A Second Breath

Two years ago, Summer Farmen began to have trouble breathing. She had never smoked a day in her life, so the mom of three was shocked when she learned the reason for her sudden symptom. "The doctors said there were tumors all over my lungs," she recalls.

A local specialist recommended treating her stage 4 disease with chemo as soon as possible. But Farmen decided to get a second opinion at Penn Medicine in Philadelphia, and the medical oncologist there had a different, more personalized plan: "When I meet a young woman who's never smoked, my initial thought is, 'There has to be a genetic target for treatment, and the first thing we need to do is find it,' " says Charu Aggarwal, MD, MPH, associate professor for lung cancer excellence.

Dr. Aggarwal and her colleagues at Penn are racing to elevate lung cancer care as they see more patients like Farmen. "The rate of lung cancer in nonsmokers has been increasing—especially among women," says Sunil Singhal, MD, chief of thoracic surgery. Researchers are investigating possible explanations, including viruses like HPV and the influence of sex hormones.

"The challenge is that most women being diagnosed are healthy, young, and they haven't smoked—so why would a doctor send them for a CAT scan of the chest?" says Dr. Singhal. "Their cancers can get pretty far along [before they're caught]."

Seeking Solutions

In some cases when lung cancer is detected early, a scan might show gray, hazy spots in the lungs called ground-glass opacities. Dr. Singhal is currently leading a clinical trial on a new surgical approach to removing these precancerous lesions (as well as tumors) using an injectable fluorescent dye; when atypical tissue absorbs the dye, it becomes easier for surgeons to see.

The team at Penn is also running trials on immunotherapies as well as studying liquid biopsy methods, because they're less invasive than traditional tissue samples. In addition, researchers are improving technologies that detect genetic mutations tied to lung cancer—tests that will hopefully lead to earlier diagnoses and more effective treatments. (Another of the team's goals: developing new screening protocols for genetically based lung cancers, since the current guidelines only apply to smokers.)

After Farmen underwent a thorough genetic workup, she learned some good news. It turned out her cancer was caused by a rare DNA mutation that responds well to several oral medications.

"Summer has experienced a complete response to treatment," says Dr. Aggarwal, who now sees Farmen every three months for follow-up scans.

With the gift of more time, Farmen is counting on the promise of research and future discoveries. "My cancer is still there, lurking," she says. "[Patients like me] have a median life expectancy of 7.5 years, which is why research is so important. I for sure want to push that envelope. And I am truly hopeful."

How to Help

Make a donation to Penn's Lung Cancer Translational Center of Excellence Gift Fund.

This article originally appeared in the April 2022 issue of Health Magazine. Click here to subscribe today!