Lung cancer diagnosis offered many lessons to this research technician
BY AMBER SMITH
Wanda Coombs went for her annual medical exam in January 2016.
“I wasn’t even going to tell the doctor I had a cough, because in January everybody has a cough, but at the end of the appointment, she said, ‘Is there anything else that’s bothering you?’”
Two X-rays and a computerized tomography scan later, Coombs had a diagnosis of lung cancer and a date for surgery. Her surgeon removed one of the lobes of her left lung, and the tumor was found to be 4.5 centimeters, a little bigger than a walnut.
Coombs, 56, of DeWitt has worked at Upstate as a microbiology research technician since 1986, soon after graduating from SUNY Binghamton with a degree in biology.
Before her diagnosis, she already knew a lot about cancer and science and medical care — yet her experience with lung cancer taught her some things:
1. Lung cancer is treatable, especially when caught early.
2. If you’re diagnosed with cancer, see an oncologist. Coombs felt fine after surgery, but she made an appointment with Upstate's Stephen Graziano, MD, because she wanted an expert to follow her care.
3. Experts can disagree. Her surgeon does not recommend chemotherapy for tumors of less than 5 centimeters. Her oncologist recommends chemotherapy for tumors larger than 4 centimeters. Under a microscope, Coombs’ tumor looked like a squamous cell carcinoma, a slow-growing type of lung cancer that is almost always caused by smoking. Coombs was not a smoker. Graziano and colleagues examined her pathology and medical scans and determined her cancer to be a rare type influenced by the Epstein-Barr virus — for which chemotherapy was not recommended.
4. Listen to your body. Coombs was vigilant, and when back pain developed at the site of her surgical scar two years after her operation, Graziano sent her for medical images that revealed “three little spots” near her lung, Coombs recalls. That’s when Graziano prescribed chemotherapy and immune therapy.
5. Second opinions can be reassuring. Coombs went to Memorial Sloan Kettering Cancer Center in New York City and learned that doctors there recommended the same course of treatment she was receiving at Upstate.
6. Treatment recommendations evolve. The spots seemed to shrink at first, but when one grew a little bit, Graziano and Upstate radiation oncologist Jeffrey Bogart, MD, recommended radiation therapy.
7. Not all information is helpful. As she read about her disease, Coombs began to realize that much of what she found was more frightening than informative. Each patient is different. “Everybody is an individual, and how I respond to treatment is different than how anybody else will,” she says.
8. Therapy may have side effects. Her first round of chemotherapy did not affect her hair, but Coombs said she lost her hair when she was switched to another type. The immune therapy she was taking damaged her adrenal gland, so now she sees an endocrinologist. And, during her treatment she developed an allergy to the antibiotic amoxicillin.
9. Staying busy is beneficial. Coombs says that continuing to work full time helps her to feel normal and to manage the fear that the cancer might return.
10. Supportive loved ones help her stay positive. She admits there are days when she starts to feel sorry for herself, but Coombs says the support of her husband, Jeff, and daughter, Samantha, helps her maintain a good mood. She is grateful for every day.
This article is from the spring 2020 issue of Cancer Care magazine.