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'As a non-smoking, vegetarian yoga fan, I never dreamed my cough could be lung cancer'

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As a non-smoking, vegetarian yoga enthusiast, 57-year-old Melanie Erwin is not the stereotypical lung cancer patient. Myths still perpetuate that it’s a disease that affects smokers, the elderly and those exposed to heavy pollution, such as miners. The reality, however, is very different.

According to the Roy Castle Lung Cancer Foundation, every day 44 women in the UK will die of lung cancer, more than breast and ovarian cancers combined, and worryingly, rates in women are increasing. One in 15 women will be diagnosed with the disease in her lifetime, and more younger women than men will die of it this year.

In addition, around a quarter of those diagnosed yearly are non-smokers. Melanie, who was diagnosed with stage 4 lung cancer earlier this year, is very familiar with the inaccurate perceptions.

“People tend to be very surprised when I tell them what type of cancer I have. They look at me and my very healthy lifestyle, having never smoked, and they can’t understand how I have this disease.

“I’ve never wanted anyone’s pity or sympathy, but it can be hard to feel that people assume we lung cancer patients have somehow ‘caused’ our own illness,” she says.

Melanie, a mother of three who lives in East London with her partner Sarah, 39, was diagnosed in August 2020 during the pandemic. “Ironically, it was Covid that saved my life at that time. I had it in April 2020, then began to suffer from symptoms of Long Covid in the months that followed, including terrible fatigue, although no cough.

“Fortunately, my GP sent me for an X-ray and blood tests, and the same afternoon I received a call to say a ‘mass’ had been detected in my left lung,” says Melanie.

“Further scans and tests revealed the mass was unrelated to Covid and that, devastatingly, I had non-small cell lung cancer (NSCLC), which is the most common type.

“I received that news by phone call and it was an enormous and crushing shock. I was terrified. Sarah was my rock, but it was so hard for my grown-up children and parents as none of them could be with me because I needed to shield to protect myself.” Within weeks, Melanie had surgery to remove half her left lung and spent four days alone in hospital as Covid restrictions meant no visitors.

“After that, I needed to have both chemotherapy and radiotherapy because although a biopsy revealed my tumour had been detected in the early stages, some cancer cells had been found in my lymph nodes.

“The chemotherapy was incredibly gruelling, I was very poorly during that time, but I had to believe it would all be worth it.”

Melanie finished treatment in March 2021 and for the next year recovered, and underwent regular scans. In April 2022, a number of tiny nodules were spotted in her right lung.

“The strong suspicion, because of my previous diagnosis, was that they were cancerous but they were too tiny for a biopsy to be performed.

“The uncertainty was very hard to bear, but I had to make a conscious decision that there was absolutely nothing I could do, and no point wasting precious time worrying.”

In March, due to the slight growth of the nodules, it was possible for a biopsy to be performed and sadly Melanie discovered she had Stage 4 lung cancer, specifically a mutation called EGFR positive, which affects around 10-15% of the 39,000 people diagnosed with lung cancer in the UK.

It’s more common in women and in people who have never smoked, and affects a higher proportion of patients in some Asian countries.

“Despite the fact I knew there was a strong possibility the cancer had returned, it was still shocking, and like many people do, I heard ‘Stage 4’ and immediately thought ‘death sentence’,” says Melanie. “Since then however, I’ve learned treatment for lung cancer is developing and improving all the time.

“I am taking a daily medication which has only been available in the UK for a few years and which inhibits the growth of tumour cells, and may even reduce them down to nothing.

“There’ll come a point when it stops working, because my cancer cells will get wise to it and mutate again, but my hope is that by then another drug will be available. My goal is to live with Stage 4 lung cancer and eventually die with it, not of it.

“Alongside the medication, I live an incredibly healthy and holistic life, with supplements, a practically sugar-free diet, no meat or alcohol.”

And as well as yoga, Melanie practises qigong – Chinese meditative movement said to aid healing. “I feel very well with lots of energy, and love spending time with Sarah, my family and little granddaughter Maya, now 21 months old,” she says.

“I’ve also started writing about my experience on Substack, something I’ve found incredibly therapeutic. Delving into my emotions and putting them into words has helped me accept what has happened to me and what I am living with. I hope another person will read it and know there is life after a lung cancer diagnosis.”

November is Lung Cancer Awareness month and Melanie, a patient advocate for the Roy Castle Lung Cancer Foundation, who has had support from charity EGFR Positive UK, is passionate about highlighting its often unknown symptoms.

“I’m delighted there is now much more knowledge about the signs of cancers like breast and ovarian, but what to watch for in terms of lung cancer still has a long way to go.

“Symptoms include the more obvious ones like a persistent cough or repeated chest infections, to lesser known ones like shoulder and chest pain, and unexplained fatigue.

“Last year, a national lung cancer screening programme was rolled out for people aged 55-74 with a GP record including a history of smoking, and I urge anyone eligible to take advantage of it. The most important thing to remember is that anyone with lungs can get lung cancer, irrespective of age or lifestyle. I am proof of that.”

■ Find out more from experts at The Roy Castle Lung Cancer Foundation

■ Read Melanie’s Substack here

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