Picture the scene… 28-year-old woman given just weeks to live. Then the phone rings with a life-saving solution. Two years later, the woman is fit, well and has no evidence of disease.
It sounds like the plot of a movie, but this is not make-believe. This is Becca Smith’s story, made possible by a biopsy and a wealth of new treatments.
“It was my mum who answer the phone. I was bed bound and on oxygen at this point. My friends had even started to come and say their goodbyes.
The lady on the phone was jumping for joy apparently. She explained they had found this ALK+ mutation from my biopsy. We didn’t really understand what that meant at the time but knew it must be good news and there was a different energy in the house after that phone call.”
People diagnosed with non-small cell lung cancer now have their tumours routinely biopsied for genetic mutations. Depending on the location of the cancer, this may be a bronchoscopy, thoracoscopy, mediastinoscopy or CT guided biopsy. A small sample of cells is taken and tested. The results can then shape your treatment path.
In Becca’s case, her biopsy identified the anaplastic lymphoma kinase positive (ALK+) mutation and she immediately started on a targeted therapy. Two years on and an upcoming 30th birthday celebration in Italy, Becca is not only surviving, she’s thriving.
“What started out as a nightmare, now feels more manageable. Liveable. My latest scans have shown no evidence of disease (NED) and whilst I know the cancer has not gone, the medication is doing its job and I believe my holistic approach to life is also playing its part.
I tell myself that my lung cancer is like a chronic illness. There’s people that live with MS. There’s people that that live with this. I take tablets every day, but my life continues.”
Not a one-time thing
But biopsies should not just be part of the initial diagnosis. “As a cancer grows, it adapts to its surroundings, evolves and spreads,” explains Dr Mike Davies, Roy Castle Lung Cancer Senior Research Fellow at the University of Liverpool.
“This means when we treat cancers with drugs or radiotherapy, it can develop so that the therapy stops working and the tumour starts to re-grow.
When this happens, it’s important to rebiopsy the tumour to try to determine how the cancer has evolved and look for new mutations in the tumours DNA. Results from the rebiospy may give us the opportunity to offer a more effective therapy, one that might not have been suitable originally, or not been available at that time.”
Nicky Peel was on a clinical trial having exhausted all available treatments for her lung cancer and subsequent bone metastases. It was a gruelling regime of intravenous immunotherapy with concurrent chemotherapy tablets.
However, a new biopsy revealed Nicky now has the KRAS G12c mutation. At the same time, the first targeted therapy for this type of lung cancer was undergoing approval. Nicky’s consultant confirmed she quality for this new treatment. The tumour has now reduced by a third in size.
“I am so grateful to have another treatment line available to me and I am so grateful to the researchers, the scientists and the patients who would have taken part in the many trials to get this drug approved.
“My experience shows just how important it is to have your tumour re-biopsied. When I was first diagnosed, I had no generic mutations. Now I do, and a new lifeline to boot.”
If you have any questions about biopsies, lung cancer tests or generic mutations, contact our Ask the Nurse helpline on 0800 358 7200 or email lungcancerhelp@roycastle.org.