Sunday 18 August 2019

'I thought I had pulled a shoulder muscle... then they said it was lung cancer' - Artist (55) on shock cancer diagnosis

What Jessica Grehan initially thought was a pulled shoulder muscle turned out to be the beginning of an arduous battle with lung cancer. She tells her courageous story to  Arlene Harris

Jessica Grehan, pictured at her home near Ballinrobe, Co Mayo, is undergoing treatment for lung cancer. Photo: Keith Heneghan
Jessica Grehan, pictured at her home near Ballinrobe, Co Mayo, is undergoing treatment for lung cancer. Photo: Keith Heneghan

More than 2,500 people are diagnosed with lung cancer in Ireland every year and the incidence of the disease has been rising steadily for the past three decades.

The Marie Keating Foundation recently launched new research entitled 'Time, Toughness & Treatment - Understanding the Experiences of People Living with Lung Cancer', which aims to highlight the experiences of Irish lung cancer patients, and the difficulties, obstacles and prejudices they face.

Jessica Grehan was diagnosed with the condition in 2016 and says what she initially thought was a pulled muscle, turned out to be the beginning of a very arduous cancer battle.

"I started suffering with pain my shoulder and jaw at the end of 2015," she says. "It carried on for a while and I went to see various people, including a physiotherapist, as I thought at first that I had pulled a muscle. I also went to see a cardiologist and had some dry needling done, but nothing seemed to make a difference.

"My physio suggested that I should get it checked out further and I was planning to. But one day, I coughed up a speck of blood, so immediately made an appointment with the GP, who referred me to A&E as I also had clubbing of my fingers, which could have been an indicator of an aneurysm or another heart problem. But after the X-ray was done, I was given two paracetamol and told to go home."

Jessica, who lives with her partner Emer in Mayo, went back to her GP for results. They showed a shadow on her lungs, which the doctor thought was pneumonia. She was put on a course of antibiotics and told to come back the following week to assess the situation.

But as the medication did little to improve her condition, she was sent for further tests, which (eight months after she experienced the first symptoms) subsequently revealed that she had lung cancer.

"I had been a smoker in the past, but had stopped many years previously, so lung cancer was the furthest thing from my mind," says the 55 year old. "It was a terrible shock, but at the same time, I became quite pragmatic and just wanted to get on with fixing the problem. My consultant said he would leave no stone unturned when it came to treatment and was keen to go with immunology. But although the first trials of the new drug failed, he still wanted me to go on it, so I decided I would get a second opinion, and the second consultant said that although immunology is the future, it wasn't the right time for me to go on it, so he put me on a course of chemotherapy.

"I wasn't suitable for surgery, as the tumour was between my lungs, but I had a good reaction to the chemo, which did a great job of shrinking the tumour."

Jessica, who is an artist, finished chemotherapy and radiotherapy in January 2017 and was looking forward to getting on with her life, but a few months later began to get a niggling pain in her abdominal area, which she initially put down to IBS as a result of all the mediation she had been on.

After several months, she was referred to hospital for tests to try and decipher the cause of the stomach pains, and it was discovered that the cancer had reappeared in her pancreas.

"I went to St James's Hospital for an endoscopic ultrasound on my pancreas, and lo and behold there was a tumour there," she says. "It was a metastasis of the lung cancer as opposed to pancreatic cancer, and I was put on a second bout of chemotherapy. I was also given pain treatment, as it was very bad at times and I had to try several different drugs to find something which would actually help with the pain. After a PET scan, it was discovered that the treatment wasn't working successfully, so I was prescribed another new drug which took months to receive as my insurance company wouldn't approve it initially. But I started on it in November 2018 and it has been working well to control the pain, and last week, I had a stent put in, which has done great things for me."

While treatment is still ongoing, the Mayo woman says people should familiarise themselves with the symptoms of lung cancer and never be afraid to seek a second opinion if they feel they are not being taken seriously.

"No one knows your body like you know it yourself," she says. "And it's very difficult to explain to someone else exactly how you are feeling or what your pain is like, so I would advise anyone who feels there is something wrong, to seek advice straight away.

"At least four or five times, I was told that I was 'grand', but I knew that something was wrong and became obsessed about finding out what it was. So I would say to people to trust their instincts as more often than not, they will be correct."

Helen Forristal, Director of Nursing Services with the Marie Keating Foundation, says early detection is vital when it comes to treating lung cancer.

"If lung cancer is detected early, there is a better chance of successful treatment," she says. "However, the majority of lung cancer patients are presenting at late stage (approximately 35pc in women and 38pc in men). Smoking avoidance or cessation is the most important preventive strategy as over 90pc of lung cancers can be attributed to cigarette smoke."

While many patients do not seek advice until the disease is well established, there are a number of tell-tail signs which, if present, should be checked by a doctor. These include:

⬤ Having a cough most of the time and/ or for prolonged periods

⬤ A change in a cough that you have had for a long time

⬤ Being short of breath

⬤ Coughing up phlegm (sputum) with signs of blood in it.

⬤ An ache or pain when breathing or coughing

⬤ Unexplained loss of appetite

⬤ Unexplained fatigue

⬤ Unexplained weight loss.

Once lung cancer has been diagnosed, Forristal says there is a variety of treatment options available to patients.

"There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)," she explains. "Most lung cancers are non-small cell lung cancer (NSCLC) and the three main types of this include: adenocarcinoma, squamous cell carcinoma and large cell carcinoma.

"Knowing which type you are helps your doctor decide what treatment is best, and this treatment will depend on the stage, grade and type of cancer cells.

"The stage looks at the size of the tumour and if it has spread from where it started. The grade of the cancer can tell if it will grow quickly or slowly. And it can be a low, moderate or high-grade cancer.

"Individual cases are discussed at multidisciplinary team meetings, where specialists give their expert opinions, and treatment options can include surgery, chemotherapy, radiotherapy, immunotherapies and biologic therapies. Some of these can be given at different stages, while some can be given together - so treatments are very individualised and patient-centric.

"I would advise anyone who has any of the signs or symptoms to seek advice from their GP, the earlier the better."

For more advice, visit mariekeating.ie 

THE FACTS: LUNG CANCER

⬤ More than 2,500 people are diagnosed in Ireland with lung cancer annually

⬤ More people die from lung cancer (than other cancers) - figures were 1,827 people in 2017

⬤ The five-year survival is only 17.9pc

⬤ The incidence of lung cancer has been rising steadily over the past three decades and is projected to increase by 141pc in women and 61pc in men by 2030.

⬤ 90pc of lung cancers are caused by smoking, therefore smokers are at risk

⬤ It is more common in those who are over 65 - in fact, 75pc occur in those 65 and over

⬤ Chronic lung conditions can cause cellular change and increase the risk of lung cancer (eg. emphysema, pneumonia)

⬤ Exposure to radon (a natural gas that can be found in the air or trapped in buildings) increases the risk, especially in smokers

⬤ Exposure to asbestos and some chemicals, employment as a painter, indoor emissions from household combustion of coal, and a family history of lung cancer can also increase risk.

Irish Independent

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