Erika McArtor had COVID-19 the first week of March 2023, but instead of getting progressively better, her symptoms worsened.

“I had a cough and shortness of breath. Additionally, when breathing deeply, I would hear a crackle in my lungs. I was convinced I had long COVID.”

A Mysterious Lymph Node Emerges

On May 24 with no end in sight, Erika visited her primary care doctor who initially agreed it appeared to be long COVID. During the consult, Erika remembered that she had a swollen lymph node near her collarbone that felt like the end of a pencil eraser.

“It was new, and I thought it was unusual,” Erika recalls.

The doctor felt the lymph node and immediately ordered a computed tomography (CT) scan.

The scan results left Erika in shock. Erika had a 6.3 by 5.3 centimeter mass in her lower left lung along with other smaller lung masses. The primary care doctor was concerned it appeared to be lung cancer, so he referred Erika to WakeMed Pulmonology & Sleep Medicine.

A Diagnosis Confirmed at WakeMed Pulmonology & Sleep Medicine

Erika underwent a bronchoscopy on May 31 under the guidance of WakeMed pulmonologist Kevin Davidson, MD.

Her worst fears were realized. When the results returned, Dr. Davidson confirmed that she had lung cancer and that they had taken biopsies which would be sent for genetic testing.

“That was the first I’d ever heard of genetic testing for cancer,” shares Erika. “Dr. Davidson said that hopefully the team could identify a genetic mutation and treat it likewise. That comment gave me hope, even though I had no idea what this really meant.”

An Introduction to Dr. Namireddy of WakeMed Cancer Care

Erika was then referred to WakeMed Cancer Care – Hematology & Medical Oncology where she had her first appointment with WakeMed oncologist Praveen Namireddy, MD.

Erika’s samples drawn from the bronchoscopy had been sent in along with lab work drawn at her appointment with Dr. Namireddy to determine the likelihood of targetable mutations — which could potentially qualify Erika for targeted cancer treatments.

“He told me that they suspected a genetic component since I was a nonsmoker and an otherwise healthy person,” says Erika.

Hope for a Promising Targeted Therapy

Erika and her husband waited agonizingly for the results. On day they came in, Dr. Namireddy reached out to Erika. He explained that Erika’s cancer was anaplastic lymphoma kinas (ALK) positive which meant there was a targetable mutation. This qualified Erika for a highly effective targeted therapy.

According to the American Lung Association, most ALK-positive cancers are in non-small cell lung cancer. The ALK gene is in the body in the embryo stage of development. It helps in the formation of the gut and nervous system. It turns off while a person is still in the womb, but for some people it then turns back on and fuses with another gene. This gene change is called an ALK fusion or ALK rearrangement and can cause cancer.

“My husband, Thomas, and I were relieved. On June 28, I began taking a targeted chemotherapy drug. Five weeks later, I had a CT scan of my lungs and magnetic resonance imaging (MRI) of my brain. The cancer had metastasized to my brain.”

The results of the scans were quite promising. After five weeks on the medication, the brain metastases and the lung cancer had shrunk about 50 percent.

“I am so grateful I was referred to WakeMed where Dr. Davidson and Dr. Namireddy treated my cancer properly because they took those extra steps with the genetic testing.”

Tolerable Medication Side Effects

Unlike general chemotherapy and radiation, Erika has also not suffered merciless side effects from her targeted treatment.

“The side effects of the drug have not been too bad at all. My bilirubin levels are a little elevated; that’s a liver enzyme. Dr. Namireddy is monitoring it. I’ve also had a little muscle weakness and tiredness as well. Those side effects have been quite tolerable in light of the results we’re seeing. I’m very thankful.”

Erika will require targeted therapeutic medical management of her cancer for the rest of her life since it is caused by a genetic mutation.

Dr. Namireddy is optimistic. “It is a privilege to join her on this transformative journey, leading the way towards a brighter future, armed with advanced treatments customized for her ALK mutation. Our collaborative, multidisciplinary approach fuels our optimism to conquer this challenge, and I extend heartfelt wishes for her unwavering strength, resilience and a path towards renewed health.”

With three available generations of her medication, the plan is to keep her on one drug for as long as it is effective before switching to the next generation. She is also in line for promising clinical trials for her cancer. ALK-positive lung cancers account for only four percent of lung cancers. With targeted therapy, studies show that many patients eventually achieve no evidence of disease for years before any reoccurrence.

“I’m currently on the second generation and may eventually switch to the third generation. We’re hoping that as doctors find new innovations, I’ll never run out of options, and my cancer will never be able to outsmart my drugs.”

A Life Worth Living and Hope for a Happy Future

Today as a retiree, Erika leads a very normal life.

“I find I have been doing everything I want to do. I spend a lot of time with my husband, my two dogs, my daughters and their families. My daughters live close to me, and I see my three young grandchildren every week. I’m also back to practicing the piano, which is good exercise for my brain. My husband and I also still enjoy traveling, mostly to the beach.

“I’m so grateful for Dr. Namireddy. He’s very knowledgeable. I have great confidence in him and have no doubt that I am receiving the very best care. I hope to live a long time.”

About WakeMed Cancer Care – Hematology & Medical Oncology

At WakeMed Cancer Care, we understand that being diagnosed with a blood disorder or cancer can feel overwhelming. Recognizing the fear and uncertainty a patient may be experiencing, we are committed to walking alongside our patients, to support, guide and render the most compassionate care for as long as we’re needed.

The most important member of our community is you. That’s why we created a community of caregivers who surround our patients with proven medical and surgical expertise, state-of-the-art-technology, world-class nursing care, advanced physical rehabilitation services and specialized support services.

No matter your condition or stage, our multidisciplinary team treats your cancer with the latest technologies and the highest standards of clinical quality.

Visit WakeMed Cancer Care –
Hematology & Medical Oncology

About WakeMed Pulmonology & Sleep Medicine

Our expert pulmonologists are committed to providing patients exceptional, collaborative care and treatment for a wide range of respiratory and lung conditions with the goal of enhancing their patients’ respiratory health.

WakeMed Pulmonology & Sleep Medicine specialists provide management and services for many lung conditions including, but not limited to the following conditions: