S A CONCERN WITH SCREENING.

YOU ARE GOING TO SEE A LOT OF STUFF AND A LOT OF IT COULD BE NOTHING BUT IF EVERYBODY STARTS KIND OF GOING HERE, THERE AND YONDER AND BISHOPS, YOU CAN BIOPSY, YOU CAN DO A LOT OF HARM TO PATIENTS AND A LOT OF PATIENTS HAVE PULMONARY NODULES AND THE MAJORITY ARE BENIGN LIKE OVER 97%.

SO YOU REALLY NEED TO THINK ABOUT HOW YOU ARE BO TOEING PROCESS ALL THAT INFORMATION IN A METHODICAL FASHION.

>> Renee: PATIENT COURTNEY IS ONE OF THE BENEFICIARIES OF THE COMPREHENSIVE APPROACH TO LUNG SCREENING.

>> YOU CAN SEE THE SPOT THERE.

IT WAS YOUR CANCER, JUST A QUARTER OF AN INCH.

>> INITIALLY I WENT IN FOR AN AN ANNUAL EXAM WITH MY FAMILY PHYSICIAN AND HE REQUESTED THAT I GET THE LOW DOSE C.T.

SCAN AS A BASELINE RECORD FOR ANY FUTURE ONES AND WE HAD A FOLLOW UP IN A YEAR AND THAT'S WHEN THEY SPOTTED SOMETHING.

AND THEN WE WAITED THREE MONTHS TO' IF THAT SPOT WOULD GROW ANY, AND IT DID SO THAT'S WHEN WE DECIDED TO DO THE SURGERY.

AND THE THORACIC SURGERY AND THEY WENT IN AND DID A WEDGE AND IT KASS CANCEROUS.

THEY GOT IT ALL AND I DID NOT HAVE TO TAKE RADIATION AND CHEMOTHERAPY DUE TO THE FACT THAT I DID THE EARLY LUNG SCENING TEST I TELL EVERYBODY THAT I KNOW TO GO GET THE STAN.

IT'S WELL WORTH IT.

YOUR LIFE BEEN PROTECTED BY HAVING IT.

>> IF YOU BELIEVE YOU QUALIFY FOR A LOW DOSE C.T.

SCAN, PLEASE CONTACT YOUR PRIMARY CARE PROVIDER.

IN OUR NEXT SEGMENT WE ARE GOING TO LOOK AT ADVANCES IN TREATMENT THAT ARE HELPING SKUNK LUNG CANCER PATIENTS LIVE LONGER.

I SPOKE WITH A PHARMACIST SPECIALIZING IN ANTICANCER AGENTS AND THE CO-DIRECTOR OF THE MOLECULAR TUMOR BOARD AT THE UNIVERSITY OF KENTUCKY.

THERE HAS BEEN A DRAMATIC CHANGE IN THE PRACTICE OF CANCER TREATMENT THAT IT IS NOT JUST RADIATION.

IT'S NOT JUST CHEMOTHERAPY ANYMORE.

TALK US THROUGH THE NEW OPPORTUNITIES AND OPTIONS AVAILABLE.

>> WELL, WHAT WE HAVE LEARNED IN CANCER OVER THE LAST 25 YEARS, THAT CANCER IS CAUSED BY MUTATIONS AND THE MUTATIONS ARE USUALLY ONE OF TWO TYPES.

TUMOR SUPPRESSER GENES ARE KIND OF LIKE THE BREAKS OF YOUR-- THE BRAKES OF YOUR CAR IF THE BRAKES GO OUT, YOUR CAR GOES OUT OF CONTROL AND THE OTHER GENES ARE LIKE THE GAS PEDAL.

IMAGINE THE GAS PEDAL JUST STUCK DOWN TO THE FLOOR.

AGAIN YOUR CAR GOES OUT OF CONTROL.

IMAGINE IF YOU HAD BOTH PROBLEMS, NO BRAKES AND PEDAL TO THE METAL AND THAT'S WHAT HAPPENS IN A CANCER CELL.

A MUTATION IN BRAKE AND GAS GENES THAT CAUSE THE CELL TO GO OUT OF CONTROL AND THAT'S WHAT CAUSES THE CANCER AND SO WE HAVE LEARNED THAT OVER THE LAST 25 YEARS, AND THE MAJOR ADVANCE THAT WE HAVE MADE REALLY IS THAT WE HAVE IDENTIFIED DRUGS THAT WORK ON THOSE SPECIFIC MUTATIONS AND THOSE GENES AND THE GREAT THING ABOUT THE DRUGS IS THAT THEY ONLY TARGET THE GENES AND THE CANCER CELLS THAT ARE MUTATED SO THEY WORK BETTER AND LESS ADVERSE AFFECTS.

>> Renee: AND DON'T ATTACK THE OTHER HEALTHY GENES.

>> RIGHT.

>> Renee: LET'S TALK ABOUT PEOPLE DIAGNOSES WITH LUNG CANCER AND WHAT WHAT THEY CAN DO TO FIND OUT WHAT THE NEXT STEPS SHOULD BE.

REQUESTING TWO MORE GENE-- TUMOR GENE SEQUENCING.

TELL ME WHAT THAT MEANS.

>> WHEN SOMEBODY IS DIAGNOSED WITH CANCER, THEY FIRST HAVE TO HAVE A BIOPSY TO CONFIRM WHAT TYPE OF CELL IT IS AND WHAT THE ORIGIN IS AND THE NEXT THING THAT THEY HAVE TO DO IS HAVE A SCAN TO SEE HOW FAR THE CANCER SPREAD AND THEN WE TAKE THE BIOPSY THAT IS OBTAINED FROM-- OR THE TISSUE SAMPLE OBTAINED FROM THE BIOPSY AND SEND IT TO THE LAB TO GO AHEAD AND DO THE WEEK-- DO THE SEQUENCING AND THE SEQUENCING TELLS US HOW MANY MUTATIONS ARE IN THE GAS GENES AND HOW MANY ARE IN THE TUMOR SUPPRESSING GENES AND ONCE WE HAVE THAT REPORT, THAT'S WHAT WE CAN USE TO IDENTIFY A THERAPY THAT MIGHT BE EFFECTIVE FOR THE PATIENTS.

>> Renee: SEVERAL TERMS I'LL HAVE YOU DIDDY FINE TO UNDERSTAND.

TARGETED THERAPY.

WHAT IS THAT AND HOW DOES IT WORK?

>> THE TARGETED THERAPIES ARE DRUG THAT ARE USUALLY ORAL MEDICATIONS AND THEY WORK ON THE BRAKE GENES AND GAS JEANS, SPECIFICALLY TO THE CANCER, SPECIFICALLY TO THOSE GENES.

>> Renee: AND IMMUNOTHERAPY.

>> THAT'S A LITTLE DIFFERENT BUT THAT'S ANOTHER MAJOR ADVANCE.

WHEN I WAS TALKING ABOUT THE GAS AND THE BRAKE GENES.

WHEN YOU HAVE THE MUTATIONS THEY MAKE AN ABNORMAL PROTEIN SO THE JOB OF THE IMMUNE SYSTEM IS TO FIND THOSE ABNORMAL PROTEINS AND GET RID OF THE CELLS BEFORE THEY CAN DEVELOP INTO A CANCER BUT THE CANCERS ARE SNEAKY, LIKE THE HARRY POTTER CLOAK, THE CLOAKING DEVICE AND SO THE CANCERS WILL PUT A CLOAKING DEVICE AROUND THEM AND HIDE FROM THE IMMUNE SYSTEM AND WHAT IMMUNOTHERAPY DOES IS IT COMES AND PULLS OFF THAT CLOAKING DEVICE AND THE IMMUNE SYSTEM CAN SEE THE CANCER AND THEN THE IMMUNE SYSTEM ELIMINATES THE CANCER CELLS.

>> Renee: THE IMMUNE SYSTEM IS DOING SOME WORK THERE.

>> THE IMMUNE SYSTEMMING IS DOING MOST OF THE WORK.

>> Renee: THIS IS SOMETHING THAT MANY PEOPLE MAY NOT KNOW ABOUT.

THE MOLECULAR TUMOR BOARD.

YOU STARTED THIS IN WISCONSIN AND THE UNIVERSITY OF KENTUCKY GRABBED YOU AND RECRUITED YOU TO START THIS TYPE OF PROGRAM HERE.

WHAT IS IT AND HOW DOES IT WORK?

>> SO THE MOLECULAR TUMOR BOARD IS AN INTERPROFESSIONAL GROUP OF PEOPLE, SO THERE ARE DOCTORS, PHARMACISTS, GENETIC COUNSELORS AND REMEMBER I WAS SAYING WHEN WE SEND THE TUMOR OFF FOR SEQUENCING, IT COMES BACK WITH A REPORT.

THIS REPORT CAN BE 50 PAGES LONG.

PATIENTS CAN HAVE 15, 20, 30 DIFFERENT MU TAGUES WITH FOUR OR FIVE DIFFERENT DRUG OPTIONS FOR EVERY MUTATION.

SO THE TEAM CAN GET TOGETHER AND LOOK OVER THE REPORT AND THE THE PATIENT HISTORY AND TRY TO HELP IDENTIFY THE BEST TREATMENT FOR AN INDIVIDUAL PATIENT.

>> Renee: IS THIS WIDELY ACCESSIBLE OR WIDELY USED TOOLS.

>> THEY HAVE BEEN IN ACADEMIC CENTERS FOR THE LAST 10 YEARS.

KENTUCKY STARTED FOUR YEARS AGO AND ONE OF THE THINGS THAT WE DID IN KENTUCKY IS WE MADE IT ACCESSIBLE TO EVERY COMMUNITY MEDICAL ONCOLOGIST IN KENTUCKY BECAUSE THEY PROBABLY DON'T HAVE THE RESOURCES IN A SMALLER COMMUNITY PRACTICE TO PUT THIS ON AND SO THAT'S WHY WE THOUGHT THAT IT WAS REALLY IMPORTANT FOR US TO OFFER THIS TO THE STATE.

>> THE LUNG HAS COLLAPSED DOWN FROM THE CANCER.

>> Renee: AT BAPTIST EAST HARDIN COUNTY IN ELIZABETH TOWN, ONCOLOGIST Dr. DONALD GOODIN, UTILIZES THE SERVICES OF THE U.K. MOLECULAR TUMOR BOARD.

>> HISTORICALLY THE TREATMENT FOR METASTATIC LUNG CANCER WAS CHEMOTHERAPY AND THOSE INDIVIDUALS WITH METASTATIC CANCER THAT GOT CHEMOTHERAPY, THE AVERAGE SURVIVAL IS NINE TO 12 MONTHS AND THAT IS EVEN WITH TREATMENT.

THEN THE TARGETED THERAPIES AND IMMUNOTHERAPY, SOME HAVE BEEN QUITE AMAZING.

I'VE SEEN PATIENTS TREAT UNDERSTAND WITH IMMUNOTHERAPIES AND TARGETED THERAPIES THAT HAD THEIR CANCER SHRINK AWAY FROM ONE SCAN TO THE NEXT SO THERE IS DRAMATIC IMPROVEMENT IN THEIR DISEASE PROCESS.

PEOPLE THAT HAVE LIVED SEVERAL YEARS ON IMMUNOTHERAPIES OR TARGETED AGENTS.

SUCH THAT YOU CAN ALMOST START TO THINK OF METASTATIC LUNG CANCER AS A CHRONIC DISEASE.

>> Renee: Dr. GOODIN CREDITS THE MOLECULAR TUMOR BOARD WITH HELPING HIM CONNECT HIS PATIENTS WITH THE LIFE ALTERING TREATMENTS.

>> THE BIGGEST BEAR BARRIER WE HAVE FOR OUR AREA IS TRANSPORTATION.

THE MOLECULAR TUMOR BOARD IS A WAY FOR TO US GET SOMEONE FROM OUR COMMUNITY TO THE UNIVERSITY WITHOUT HAVING THEM GO THERE DIRECTLY.

SO IT ALLOWS US A MECHANISM FOR THOSE INDIVIDUALS TO BE REVIEWED , ESPECIALLY IF THEY HAVE A MUTATION THAT ALSO ALLOWS US TO A WAY TO ACCESS THE MEDICATIONS THAT ARE DREKED AGAINST THE MUTATIONS.

SO THEY'RE TYPICALLY ALL FDA APPROVED MEDICATIONS SO WE HAVE ACCESS TO THEM BUT HAVING THE MOLECULAR TUMOR BOARD AS A SECOND OPINION, IF YOU WILL, MAKES IT EASIER FOR US TO OBTAIN THE MEDICINES AND I THINK THAT HAS BEEN THE MAJOR THING WE HAVE SEEN WITH THE MOLECULAR TUMOR BOARD.

>> WE JUST DID AN ANALYSIS OF THE MOLECULAR TUMOR BOARD AND FOCUSED IT SOLELY ON NON-SMALL CELL LUNG CANCER AND WHAT WE ARE ABLE TO SHOW IS THAT PATIENTS WHO RECEIVED REVIEW FROM THE MOLECULAR TUMOR BOARD HAD IMPROVED OVERALL SURVIVAL COMPARED TO PATIENTS DIAGNOSED IN KENTUCKY WITH THE SAME STAGE OF DISEASE THAT DID NOT HAVE THE MOLECULAR TUMOR BOARD REVIEW.

AND THE EAR THING THAT WE THING THAT WE THINK IS IMPORTANT, WE LOOKED DOES IT MATTER IF THE PATIENT WAS TREATED IN THE COMMUNITY OR ACADEMIC MEDICAL CENTER AND IT DID NOT.

SO AS LONG AS THEY RECEIVE THE MOLECULAR TUMOR BOARD REVIEW, THEY DID AS WELL AS THE PATIENTS IN THE ACADEMIC CENTERS.

>> Renee: THIS HAS BEEN A MISSING LINK BEFORE YOU CAME ON BOARD.

>> THE REASON THAT WE ALL GOT INTO CANCER RESEARCH WAS TO HELP PEOPLE AND I'M REALLY GRAT GRATIFIED.

THAT'S WHY I GO TO WORK EVERY DAY TO HELP PEOPLE EVEN IN A SMALL WAY.

>> Renee: BECAUSE OF THE U.K. MOLECULAR TUMOR BOARD, ALL KENTUCKIANS CAN HAVE ACCESS TO STATE-OF-THE-ART TREATMENT RECOMMENDATIONS AND CLINICAL TRIALS FOR LUNG CANCER.

OVER TWO-THIRDS OF PEOPLE WITH LUNG CANCER ARE FORMER SMOKERS OR NEVER SMOKERS.

WE WERE FORTUNATE TO BRING TOGETHER THREE SURVIVORS WHO ARE MEMBERS OF THIS GROUP FOR A CONVERSATION ABOUT HOW THEY CAME TO BE DIAGNOSED AND WHAT THEY WANTED PEOPLE TO KNOW ABOUT LUNG CANCER.

>> WELCOME LINDY, STEVE, KATHY.

APPRECIATE YOU ALL SHARING YOUR STORIES WITH US.

IT'S GOOD TO HAVE YOU IN OUR STUDIOS.

LIPPEDY, I'LL BEGIN WITH YOU AND I UNDERSTAND QUESTION TO EACH OF YOU ABOUT SHARING YOUR JOURNEY OF LUNG CANCER WITH US AND TELL US ABOUT YOUR DIAGNOSIS AND TREATMENT AND WHERE YOU ARE NOW.

>> SUMMER OF 2017, I WAS HAVING ACID REFLUX ISSUES AND MY DOCTOR THOUGHT SHE MIGHT JUST GO AHEAD AND X-RAY ME IN AUGUST OF 2017.

SHE SAID THERE IS A SMALL SHADOW ON YOUR X-RAY BUT I HAD NOT HAD ANY KNOWN RISK FACTORS FOR THE DISEASE SO SHE SAID IT IS PROBABLY NOTHING BUT LET'S GET YOU A C.T.

SCAN AND SO AFTER THE C.T.

SCAN, IT SHOWED A 1.2-CENTIMETER NODULE.

TYPICALLY THERE IS NOT A LOT OF CONCERN BUT WE JUST PUSHED TO HAVE IT WATCHED FOR A COUPLE OF YEARS.

FINALLY DOCTORS IN NOVEMBER OF 2017 SAID WE NEED TO GET IT OUT.

NOTHING SHOULD BE GROWING IN YOUR LUNGS.

I WOKE UP TO MY DOCTOR STANDING BY MY SIDE AND HE SAID WE TOOK TWO LOBES OF YOUR RIGHT LUNG OUT, YOUR NODULE WAS LUNG CANCER.

I DON'T THINK I KNEW TO REALLY WORRY AT THE TIME.

I THOUGHT THEY GOT IT ALL.

I KNEW NOBODY AT THE TIME LIVING WITH LUNG CANCER SO NOBODY WAS TALKING ABOUT IT ANYBODY I KNEW OR ANYBODY MY FRIENDS OR FAMILY KNEW HAD PASSED FROM LUNG CANCER.

MEANWHILE I GOT SCANS EVERY THREE MONTHS AND WAS BASICALLY TOLD I WAS CURED.

TOOK ABOUT A YEAR YEAR AND A HALF AND THEN SOME SPOTS STARTED SHOWING IN MY LEFT LUNG.

IT, TOO, WAS CANCER.

NOW IT WAS TIME TO DO SOME BIOMARKER TESTING TO SEE IF THERE WAS A MU TITION, ANY REASON FOR THE CANCER TO KEEP GROWING IN MY LUNGS AND IT INDICATE CAME BACK TO SHOW I HAVE EXR DELETION.

IT IS A MUTATION, DAMAGE TO THE DNA IN YOUR LUNGS THAT WE THINK MIGHT POSSIBLY HAVE COME FROM PREVIOUS EXPOSURE TO SECONDHAND SMOKE AND RADON.

I'M ON A TARGETED THERAPY PILL I TAKE EVERY DAY AND I WILL TAKE IT UNTIL THE CANCER STARTS GROWING AGAIN SO WE JUST HAVE TO UNDERSTAND AND ERASE THE STIGMA AND REALIZE THAT WE DON'T NEED TO LOOK AT THE CAUSE.

WE NEED TO LOOK AT THE CURES AND REALLY UNDERSTAND THERE ARE MULTIPLE CAUSES.

THE STIGMA HAS STIFLED PROGRESS FOR SO LONG.

>> Renee: KATHY, YOU WERE SHAKING YOUR HEAD YES, LOOK AT THE CURE, NOT THE CAUSES AND WE WANT TO ASSIGN BLAME BECAUSE IT'S BEHAVIORAL CHOICES YOU ARE A SMOKER.

TELL US ABOUT YOUR EXPERIENCE.

>> MINE GOES BACK TO 2003 WHEN MY HEALTHY VERY INDEPENDENT MOTHER LIVED IN MICHIGAN WAS IN A CAR ACCIDENT.

THEY DID SOME SCANS AND FOUND SOMETHING THAT DIDN'T LOOK RIGHT ON HER LUNG.

THEY RAN SOME MORE TESTS AND SHE HAD STAGE 4 LUNG CANCER, JUST OUT OF THE CLEAR BLUE SKY AND SHE PASSED AWAY SIX MONTHS LATER.

AND IN THAT PROCESS BECAUSE MY MOM HAD NONE OF THE RISK FACTORS EITHER.

I STARTED LOOKING INTO IT MORE AND FOUND OUT ABOUT THIS LOW DOSE C.T.

SCANS.

FAST FORWARD, I WAS IN JUST HAVING MY REGULAR ANNUAL EXAM WITH MY DOCTOR AND I SAID, YOU KNOW, I HAVE BEEN SEEING SOMETHING ABOUT THE LOW DOSE C.T.

SCANS.

I THINK MAYBE I SHOULD GET ONE.

HE SAID YOU ARE VERY HEALTHY.

I HAD QUIT SMOKING LIKE 30 YEARS AGO.

HE SAID I DON'T REALLY THINK HE SAID THEY'RE NOT COVERED BY INSURANCE.

WELL HOW MUCH ARE THEY.

HE HAD HIS NURSE CHECK $185.

LET'S JUST DO THIS I SAID.

SO I HAD THE FIRST ONE, IT SHOWED A SHADOW.

WE FOLLOWED UP IN SIX MONTHS.

STILL A SHADOW.

HE THINK I THINK WE ARE GOOD.

I SAID LET'S JUST DO ONE MORE, ONE MORE AND SURE ENOUGH, IT HAD GROWN.

THEY DID A NEEDLE BIOPSY AND IT WAS MALIGNANT.

I DON'T FOE WHO WAS MORE SHOCKED, THE DOCTOR OR ME.

YOU KNOW HOW YOU KNOW ABOUT YOUR BODY AND YOU JUST LISTEN.

>> Renee: BECAUSE YOU WERE INSISTENT.

>> I WAS INSISTENT AGAINST THE DOCTORS ORDERS.

THAT WAS SEVEN YEARS AGO.

I HAD THE LEFT UPPER LOBE REMOVED AND DIDN'T HAVE TO HAVE ANY CHEMO.

AS YOU KNOW, I OWN TODAY'S WOMAN MAGAZINE UNTIL MARCH WHEN I SOLD IT BUT I USED THAT AS A FORUM TO GET THE WORD OUT.

IT'S A VERY INSIDIOUS DISEASE.

IT KILLS MORE PEOPLE THAN BREAST CANCER, CERVICAL CANCER, COLON CANCER COMBINED.

>> Renee: ARE YOU HOPEFUL ABOUT YOUR FUTURE.

>> I'M VERY HOPEFUL.

I HAD ANNUAL SCANS FOR THE FIRST FIVE YEARS AND AFTER THAT, THE DOCTOR SAID WE ARE GOOD.

>> Renee: STEVE.

>> I'LL TAKE YOU BACK TO 2014, THE LATTER PART OF THAT YEAR.

I ACTUALLY, A MONTH AFTER HAVING BEEN MARRIED TO MY WIFE SARAH, SARAH TOLD ME MY MOTHER HAD READ AN ARTICLE IN TODAY'S WOMAN THAT SHE ALWAYS READS AND SHE SEEN SOMETHING THAT SAID SHE THOUGHT I MET ALL CRITERIA TO GET A LOW DOSE C.T.

SCAN AND IT'S SOMETHING INITIALLY I DISCOUNTED THINKING I'M GREAT.

I FEEL FINE.

I'M HEALTHY.

I DON'T NEED A C.T.

SCAN.

SHE WAS PERSISTENT AS WAS MY MOTHER AND I HAD THE LOW DOSE C.T.

SCAN DONE AND GOSH IT WAS THE MOST SHOCKING NEWS I'VE EVER RECEIVED.

THE NURSE CAME IN AND SAID WE ARE GOING TO CALL THE DOCTOR IN TO CAULK TO YOU.

THEY GOT US ALL BACK IN THE ROOM AND THEY SAID WE SEE A COUPLE SPOTS SO NEVERTHELESS, I HAD A PET SCAN DONE.

THEY SAID YOU DEFINITELY HAVE LUNG CANCER.

BUT THE WORST PART WAS THAT IT WAS IN BOTH LUNGS.

SO IMMEDIATELY YOU THINK, HOW LONG DO I HAVE?

I QUALIFIED FOR SURGERY BECAUSE IT HAD NOT METASTASIZED OR ANYTHING.

IT WAS LOCALIZED WITHIN MY LUNGS SO METALLY THEY TOOK ME IN AND I HAD THE ENTIRE TOP PORTION OF MY RIGHT LUNG REMOVED AND TWO MONTHS LATER AFTER ENOUGH TIME FOR ME TO HEAL, THEY DID THE SAME THING WITH THE LEFT LUNG.

I HONESTLY SAY I FELT LIKE I WAS BLESSED.

I FEEL LIKE I OWE IT TO KATHY'S ARTICLE IN TODAY'S WOMAN BECAUSE I'LL TELL YOU, IT IS QUITE AMAZING HOW YOU FIND SOMETHING.

THE AWARENESS IS NOT THERE BUT YOU FIND SOMETHING AND IT CHANGED MY LIFE.

>> Renee: I WAS GOING TO SAY, TO HAVE BOTH OF YOU HERE IN THIS CIRCLE THAT KATHY, YOU COULD HAVE SAVED STEVE'S LIFE, IN FACT YOU DID BECAUSE OF YOUR ADVOCACY OF WHAT YOU WERE DOING IN A MEDIA PLATFORM WITH THE BROAD AUDIENCE THAT TODAY'S WOMAN HAS.

SO IT GOSS WHAT COULD THE MEDIA BE DOING, RIGHT?

BECAUSE LUNG CANCER IS NOT SOMETHING THAT IS TALKED ABOUT AS MUCH AS OTHER FORMS OF CANCER AND DISEASES.

>> THE BIGGEST PROBLEM IS FUNDING BECAUSE THERE IS NOT ENOUGH RESEARCH WHEN ONE TREATMENT FAILS, YOU NEED OPTIONS AND SO MANY OF THE TREATMENTS, THE TARGETED DRUG I'M ON HAS SHOWN SUCCESS FOR 18 TO 36 MONTHS.

SO WE NEED OPTIONS WHEN THE CANCER BEGINS OUTSMART THE TREATMENTS AND THAT'S THE BIGGEST FAILURE RIGHT NOW IS THE LACK OF FUNDING FOR THIS DISEASE FOR A LOT OF THE REASONS THAT WE HAVE MENTIONED, THE STIGMA BEING THE MAIN ONE.

>> I WANT TO ASK YOU AND I'LL START WITH YOU, ONE FINAL TAKEAWAY.

IF VIEWERS DON'T LEARN ANYTHING ELSE FROM THE SERIES AND HEAR JUST ONE THING, WHAT DO YOU HOPE IT WOULD BE.

>> FOR ME IT'S ALL ABOUT CLEAN AIR.

TAKE ADVANTAGE OF THE CLEANEST AIR WE CAN BREATHE AND TAKE IN.

>> ANY FINAL TAKEAWAY FROM YOU KATHY?

>> IF YOU HAVE LUNGS, YOU CAN GET LUNG CANCER.

SADLY THAT'S THE BIG TAKE AWAY.

>> Renee: LINDY, LAST WORD.

>> MY HASHTAG IS ANYONE WITH LUNGS.

AND THAT IS ONE OF THE BIGGEST MESSAGES WE HAVE TO PUSH THROUGH GIVING LARGER PLATFORMS TO THE SURVIVORS BECAUSE SOMETIMES I FEEL LIKE WE REMAIN IN A BUBBLE HELPING EACH OTHER BUT WE NEED THE MEDIA, LARGE ORGANIZATIONS, EVEN CELEBRITIES DIAGNOSED TO REALLY SPEAK UP AND HELP US FIGHT THIS CAUSE BECAUSE IT'S A BIG ONE.

IT'S A WILDFIRE.

>> Renee: THANK YOU ALL FOR FIGHTING.

WE WON'T STOP FIGHTING.

I.

>> HAVE NO DOUBT ABOUT THAT.

NONE WHATSOEVER.

WE DEUCING THE STIGMA SURROUNDING LUNG CANCER WILL FURTHER ADVANCEMENTS IN RESEARCH AND TREATMENT WHICH WILL HELP EVERYBODY AFFECTED BY THIS DISEASE.

THAT'S ALL FOR THIS EPISODE OF FIGHTING TO BREATHE.

REMEMBER, THAT ANYONE WITH LUNGS CAN GET LUNG DISEASE.

CLEAN AIR IS ESSENTIAL TO LIFE AND IS SOMETHING WE ALL SHOULD BE FIGHTING FOR.

BOTH FOR OURSELVES AND OUR FELLOW CITIZENS.

PLEASE VISIT OUR WEBSITE AT ket.org/RESPIRATORY FOR MORE INFORMATION AND TO WATCH AN ARCHIVE VERSION OF THIS PROGRAM.

THANK YOU SO MUCH FOR JOINING US.