Stage IV Non-Small Cell Lung Cancer: Eugenia's Patient Story

What happened, in summary

Eugenia Horan was 46 when she was diagnosed with poorly differentiated non-small cell lung cancer. Her symptoms began after what seemed like a cold or flu in late 2018, followed by chest tightness, coughing blood, weight loss, and a racing pulse. Her concerns were initially treated as anxiety, but a scan later showed a 5 cm mass at the apex of her right lung and another mass pressing on her right main bronchus.

Eugenia’s early care was difficult and fragmented. Some options offered were palliative rather than curative, and one biopsy did not provide useful tissue because the wrong lobe had been sampled. As her disease worsened, a tumor grew through the bronchi and over the trachea. By June 5, 2019, she started low-dose chemotherapy because she was running out of choices. Soon after, she experienced respiratory failure, and by July her trachea was about 95% blocked by a bleeding, friable tumor.

At a higher-level center, doctors used brachytherapy/internal radiation, external radiation, repeated cryotherapy, and CyberKnife to clear the tracheal tumor. While critically ill, she then had surgery for a bowel/bile obstruction that proved cancerous, making the disease Stage IV. A resident identified an 80% match for Keytruda, and Eugenia pushed to receive it. She started Keytruda on August 29, 2019. As of February 2025, she was alive 5 years later and sharing her story as a warning not to lose one’s voice in care.