Congenital heart disease in adults - Symptoms and causes
How Common Is Lung Cancer In Non-smokers?
Lung cancer remains one of the most prevalent cancers globally and is the leading cause of cancer-related deaths. The primary risk factor for this disease is tobacco smoking, with current estimates indicating that smoking is linked to approximately 80% of lung cancer fatalities.However, lung cancer is not exclusive to smokers. About 10-20% of lung cancers are diagnosed in non-smokers, often due to exposure to environmental risk factors such as radon, secondhand smoke, asbestos, diesel exhaust, and various chemicals. Women are statistically more likely to develop lung cancer under these conditions than men.Genetic mutations that affect cell growth regulation can also contribute to lung cancer. These mutations may be inherited and can run in families, highlighting the importance of genetic screening for those with a family history of the disease.Both smokers and non-smokers may experience similar symptoms, including chest pain, breathlessness, cough, wheezing, recurrent lung infections, blood in sputum, weight loss, fever, and loss of appetite.Currently, there are no standardized guidelines for lung cancer screening in non-smokers. Nonetheless, individuals with a higher risk due to family history or other risk factors should undergo careful monitoring for symptoms that may necessitate further investigation.
Initial diagnostic tests may involve blood work, chest X-rays, CT scans, PET scans, and evaluation of lung nodes through bronchoscopy and endobronchial ultrasound. Advances in genomic sequencing allow for the identification of genetic mutations in cancer cells, which can be crucial for guiding treatment and determining prognosis.A multidisciplinary tumor board, comprising various specialists, plays a key role in determining the type and stage of the tumor and recommending appropriate treatment. Treatment options for lung cancer vary based on its type and stage and may include chemotherapy, radiotherapy, immunotherapy, surgery, and targeted therapy.Successful treatment of lung cancer requires an organized, team-based approach and an integrated, holistic strategy. Genomic testing, sequencing, and accurate staging are vital components in managing the disease and tailoring effective treatment plans.(Author: Dr Prashant Saxena, Senior Director & Unit Head pulmonology and sleep medicine, Fortis Memorial Research Institute, Gurugram)Key symptoms of lung cancer you must pay attention to
Lung Cancer Survivor Sets Sights On 186-mile Pan-Mass Challenge
PLAISTOW — Lauren Coye has set out to defeat and prove her biggest enemy, and motivator, wrong.
The 26-year-old lung cancer survivor is challenging herself to accomplish feats she was told she would never be able to conquer after her diagnosis in 2022 — long after she began developing symptoms at age 9 but was misdiagnosed with asthma.
Coye, a Plaistow native, ran — and won — her first 5K race in Beverly at age 24. Then she completed a half marathon in Alaska. Her next challenge is to do the 186-mile bicycle route in the Pan-Mass Challenge over the course of the two-day event beginning Aug. 3.
The annual bike-a-thon raises money for cancer research and treatment at Dana-Farber Institute. So far, Coye has raised more than $6,000. She'll bike with Team Lung Strong.
"I was told I would never be able to run a marathon. Someone even told me I would struggle going up a flight of stairs the rest of my life," Coye said.
"I made it a goal that every year that my scans come back clean, I was going to challenge myself to do something doctors told me I never would be able to do," she added.
At 9 years old, Coye began what she didn't know at the time would become a 12-year battle with lung cancer. Her illness was misdiagnosed as asthma, bronchitis and pneumonia throughout her adolescence and into adulthood.
When she was young, Coye would get bronchitis and pneumonia a few times each year. Her twin sister grew out of asthma, but Coye continued to struggle to breathe.
As she grew older, her asthma worsened. In high school and college, pneumonia and bronchitis spells continued, along with constant wheezing. She began to spike random high fevers.
"There was one night I had to call my mom and I was laying on the floor because my fever was so high," Coye said.
Then the COVID-19 pandemic hit in 2020, complicating her eventual diagnosis. Her breathing worsened, but she assumed it was a symptom of COVID – and her doctors did, too.
Things took a turn in 2021 after she jumped in a lake.
"All of a sudden I hit the water and just immediately started drowning," Coye said.
She was given more antibiotics for bronchitis and pneumonia. But she landed in the emergency room after her fever spiked to 103 degrees. Doctors there told her she likely had a collapsed lung from the lake incident and an infection would clear itself.
Coye said she refused to leave the hospital until doctors agreed to order a CT scan. A month later, Coye found out she had a tumor in her lung.
Doctors initially thought it wasn't cancerous because she never smoked and was young. No one in her family smoked either, and there weren't any environmental factors like asbestos or radon found in her home.
Coye pushed for a biopsy and a bronchoscopy, which led to the discovery that she had a rare lung carcinoid tumor in neuroendocrine cells in her right lung.
She said there are misconceptions about who can get lung cancer. It's not only caused by smoking cigarettes.
"But here I am," Coye said. "Lung cancer affects anyone with lungs. It's not biased and it's not prejudiced."
This type of tumor accounts for less than 2% of lung cancer diagnoses, according to the American Cancer Society. Two-thirds of her right lung was removed. She only has its upper lobe remaining.
Coye played sports growing up and maintained an active lifestyle enjoying hiking throughout her life. But she said she didn't start running or biking until after her diagnosis when doctors said she would never get her stamina back after the bi-lobectomy.
The Pan-Mass Challenge, hiking and other marathons she's completed since finding out she had lung cancer have been about proving others wrong and proving to herself she can do it.
Coye said she set out to prove not only to herself, but to others that a cancer diagnosis shouldn't prevent anyone from living life.
"You are still able to do wonderful and amazing things," Coye said.
It's been two years since her surgery and she still has flare-ups with pneumonia and will get it along with bronchitis about three times a year.
Coye continues to monitor the cancer and gets follow-up scans. Her breathing is still bad and she's on three different inhalers. But it hasn't stopped her from training for the bike ride.
She bikes 30 to 40 miles at a time around Plaistow, Newton, Danville and Newburyport.
"I've tried to keep it local just in case something happens because I'm not a great biker," Coye said, then laughed.
Her mother has supported her throughout the battle, along with friends in the cancer community. Coye's mom plans to volunteer along the bike route in support of her daughter.
"Cancer has been my biggest enemy, but it's also been my biggest motivator," Coye said. "I like to prove to other people that when you get a cancer diagnosis, it doesn't have to be the end of the world."
A Breath Of Fresh Air: Richmonder Has New Perspective After 2 Double-lung Transplants
It was a simple game of kickball, played among friends on a reconfigured baseball diamond at Gillies Creek Park in Richmond's East End on a warm summer evening.
To the casual onlooker, it was just a bunch of young adults, joking and laughing, running about and letting off steam after a long day at work before they headed off to enjoy a round or two of golden-hued libations.
This was no ordinary kickball game, however.
This July 11 matchup between two teams who compete under the River City Social Sports Club banner was celebrating the 18th anniversary of Chris Nalley's first double-lung transplant.
Chris Nalley rolls a pitch during a kickball game in Richmond.
Courtesy of Cat McCarthy CreativeNalley, a Newport News native who's 44, pitched (or rolled, as it were) for his team, the members of which wore T-shirts provided by the United Network for Organ Sharing.
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Their opponent was the New Kicks.
"They were very nice, but they were very astounded," Nalley said a few days later as he recounted the moment. "'Why are you guys wearing these T-shirts?' We explained what was going on. They were like, 'That's amazing that you're out here doing this.'"
Quitting not an option
To Nalley, the concept of "amazing" is relative.
Yes, he was born with cystic fibrosis and, though he never led a "normal" life, he led the life he was given, and he lived it the very best he could.
Yes, he spent much of his youth and early adulthood in and out of hospitals, including, when he was 20, a five-month eternity in a medically induced coma so doctors could treat him safely for pneumonia, after which he went to a ventilator rehab facility before returning home on 24/7 oxygen.
Yes, when he was 26, he had his first transplant at the University of Virginia Medical Center following an 18-month stay on the waiting list.
And, yes, four years later he contracted an infection that triggered rejection of the donor lungs. Three years hence at 33, he underwent a second transplant, also at UVa, and afterward endured a series of potentially deadly complications that slowed his recovery to glacial pace.
But, no, he never quit. You see, when he was 9 years old, doctors told his family that he probably wouldn't live to 21, so by necessity he developed uncommon toughness, resolve and resilience.
Nothing, not even the specter of death, could scare him. Odds, he knew and has proved, are simply numbers.
"My life motto has always been 'carpe diem,' 'seize the day," he said. "With these transplants, every day's a gift, an extra day, so the coffee doesn't get cold, and the traffic's not so bad, so to speak."
Chris Nalley is seen with his kickball team earlier this summer in Richmond. They wore T-shirts provided by the United Network for Organ Sharing.
photos Courtesy of Cat McCarthy CreativeHow has Nalley honored "the greatest gift" two times over?
With eternal gratitude, for sure, because he remembers well the obstacles he faced when CF ruled his life.
As a youngster, he attended a few basketball camps, but strenuous physical activities including competitive athletics were out of the question.
"I was the last one across the finish line in the Presidential Fitness Test that you had to take every year in gym class," he said. "The mile, pushups, jumping jacks … not my forte, just because you need to breathe to be able to do that."
After graduating from Warwick High School, he spent two years at Thomas Nelson Community College and always worked, mostly in retail management, when his health allowed.
"My father was a firefighter and instilled a work ethic in me early on," he said. "I had some rough days in my 20s when I got up to go to work, and it was so difficult. I tried not to think about it. I just tried to live an as-normal-as-I-could life."
Still, the sword of Damocles hung constantly over his head.
"I tried to be as compliant as possible with airway clearance techniques and taking my medicine every day," he said. "I didn't even think about transplant being in my future. I pretty much thought that one day, I'd get sick enough and, to put it bluntly, choke to death."
When Nalley was 25, his already fragile health spiraled downward.
"I kept getting pneumonia," he said, "and I'd been on antibiotics for so long that it was just harder and harder to fight the infections off."
The challenges of daily living intensified even more. Simple activities like climbing stairs, walking even short distances and shopping for groceries became arduous tasks.
The waiting game for donor lungs began.
The call came around 6 a.M. On July 6, 2006.
"When they pulled the intubation tube out, the first breath I took was the longest I'd ever taken," he said. "I was so used to short, labored breaths.
"I describe it as … if you put a mint in your mouth and you breathe in air on a cool day, it fills your chest. It felt weird because I kept breathing in and my chest kept expanding. I wasn't used to that."
'It's very fun'
Five months later, Nalley ran his first-ever 5K. He started a flag football league that played regularly at the Humphrey Calder Community Center.
He ran numerous 10K's and in 2009 ran the Richmond half-marathon with Dr. Mark Robbins, a competitive runner and triathlete and his transplant surgeon.
"It was almost unreal," Nalley said. "He (Robbins) kept pace with me and supported me the whole way. My time wasn't that good, but I completed it and felt accomplished. Didn't get off the couch the next day."
In 2010, he entered yet another infection-induced health crisis that medication could only slow but not overcome. So began the next leg of his odyssey. The probability of another transplant loomed.
"There was a very weird time when I was too healthy to be relisted, so I just had to suffer," he said. "It was reminiscent of living with CF. I couldn't be as active, but I have a great group of friends who supported me and helped me navigate this new normal."
His lung function ultimately decreased to a point that he could be listed. After nine months, the call came on June 7, 2013, again around 6 a.M.
A plethora of complications ensued, and he remained in the hospital three weeks before beginning a long, grueling outpatient recovery. It took him a year, he said, to return to "almost normal."
Once he regained his health, he's hardly broken stride.
Competing for Team Virginia, he medaled in 3-on-3 basketball in the Transplant Games of America in 2014 and 2016.
In 2015, to honor his donors and the once-unlikely 35th birthday milestone, he ran 35 races of various distances over a variety of terrains.
The sheer volume of competitions over a relatively short time span took a serious toll on his knees, so now he occasionally slow-runs or walks a 5K or 8K if it supports a cause that speaks to him.
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Mostly, he stays active with social sports like touch football, dodgeball and kickball.
"It's one night a week, one season or two a year ... Not that bad," he said. "It's very fun."
Actually, it's more than "fun."
"The more active I am, the better my pulmonary function is because I'm building up the muscles around my lungs," he said. "Most recently, about a year ago, it was as high as it's ever been. I'm doing my due diligence to go out and be active and run, even if it's just from home plate to first base, and by being active, I'm honoring my donors."
Chris Nalley — seen with his girlfriend, Janet Lynn, earlier this summer — underwent double-lung transplants at the age of 26 and 33. The Newport News native is now 44.
Courtesy of Cat McCarthy CreativeYes … donors. The guardian angels of transplant survivors.
Nalley, of course, has had two. The first was Ryan, the second Hans. Nalley has met the mothers of both.
Ryan's passed away before his second transplant. Hans's now lives in Colorado where Nalley has visited her and four times has joined her for the Donor Dash 5K in Denver.
"It's almost like having another family," he said. "She looks at my success, family life, playing sports, and having a job as something good that came from her son's death."
Eleven years after his second transplant, Nalley soldiers on.
He pays forward his gifts by sharing his story and advocating for organ donation as a volunteer with UNOS, LifeNet Health, and Donate Life America.
More about UNOSThe United Network for Organ Sharing (UNOS) reports that 3,026 lung transplants were performed in the United States in 2023. That number far surpasses the 1,405 performed in 2006, the year of Nalley's first transplant. There are currently 893 patients on the lung transplant waiting list nationwide. Last year, 77 lung transplants were performed in Virginia hospitals. Today, 27 people remain on the waiting list in Virginia.
In 2023, surgeons transplanted 46,629 total organs, a number significantly higher than the 28,941 in 2006.
He works full time as warehouse manager for West Shore Homes, a home remodeling company.
Mainly, he counts his blessings and values the perspective he's gained from facing the myriad challenges thrown his way, the connections he's made throughout his journey, and the productive and meaningful life that was never guaranteed.
"One of the core values at work is 'Find Your Why,'" he said. "That's big. My 'Why' is two people who didn't get to leave the hospital, and I did.
"I've seen the good, bad and ugly. I've had opportunities and extra time. I have a zest and joy for life. My first transplant is 18 and old enough to vote. I've had a couple of different lives. Without the donors, I wouldn't have any of those.
"When death has knocked on your door, you have a different frame of mind. Every second is more valuable. Everything's more valuable."
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