"Precision medicine has transformed my prognosis from extremely poor to hopeful"

By Yuan Lew

I am here to share my journey, offering hope and underscoring the critical role of precision medicine in cancer treatment.

In 2022, during my late 40s, I received a devastating diagnosis of Stage IVB EGFR+ lung cancer. The news was particularly shocking as I had no family history of cancer. This was the dreaded 'C-word', presenting at an advanced stage with minimal symptoms. I was stunned to learn from the radiology reports that I had "innumerable" tumours.

In the wake of my diagnosis, I underwent genomic testing to guide my treatment plan. Despite my background as a life scientist, I was unaware of the recent advances in oncology. In those initial days post-diagnosis, I found myself navigating a bewildering array of medical appointments. Thankfully, I was supported by a dedicated team of physicians who ordered the appropriate tests, including Next Generation Sequencing (NGS) to identify any actionable mutations in my cancer cells. The process was straightforward; samples from a thoracentesis were sent to a laboratory for processing and analysis. The goal was to identify specific genetic mutations, such as EGFR, to guide targeted treatment options tailored to the unique genetic profile of my cancer.

As a never-smoker, Asian, female, and under 50 years of age, my physicians suspected that I likely had mutations in the EGFR gene. We received the genomic testing report within three weeks that confirmed our suspicions: I had EGFR mutations that could be targeted with available therapies. Instead of undergoing traditional chemotherapy, my treatment plan was simplified to a single daily pill. I am continually amazed by the power of science, as this small daily pill has been instrumental in my treatment journey.

The personalized approach to my treatment, tailored to address the specific genetic mutations driving my cancer, has been life-changing. Not only do I benefit from a treatment regimen that requires minimal hospital visits, but I also experience fewer side effects compared to conventional chemotherapy. Remarkably, many of my tumours have shrunk within just 10 weeks, and I have regained most of my lung function. By the third month of treatment, my palliative care doctor even discussed “rehabilitation” with me, marking the beginning of my journey to reclaim what cancer had taken from me.

Today, while my cancer remains stable, I am focused on living my life to the fullest and advocating for others. Precision medicine has transformed my prognosis from extremely poor to hopeful, allowing me to envision a future where I may live with Stage IV EGFR+ cancer as a chronic condition.

However, despite the promising benefits of precision medicine, significant challenges persist. While I was able to access precision medicine without difficulty, my advocacy work has revealed that not everyone has had the same experience. Access and equity in precision medicine vary across different regions, and targeted therapies are not universally covered by provincial healthcare plans. I am profoundly grateful to have private insurance, acknowledging the immense privilege this affords me.

Another obstacle in the realm of precision medicine is the traditional classification of cancers based on their organ of origin. With the advent of precision medicine, this approach is no longer the most suitable. For instance, EGFR+ cancers can originate in various organs, including the brain (glioblastoma), colorectal, and head and neck. Yet, current clinical trial designs, drug approvals, and drug funding reviews are predominantly based on primary tumour types. These systems can hinder the rapid development and accessibility of innovative drugs emerging from precision medicine. To fully harness the potential of precision medicine, it is crucial that we transition from this conventional approach.

Moving forward, I share hope. I envision a future where every cancer patient has access to personalized treatment options based on their unique genetic profile, leading to more effective and less toxic treatments. We must unite in our efforts to enhance the lives of cancer patients by investing in research and expanding access to precision medicine.

By sharing my story and advocating for precision medicine, I aim to inspire others to join the fight against cancer and contribute to the advancement of personalized cancer care for all. Together, we can make precision medicine accessible and equitable for everyone, regardless of their background or geographical location.

Yuan Lew is a member of the MOHCCN Patient Working Group based in the Greater Toronto Area.