Lung Cancer: A Breath of Relief

JoAnn Durrett thought she had picked up an illness from her students. A retiree, she worked part time as a reading tutor at a Milwaukee elementary school and had a fever, congestion and body aches she couldn’t shake. She was also having trouble breathing, so in March 2024, she visited the Emergency Department at Froedtert Menomonee Falls Hospital, part of the Froedtert & the Medical College of Wisconsin health network. A chest X-ray indicated her problem was something other than an upper respiratory infection. 

The X-ray showed a small nodule on her right lung. She was referred to Steven Verga, MD, interventional pulmonologist and MCW faculty member. Dr. Verga quickly scheduled JoAnn for a bronchoscopy, a procedure that allowed him to obtain images of the nodule and biopsy the tissue and nearby lymph nodes. A week later, JoAnn learned she had stage III non-small cell lung cancer. 

“I was shocked when they said cancer because that wasn’t even on my radar,” JoAnn said. 

To discuss her treatment plan, she met with Jonathan Thompson, MD, MS, medical oncologist and MCW faculty member, followed by an appointment with Lindsay Puckett, MD, radiation oncologist and MCW faculty member. JoAnn brought her friend Vivian along to take notes during the appointments. She felt overwhelmed by her new diagnosis and didn’t want to miss anything. 

“Later, I was reading her notes,” JoAnn said. “I said, ‘Hey, Vivian, did you know this is treatable and curable?’ She said, ‘Yes, that was the first thing Dr. Thompson said.’”

The Latest Lung Cancer Treatment Options

 JoAnn knew she was with an experienced team. Dr. Thompson and Dr. Puckett specialize in treating people with lung cancer. 

“Stage III non-small cell lung cancer has many potential treatments,” Dr. Thompson said. “Multidisciplinary input is crucial, as many patients can receive surgery as part of the treatment if a surgeon determines the cancer is surgically removable. If the cancer is not surgically removable, chemoradiation, a combination of simultaneous chemotherapy and radiation therapy, is the standard of care. 

“Cancer genomic testing is essential. For patients with driver mutations, like JoAnn, using targeted therapies before or after surgery or after chemoradiation lowers the chance of cancer recurrence. For patients without driver mutations, immunotherapy before or after surgery or after chemoradiation can lower the chance of recurrence.” 

JoAnn’s cancer had spread to nearby lymph nodes. Because surgery was not recommended, she began chemoradiation therapy. 

She met weekly with her cancer team to make sure her body was tolerating the treatments. Chemoradiation therapy, for example, can cause severe fatigue. When radiation is directed at the patient’s chest area, some patients develop temporary swallowing difficulties. 

“JoAnn did really well,” Dr. Puckett said. “She was mostly able to eat a regular diet throughout, although she did feel tired. That’s normal and we encourage patients to continue their regular activities as best they can."

After chemoradiation, many patients with stage III lung cancer take an immunotherapy drug that reduces the risk of the cancer progressing. To ensure this approach would work for JoAnn, her cancer team tested the genes in her tumor tissue. This genetic testing does not happen in every hospital but is standard for patients within the Cancer Network who have non-small cell lung cancer. They learned that JoAnn’s cancer had a gene mutation known as EGFR. 

Dr. Thompson explained that immunotherapy does not work well for people with EGFR mutations. He and his colleagues had recently attended a national cancer conference where they learned about a new study, known as the LAURA trial, which found that people with the EGFR mutation have a reduced risk of the cancer returning if they take a medication known as osimertinib. This trial information was not yet widely known. 

“We used our expertise to bring her a highly effective therapy that dramatically lowered her recurrence risk,” Dr. Thompson said. JoAnn continues to take osimertinib and she has remained cancer-free.

Grateful for Good Health 

Looking back over her treatment, JoAnn appreciates how well the Froedtert & MCW team coordinated her care and worked to accommodate her life. She was eager to continue tutoring her students in the morning, so her care team scheduled her radiation therapy and chemotherapy appointments in the afternoon. 

JoAnn likes that her follow-up visits are usually grouped together. 

“Appointments, lab tests, imaging and oncology visits are ofien scheduled same day, which makes a tremendous difference,” she said. Her schedule is busy once again. She began taking classes at the YMCA designed for people who have had cancer. She made friends in the class, and they continue to meet weekly to exercise and socialize. She is also back to golfing, one of her favorite hobbies, and is grateful to have her life back. 

“I am deeply appreciative of the care I have received,” she said. “I recommend the Cancer Network to everybody I know.”