Health

Biomarker testing for lung cancer: A survivor’s story

New York educator Lavern McDonald received specialized testing which allowed doctors to personalize her cancer treatment (Photo courtesy of Lavern McDonald)

By HEATHER M. BUTTS, JD, MPH, MA

Special to the AmNews

Lung cancer is the leading cause of death from cancer in the United States making up 25% of all cancer deaths. While disparities in treatment, especially among Black and brown communities persist, advances in lung cancer treatments, and knowledge of those advances, especially for those in underserved communities, can lead to better outcomes and prognosis. In New York, the survival rate has increased over the past five years, from 14.1% to 28.1%.

Lavern McDonald is an educator who has worked at The Calhoun School in New York City for over 20 years. [Full disclosure, Blacklight Editor Damaso Reyes is a Calhoun alumni but graduated before McDonald joined the faculty.] In 2018, at 52 years old, she was diagnosed with stage IV non-small cell lung cancer (NSCLC). McDonald told the AmNews that she was “going along [living] my merry life as a New Yorker… in January/February of 2018, I started experiencing shortness of breath.”

Her primary care physician (“PCP”) directed her to Mount Sinai Hospital and she saw a pulmonologist who ordered a CT scan. “I go back the following week and my whole chest lights up like a holiday tree on the CT scan and so typically when you have healthy lungs they show up on scans and things like that as black images because they’re full of air…In my case, they [were] fully white because cancer [was] everywhere throughout my lungs. I [was] directed to a satellite office for a PET scan. I [was] immediately scheduled for [a] tissue biopsy.”

According to McDonald, her doctors at Mount Sinai told her, “‘You’re healthy in other ways, we suspect it’s a particular kind of expression of lung cancer,’ and they said, ‘well if in fact we can confirm this through tissue and…blood biopsies… there are all sorts of treatment agents available to you including one that had only been approved that April of 2018.’”

Upon further testing, “Tissue and blood biopsy confirmed within the month that I was in fact having an expression of an EGFR Exon 19 C- Helix Deletion.” According to the American Lung Association, “EGFR” or epidermal growth factor receptor “is a protein on cells that helps them grow. A mutation in the gene for EGFR can make it grow too much, which can cause cancer. ” The particular testing that McDonald received is called biomarker testing.

If doctors know exactly what causes the tumor to grow, a patient may be able to go on a ‘targeted’ therapy that can slow tumor growth or shrink the tumor. While this approach has become more common, disparities in biomarker testing rates have been documented in several studies, with particular focus on disparities for Black Americans.

In a statement provided to the AmNews, Dr. Jorge Gomez, medical director of the solid tumor oncology inpatient unit at Mount Sinai Hospital, said, “It is critical for doctors to perform biomarker testing before making any treatment plan—particularly for Black Americans as recent studies show they do not receive biomarker testing at the same rate as white Americans resulting in worse lung cancer outcomes.”

Fortunately for McDonald, she did receive biomarker testing which led to specialized treatment for her cancer. “[This] set me up for a particular treatment agent which I started [in] September [2018] and by January [2019], in four months, that treatment agent had cleared all of my expressions including all my lung expressions of cancer, including metastatic action including my brain including in my bones I had the metastatic action had spread to my spine and my femur all over my body…within four months. In fact my response was so rapid that within two weeks…we took a scan and…all of my tumors and lesions and so on had been halved…and within four months everything had cleared.”

As to how McDonald is doing today, she described that, while she has had progression of her disease since 2021, she has been on a new “course of treatment” with “wonderful results.”

McDonald’s parting advice? “I would suggest that [people] really continue to advocate for themselves, pay attention to your body, your body is quite smart, it tells you.”

To learn more about lung cancer, please visit: https://www1.nyc. gov/site/doh/health/ health-topics/lungcancer.page and to find a lung cancer screening site call 311 or visit www1.nyc.gov/assets/ doh/downloads/pdf/ cancer/nyc-lung-cancerscreening-sites.pdf