newly diagnosed lung cancer

Lung cancer treatments today are worlds apart from those available in your mom’s or grandfather’s time. In the last 20 years, more progress has been made in lung cancer treatment than in all of modern medicine before. That’s no exaggeration. If I had been diagnosed just 20 years ago, I likely wouldn’t have survived. Hospice would have been a more common path than effective treatment. Yet here I am, in full remission, four and a half years on.

While you’re still unsure if it is cancer, radon-induced lung cancer often presents with a high tumor mutational burden (TMB), which can make it more susceptible to immunotherapy. Treatments like immunotherapy weren’t an option in your mom’s or grandparents’ time but are now game-changers. When you've learned more I'll be here to help answer questions or share more about what I’ve learned.

While absolutely everything points to malignancy, without putting the tissue under a microscope, they can't definitively say it's cancer. I don't care if you're the chief thoracic surgeon at MD Anderson.

Being in the boondocks may mean getting results back for genetic profiling takes longer, but it shouldn't take more than 4 to 6 weeks tops.

While it's not possible to confirm radon exposure as the cause, many cancers suspected of being linked to radon display high tumor mutation burdens (TMB). This makes immunotherapy a potentially good treatment option. Additionally, mutations in EGFR and KRAS G12C are often seen in these cases, both of which have targeted treatments available.

Given your family history and the fact that you're a never-smoker, this likely points to a combination of environmental and genetic factors. Living in Maine—where radon exposure is a known risk—further supports the case for environmental contributions.

They don’t normally run tests that specifically point to radon exposure because it wouldn’t change the course of treatment. These tests are specialized and expensive. However, research facilities near you may offer access. On the other hand, mutations in TP53 or BRCA2 are routinely tested for, as these inherited mutations can increase susceptibility to cancer, even though they don’t directly cause it. Hopefully, these tests will be part of your genetic workup.

I recommend testing your home for radon and monitoring levels over time. It's equally, if not more, important to test your daughter's home. Radon detectors are relatively inexpensive for what they do, and if high levels are found, the houses can undergo radon mitigation. Here's a link to a guide on radon detectors:

https://radon.org/uncovering-the-best-digital-radon-detector-a-comprehensive-review/

Genetic testing for cancer susceptibility is also available. With your family history, it may be possible for your daughter to have insurance cover this cost. If your cancer is found to have mutations in TP53 or BRCA2, this would provide further evidence to support insurance coverage for her testing.