Nonsmoker’s lung cancer gave him new perspective

Jim Morrison was rarely out of breath.

He was 50 and fit – a man who spent his weekdays at a physically demanding job and his weekends in the woods. But one winter morning, the Post Falls resident was winded and struggling to breathe as he shoveled the snow off his driveway. He had a day of duck hunting planned with his son and brother-in-law.

The men set up blinds and decoys in a marsh near Lake Coeur d’Alene, but they abandoned the hunt when Morrison wanted to return to the truck. He couldn’t shake the feeling of exhaustion.

A few days later, medical tests revealed the cause: A cancerous tumor had filled the top third of his left lung. Morrison was stunned.

“I had never smoked,” he said.

Lung cancer is a disease that predominantly affects smokers. About 90 percent of lung cancer deaths in men are linked to smoking, according to the American Lung Association. For women, the figure is 80 percent.

But diagnoses like Morrison’s are becoming more common. Each year, between 16,000 and 24,000 nonsmokers die of lung cancer. Researchers suspect that environmental causes, including air pollution, are behind the rising cancer rates in nonsmokers.

Nonsmokers face challenges with diagnoses. They’re less likely to be tested for lung cancer than smokers. As a result, most diagnoses don’t occur until patients have late-stage lung cancer, which reduces their chances of survival.

Nonsmokers often overlook their symptoms, attributing a nagging cough to allergies or a lingering cold. Their doctor might not catch the symptoms, either.

“They don’t fit the typical profile of a lung cancer patient,” said Dr. Daniel Flora, an oncologist in the Cincinnati area who tracks the rise of lung cancer in nonsmokers.

For other types of cancers, particularly breast and colon cancer, effective screening has increased early detection and improved patients’ survival rates, Flora said. However, there’s nothing comparable to a mammogram or colonoscopy for early detection of lung cancer.

That’s one reason lung cancer remains a killer for both smokers and nonsmokers. More than half of patients die within a year of learning they have the disease.

Morrison is one of the survivors. Against staggering odds, he’s been in remission for nine years.

He asked: Why me?

When Morrison got the initial diagnosis, he reached for his wife Sandi’s hand.

The news was grim. The cancer had metastasized, spreading from his left lung to the lining around his heart. He needed surgery to remove fluid around his heart, and chemotherapy to address the cancer in the pericardial sac around his heart. And he would lose part of a lung when the tumor was removed.

Even with treatment, Morrison would be lucky to last six months. The unfairness angered him.

After a life of hard work, he had built a successful heating and air conditioning company. He and Sandi had two nice kids and a house on 5 acres.

“I don’t deserve cancer,” Morrison recalled thinking. “I’ve always considered myself a pretty good guy, husband and dad. I never smoked. Why me?”

Some days, despair overwhelmed him. During chemotherapy, the only food he could keep down was gummy bears, which his wife bought in 8-pound sacks. But the Type A personality that had driven Morrison all his life also asserted itself.

“What are my chances of living five years?” he asked Dr. Haluk Tezcan, his former oncologist. The answer was 2 percent.

But Tezcan also offered Morrison a bit of hope. If he could live another 12 months, new drugs targeting non-small cell lung cancer would be available.

Morrison started setting goals. His daughter, Kym, had planned to get married in six months, but wanted to move up the date.

“Don’t change your plans,” Morrison told her. “I’ll walk you down the aisle and we’ll dance together at your wedding.”

He kept that promise and set a new goal. Next, Morrison wanted to be alive for the birth of his first grandchild.

“He was always positive. He set goals for himself throughout his treatment, realizing it may not work out,” Tezcan said. “And he had a strong network of family and friends to see him through the difficult times.”

Environmental exposure

For many nonsmokers, the source of their lung cancer remains a puzzling unknown. Both genetics and environment play a role, said Flora, the Cincinnati-area oncologist.

Two-pack-a-day smokers can escape lung cancer, he said. The 28-year-old woman who never smoked, but died of lung cancer, is an equal mystery.

Exposure to radon, an odorless gas produced by the decay of uranium in rocks and soil, is believed to be the leading cause of lung cancer after smoking, according to the American Lung Association. Studies of lung cancer clusters in nonsmokers also point to other environmental causes, such as air pollution or exposure to other chemicals, Flora said.

In Morrison’s case, pathologists discovered asbestos fibers in his tumor.

During the early 1980s, he was an apprentice in the heating and air conditioning trade. Property owners were switching out old steam heaters for natural gas furnaces, and Morrison’s job was to tear out old pipes wrapped in asbestos insulation. Some days, he couldn’t see through the clouds of white dust. Safety regulations to protect workers from asbestos wouldn’t emerge until later.

“I had environmental exposure, but I had bad luck, too,” Morrison said. He keeps in touch with two former co-workers. Neither has cancer.

When people learn about Morrison’s lung cancer, they often assume he was a smoker. He understands, because he’s made those judgments in the past. “The stigma is really bad,” he said. “There’s an assumption that you smoked, and it’s your own fault.”

Defying the odds

At 62, Morrison has survived a dozen years since his diagnosis. He’s been through two relapses and three years of chemotherapy, and he maxed out his first health insurance policy. During his treatments, he and Sandi cashed in two life insurance policies to keep up with bills.

But the struggles were worth the family milestones he lived to see, Morrison said. He survived to see his son graduate from college and get married. He and Sandi have four grandchildren. And there have been more duck hunting trips.

“Cancer has made me a better person,” he said. “It cut all the crap out of my life. I don’t have time to worry about petty things.”

In a self-published book, “To See Another Sunrise,” Morrison talks about having hope amid the realities of a cancer diagnosis. He runs two cancer support groups and frequently counsels people with cancer. He encourages them to adopt a fighting attitude.

“They’re going into cancer like it’s a broken leg. I tell them, ‘You are in for the battle of your life,’ ” he said.

Morrison’s survival is remarkable given his initial prognosis, Tezcan said. “Multiple things worked in his favor.”

Morrison credits his family and faith for his nine years of remission. He also benefited from new drug therapies developed for the type of lung cancer he had. The drugs target receptors in what are called “EGFR-positive” tumors, which helps keep the cancer stable, Tezcan said.

Morrison is working on a second book, in which he’ll devote a chapter to survivor’s guilt. It’s a real phenomenon for people like him. Though he beat the odds, Morrison attends at least one funeral per month for someone who died of cancer.

His other message: Be vigilant about lung cancer, a disease often overlooked in nonsmokers.

“If you’ve got a nagging cough you can’t get rid of, baby, go get a scan,” Morrison said.