Stage 4 diagnosis drove nonsmoker to teach that it can happen to anyone

By Marissa Harshman, Columbian Health Reporter

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By the Numbers

222,500: Estimated number of new lung cancer cases in the U.S. in 2017.

• 4,390: Estimated number of new lung cancer cases in Washington in 2017.

• 155,870: Estimated number of lung cancer deaths in the U.S. in 2017.

• 3,100: Estimated number of lung cancer deaths in Washington in 2017.

• 70: Average age at the time of lung cancer diagnosis.

Source: American Cancer Society

More than 200,000 people are diagnosed with lung cancer each year. Eighty to 90 percent of those diagnosed are current or former cigarette smokers.

Dawn Horner is among the 10 to 20 percent of nonsmokers diagnosed with lung cancer.

And in the three years since her Stage 4 cancer diagnosis, Horner has felt the stigma associated with lung cancer time and time again. She’s often asked if she was a smoker. She’s been met with disbelief when she says “no.” She’s even had doctors seem to doubt her.

Still, the Vancouver woman has taken the experience and the doubt as an opportunity to educate people about the disease that her mother, father, aunt and uncle have battled.

“I want people to know that anyone with lungs can get lung cancer,” said Horner, 54.

Common cancer

Lung cancer is the second most common cancer in both men and women; about 14 percent of all new cancers are lung cancer, according to the American Cancer Society. Among men, only prostate cancer is more common. Among women, more are diagnosed with breast cancer.

While it’s the second most common cancer, lung cancer is by far the leading cause of cancer death among men and women — accounting for about 25 percent of U.S. cancer deaths. Each year, more people die from lung cancer than from colon, breast and prostate cancers combined, according to the American Cancer Society.

The five-year relative survival rate for lung cancer is just 18 percent. By comparison, the survival rate for breast cancer is 90 percent and prostate cancer is 99 percent, according to the American Cancer Society.

The dramatic difference is because lung cancer is often diagnosed at later stages when survival rates are lower. Lung cancer doesn’t typically show signs until it’s advanced. The five-year survival rate for distant lung cancer — malignant cancer that has spread to distant organs or tissues — is only 4 percent, according to the American Cancer Society.

That’s the category Horner finds herself in.

Slow diagnosis

About two years before her diagnosis, Horner started experiencing shortness of breath. She went to her primary care provider, who performed some breathing tests but told Horner everything was OK. Her doctor thought maybe Horner, a runner, had exercise-induced asthma or allergies.

Six months later, Horner had developed a nagging cough. She had a chest X-ray, but it came back normal.

Horner had been prescribed a variety of inhalers, allergy medications and antacids, but the cough persisted. Horner demanded another chest X-ray 10 months later. Her doctor said the results were normal.

“My doctor looked me in the eye and said, ‘You don’t have lung cancer,’ ” Horner said.

Unconvinced, Horner took her two X-rays to a pulmonologist, who noticed a shadow behind the left lower lobe of Horner’s heart. Additional tests revealed the shadow was a tumor. They also revealed the cancer had spread to Horner’s spine, ribs, hip and tailbone.

She was diagnosed with Stage 4 adenocarcinoma lung cancer Aug. 12, 2014. It is the most common form of lung cancer found in nonsmokers, according to the American Cancer Society. Surgery wasn’t an option since the cancer had already spread, and the specific mutation of Horner’s cancer has very few targeted treatment drug options, she said.

Horner’s doctor gave her six months to a year to live.

“I just decided right then and there, I was going to live,” Horner said.

Horner found a team of lung specialists at Seattle Cancer Care Alliance and began treatment. She drove to Seattle for chemotherapy treatment once every three weeks for three years.

For three years, the treatment worked. Horner’s cancer was being held at bay. But on the third anniversary of her diagnosis this August, Horner learned her cancer was growing again.

She stopped chemotherapy treatment and, in October, enrolled in a cancer drug trial at MD Anderson Cancer Center in Houston. She’s one of 49 people taking the oral chemotherapy drug, poziotinib.

“I’m lucky I lived long enough to get to this trial,” Horner said.

She’ll have her first scan Dec. 13 to determine whether the drug is stopping — or, ideally, shrinking — her cancer. Horner is optimistic. This summer, she developed the nagging cough again. Since beginning the trial drug, the cough has gone away.

“My hope is if we fund more research there would be another drug for me to take when this stops working,” Horner said.

Building awareness

After receiving her diagnosis, Horner’s doctor told her there had been no advancements in lung cancer drugs for many years. Only in the last five years have new drugs been coming out and, even then, it’s only been about a dozen drugs.

Horner hopes to see that change.

“Because of these drugs, lung cancer patients are living longer,” Horner said. “So now our voices are being heard because we’re still here.”

After her diagnosis, Horner got involved with the Lung Cancer Alliance. She helped organize the group’s first awareness walk less than a year after she became a cancer patient. She’s also flown to Washington, D.C., on behalf of the group to advocate for lung cancer research, telling her story to anyone who will listen.

If she and others with lung cancer don’t speak up, Horner said, nothing will ever change. But Horner’s husband of 27 years, Greg Horner, said his wife is already contributing to change.

“She’s making a difference in her own battle and for others,” he said.