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I've never touched a cigarette. So why was I diagnosed with 'death sentence' lung cancer at 43?
A Kentucky woman was diagnosed with stage four lung cancer and given just six months to live, despite never smoking and being physically active.
Leah Phillips was just 43 years old in September 2019 when she developed a dry, nagging cough. Two weeks later, doctors dismissed it as just a remnant from a generic virus she had contracted.
A few days taking corticosteroids eased the cough, though it returned several weeks later, along with shortness of breath. A distance runner, Ms Phillips now had trouble keeping up with her jogging group and suffered a 'heaviness' in her chest.
After returning to the doctor and pushing for more tests, scans showed consolidation in her right lung, which occurs when air in the airways is replaced with fluid, blood, or other materials. It can be a sign of multiple health complications, and the mother-of-three was diagnosed with pneumonia.
Leah Phillips (top right with her husband and children) was diagnosed with stage four non-small cell lung cancer at 43, despite never smoking
'It knocked my mom and my husband and I over with a feather because none of us even knew that you could get lung cancer without smoking,' Ms Phillips told The Patient Story
She was prescribed antibiotics, but halfway through treatment she started coughing up blood. Doctors gave her stronger antibiotics and later admitted her to the hospital for four days for further testing and observation.
The medical team insisted Ms Phillips just had a persistent case of pneumonia, despite the fact she now was losing weight, coughing, could hardly walk up the stairs, and had pain in her right shoulder and right rib.
'I looked awful,' Ms Phillips, now 47, told The Patient Story.
'I was standing in the doctor's office crying at the front ladies, saying, "There's something seriously wrong with me. I need someone to see me. I need someone to listen to me."
'I said, "I'm not leaving here until someone sees me."'
A few months later, in December 2019, CT scans and bone biopsies revealed stage four non-small cell lung cancer.
She said: 'It knocked my mom and my husband and I over with a feather because none of us even knew that you could get lung cancer without smoking.
'That oncologist told me I had six to 12 months to live and that I need to get my affairs in order. I was 43 with small kids.
'I remember sitting there, bursting into tears. I was like, "This can't be happening. Metastatic cancer is what you die from, and I'm living now."'
Lung cancer is the deadliest form of cancer in the US, according to the National Cancer Institute (NCI). It accounts for one in five cancer deaths, and just over half of cases are diagnosed after the disease has spread to other organs.
In Ms Phillips' case, her cancer had spread to her spine and pelvis.
Only one in four lung cancerpatients survive after five years.
Non-small cell lung cancer is the most common type, accounting for nine out of 10 lung cancer diagnoses. It typically grows more slowly than small cell lung cancer and usually doesn't cause any symptoms until it has progressed.
The mother of three (left), here with her family, had been physically active and was part of a running club when she received her lung cancer diagnosis
Ms Phillips, pictured with her son, is stable, though she 'will never been in remission' due to the aggressive nature of the cancer
Ms Phillips is among a growing group of people being diagnosed with early-onset cancer - a diagnosis before the age of 50.
One in 10 lung cancer diagnoses in the US are in patients under 55, but experts have warned that rate of early cases has been increasing for the past two decades.
And though cigarette smoking remains the leading cause of lung cancer, the share of young patients who have never smoked is also on the rise.
Genetic testing revealed Ms Phillips had a mutation in her EGFR gene, which is most common in female, nonsmoking lung cancer patients patients.
About 10 to 15 percent of the 234,000 patients diagnosed with lung cancer per year have an EGFR mutation.
She also wrote for Project Environmental her doctor believes exposure to radon increased her risk of developing cancer.
Radon, a known carcinogen, is an invisible odorless gas produced from the radioactive decay of uranium in rocks, soil, and water. The World Health Organization estimates radon is responsible for three to 14 percent of lung cancers.
She believes that living in Kentucky has increased her radon exposure, as the chemical is common there.
Dr Laura Mezquita, a medical oncologist in Spain, said at an oncology conference earlier this summer: ‘Radon is the main cause of cancer in non-smokers. Radon is a risk factor also in young populations.'
She said this could be due to radon exposure from birth, which could occur if radon enters a home through contaminated soil. And a 2019 report in Nature found radon exposure in homes is increasing due to modern construction being more airtight and trapping in chemicals.
Ms Phillips quickly began taking the oral chemotherapy medication osimertinib, which is used specifically to treat non-small cell lung cancer in patients with genetic mutations.
After a year of treatment, the main tumor in her right lung had shrunk by 70 percent, and the disease in her bones had diminished.
In November 2020, she began eight sessions of intensive radiation to attack the remaining cancer.
The cancer has been stable since then, though the chemotherapty drug is only estimated to the cancer at bay for two to three years. It then can grow and spread again.
While Ms Phillips' condition has been stable on the drug for four and a half years, her doctors believe the medication will run its course. And even if it continues to work, her tumors will not shrink anymore.
'It's not a matter of if I will progress, it's a matter of when,' she said. 'I'm on, I guess borrowed time. There is no official next step.
'I'll never be in remission. I'll never be cured.'
Though Ms Phillips' outlook is grim, she is now urging other young people to advocate for themselves to doctors and not take no for an answer.
She said: 'What if I were not educated? What if I wouldn't have stood up for myself? What if I didn't have the financial means or the insurance to keep going back. That's who my heart breaks for.
'Being dismissed has never been my style. I'm not a confrontational person, but when I'm passionate about something... I will stand up for what I believe in, and I knew I deserved better care than what I was getting.
'You've got to be your own self advocate, and if you don't feel like you can be, you need to find someone who will be.'