I grew up on a dairy farm in Virginia and thought I was going to be a veterinarian. Somewhere along the way I decided I liked people better than animals, so I changed my career goal.
I started my medical school training at the University of Virginia but took two years off to come to New York City to pursue cancer research. I focused on lung and esophageal cancer because of my family history. My grandfather died of lung cancer when I was a baby, and my dad was a lifelong smoker. In 2005, he was diagnosed with lung cancer and passed away relatively quickly.
A few years before his diagnosis, I had convinced my dad to get a CT scan to screen for lung cancer, when such programs were in their infancy. He had a couple of CT scans in Virginia, but the results of a pivotal trial proving the efficacy of CT screening for lung cancer hadn’t yet been published, so that screening program was abandoned and my dad stopped getting scans. Five years later, he suddenly felt sick and went to the ER, where he was diagnosed with stage 4 lung cancer. He passed away just two months later.
That experience cemented my resolve to focus on lung cancer, both in the clinic and in my research. I suspect that we probably could have caught and treated his lung cancer had he been getting screened each year, or if we had had better biomarkers to identify his cancer at an earlier stage. As a result, I’m a big believer in screening high-risk patients for lung cancer. To me, we (the medical community) failed my dad on the early diagnosis end. But we also failed him on the treatment end. At the time, we were still using chemotherapy and radiation therapy that had been developed in the 1970s. We didn’t have the targeted therapy and immunotherapy drugs that we have today. These drugs have truly revolutionized lung cancer treatment.
Despite these advances in treatment, lung cancer is by far the number-one cancer killer. Certainly, smoking is the main cause of lung cancer, but nonsmokers get lung cancer, too. The survival rate for lung cancer patients remains abysmal. Survival at five years after diagnosis hovers around 15 to 20 percent for all newly diagnosed patients. Even if we surgically remove a stage 1 lung cancer, 20 to 30 percent of patients will have a recurrence. For stage 2 or 3 lung cancer, over 50 percent of patients may experience a recurrence.