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Submitted by PatientsEngage on 23 December 2018

Shailaja Asave, a non-smoker, who developed lung cancer at 67, believed to be due to a gene mutation prevalent in Asian women, is undergoing targeted therapy and living each day to the fullest. Read about her diagnosis, treatment and unbeatable spirit.

When were you detected with lung cancer?

Last year in February 2017. It was already in the advanced stage, what is called Stage IV.

What were your initial symptoms?

I had a persistent dry cough for 3 months which did not go away with anti-allergy or anti-cough medications or any other home remedies. I consulted an internal medicine specialist.

What tests were done that indicated lung cancer?

The X-ray did not show anything as the left lung tumour was hidden by the heart. Hence, we did a CT scan which revealed the tumour in both lungs. The brain MRI was also done and showed the lesions in the brain.

Which type of lung cancer were your diagnosed with?

Adenocarcinoma of the lung – non-small cell but EGFR positive.

(Non-small cell lung cancer (NSCLC) accounts for about 85% of all lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of NSCLC. EGFR positive lung cancer refers to lung cancers that test positive for an EGFR mutation. EGFR stands for epidermal growth factor receptor.)

Which medicine have you been prescribed?

Started with a targeted medication which is especially for EGFR positive patients - Gefitinib-also called Iressa made by AstraZeneca. I used it for 21 months and have now shifted to the second line of drug called Tagrisso-Osimertinib as there were new lesions in the brain but the lung cancer remains unchanged.

More about Targeted Therapies, the latest weapon for Lung Cancer Treatment

How much better do you feel with targeted therapy, against traditional cancer medicines like chemo?

If I had to undergo chemo or surgery, there would have been a lot of physical debilitation that would have resulted from it. Chemo has so many side effects, even surgery has, especially in lung cancer it can be a little difficult in the last stages. But in targeted treatment, all that you do is take one tablet, with minimal side effects like fatigue or little bit of rash. So definitely it makes a very big difference. And that is why these newer drugs, which have really come up only in the last 5-6 years are so beneficial.

Editor's note: While some people have fewer side effects due to targeted therapy being more precisely directed, it is not always the case. There can be substantial side effects according to National Cancer Institute.

The support and caring by the doctors at Tata memorial Hospital has also helped a lot.

Considering you are a non-smoker, what was the reason for your lung cancer?

Apparently, my type of lung cancer is common among Asian women who are non-smokers. I came to know about it afterwards. So, if you are Asian, a non-smoker, you could still be at risk of getting lung cancer. Asian women undergo a certain gene mutation which makes them vulnerable. It is not known why these genes mutate. But this is found commonly in Asian women. So I developed this cancer because of certain gene mutation. I have never smoked in my life.

Are there any changes that you have introduced in your life recently?

I would say I am fortunate because there are targeted medicines for my lung cancer for this particular mutation. There is no chemotherapy. All that I have to take is one medicine. Unlike chemo, the side effects of this tablet are minimal. It does cause a certain degree of fatigue and tiredness. Other than that, most days you feel fairly okay. I feel I have been able to work, maintain my lifestyle. Because you don’t feel tired, you land up focussing on things that are important and not waste time on things that are not. I think it just makes you more efficient in a way.

So targeted therapy helps you lead a more normal life.

Yes. It has definitely helped me lead a more normal, active life.

What would you like to tell other Asian female non-smokers who could be at risk of developing lung cancer?

One thing is, as I said, this thing can happen to anybody. I have always led a very healthy lifestyle. I always ate the right thing, did my exercises, kept myself very active. I think this healthy lifestyle has helped me take on my cancer more ably. I am still able to lead a fairly active life. I work every day. I do all the usual things I do every day. I exercise. I meditate. I work for a foundation that does a lot of work with NGOs. I think the main thing is to have the right attitude when something like this is discovered.

And remember, as soon as we are born, we are all going to die. That is a guarantee. Remember that and live each day fully. Focus on what is important.

It is quite amazing that despite your condition, you are still actively involved in social work through the Foundation? Could you tell us a bit about its activities.

Actually, we are involved with various health and education projects. For example, we are trying to use technology, like very low-cost iPads, to help children learn in the classrooms. We are working with almost 50,000 kids in Bombay, Pune and Delhi. In health care, we are just going to start a programme in collaboration with Tata Memorial and Tata Trust where we will be helping train almost a 1000 doctors, nurses and technicians from the government medical colleges in Maharashtra, so that people don’t have to come to Tata for treatment. They can go to the local government medical colleges itself. Tata Memorial can be really crowded because everybody tends to come there thinking this is the best place. But there should centres like that all over the country, because this disease is more rampant than we had thought. So we are trying to help in that. There are various other projects we are assisting. The foundation is called Motivation for Excellence.

Could you give us a little background about yourself?

I used to run my own textile business for 25 years, manufacturing specialised fabrics for export; and then I sold it and retired. I focus now on actively working with a foundation that supports NGOs in education, women empowerment and health.

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