What happened, in summary

Niko was diagnosed with lung adenocarcinoma about 2 years before the May 2024 interview. The first sign was frequent coughing during the COVID period. A doctor listened to her chest, suspected pleural effusion, ordered a chest X-ray, and sent her to the hospital. The pleural fluid was drained and tested, and genetic testing showed ALK-positive lung cancer. Additional PET-CT and brain MRI found disease in lymph nodes and scattered brain lesions, confirming Stage IV disease. Niko started a second-generation ALK targeted drug at diagnosis. She stayed on it for about 1.5 years before resistance developed, then moved to a third-generation ALK targeted drug for about 8-9 months. Neither ALK drug is named. Side effects were more noticeable on third-generation treatment: rapid weight gain, edema, numbness in the hands and feet, high cholesterol that required medication, itching, eczema-like rash, and prurigo-type skin problems. Even so, she described targeted therapy as easier than conventional chemotherapy because it was oral treatment and her cancer was well controlled. After 6 months on third-generation treatment, MRI and PET-CT showed no brain lesion, and previously active disease had become dormant and stable. As of May 2024, Niko remained on long-term targeted therapy with responding Stage IV ALK-positive lung cancer.