Biomarker Testing in Lung Cancer - Episode 5

Receiving a Diagnosis of Non-Small Cell Lung Cancer

Allison Collins describes her diagnosis with KRAS-positive non-small cell lung cancer and the symptoms that led her to seek medical attention.

Vamsidhar Velcheti, M.D.: Hello everyone and welcome to CURE Expert Connections®. I’m Dr. Vamsidhar Velcheti, and I’d like to welcome Allison who is here to share her incredible journey with KRAS-mutation positive non-small cell lung cancer. Hello, Allison.

Allison Collins: Hello.

Vamsidhar Velcheti, M.D.: Can you introduce yourself to our audience?

Allison Collins: My name is Allison Collins, and I was diagnosed as KRAS positive in April 2018.

Vamsidhar Velcheti, M.D.: Thank you for joining us, Allison. We’re really excited to have you here and looking forward to chatting with you. It’s been an incredible few years for all the researchers and clinicians treating patients with non-small cell lung cancer. We’ve seen a lot of advances in terms of treatments and treatment modalities. It’s been a really exciting few years in terms of our knowledge. We have an increasing number of treatment options for our patients with non-small cell lung cancer. Just a general overview of lung cancer, there are a lot of different types of lung cancer, non-small cell lung cancer being the most common type. There are a lot of different types of non-small cell lung cancer. There are squamous cell and nonsquamous histologies. At a fundamental molecular level, there are a lot of different molecular subtypes of lung cancer, as we are realizing now that understanding these different subsets and molecular subsets of lung cancer can allow us to treat patients with a more targeted approach and more personalized treatment approaches.

I’m so glad Allison was able to join us today. Allison, could you tell us about your diagnosis and what are the symptoms you had when you were first diagnosed? Just tell us about your journey through the early diagnosis. What did you know about lung cancer at that time, and how was your journey and how did you navigate through this process?

Allison Collins: Well, mine started off as what I thought were allergy issues or sinus issues because I’ve always had them in the past. I woke up with laryngitis, and I’d never had laryngitis before, so I went to the closest urgent care, and she treated me for sinus infection and throat infection. She gave me a prescription for amoxicillin, and she said if it hadn’t cleared up in three weeks to come back. Well, three weeks passed and it didn’t clear up. Actually, I coughed and I saw blood. I really got scared so I went back, and again she said she thought it was still sinus infection and she put me on another prescription of amoxicillin. In the meantime, she made a referral for me to see the ear, nose, and throat specialist. I still had to wait another three weeks before I could see him. My voice was not getting better, it was actually like I was straining and that hurt. But I went to see him, and he did his usual thing where they go up and look in your sinuses and look down your throat. He noticed that I had a paralyzed vocal cord. The left vocal chord was paralyzed. He wanted to do a CT [computed tomography] scan of my neck and chest. Still I waited to get approval, so that was another two and a half weeks before I got my first CT scan.

But when I did go and do it, they called me back really quickly because they had found something on there. He called me back in, but he was just an ear, nose, and throat specialist so he didn’t really know, per se. He saw a 2-centimeter nodule at the top left of my lung, and he didn’t know if it was cancer. He was going to send me to a local pulmonologist here in Lumberton [North Carolina]. My experience in the past with cancer in my family was scary. I hadn’t seen good results here locally, so I decided on my own I asked for a referral to Duke [Cancer Institute]. From here I went to Duke. I was in Duke in April. As soon as I walked in the door, I had a pulmonary function test, a PET [positron emission tomography] scan, CT scans, and I saw a thoracic surgeon. She was the one who told me that she did feel like it was lung cancer but she needed to do a biopsy.

Transcript edited for clarity.