Celebrating the ‘little victories’: Lung cancer survivor looks back over a year of ups and downs

If there has ever been a textbook lung cancer patient, it was not Denise Swick. From a supposedly slow-growing cancer that in actuality grew quickly to complications that required specialists across MUSC, Swick’s 2024 was challenging, to say the least, as she navigated non-small cell lung cancer treatment. That made it all the more important to celebrate the small victories as they came, said her daughter and caregiver, Sarah Martin.

"We had a rough start, and we hit a lot of speed bumps. But at the end of the day, I just had to keep telling her that these little victories matter. The little victories have to be celebrated."

Sarah Martin
daughter and caregiver

“We had a rough start, and we hit a lot of speed bumps. But at the end of the day, I just had to keep telling her that these little victories matter. The little victories have to be celebrated. Because if we didn't celebrate those, this was going to be one hell of a long, difficult year,” Martin said.

Swick’s long year started in May when she had a general flu-ish feeling.

"I was taking Tylenol and Motrin like they were candy. Finally went to urgent care, and I said, ‘Look, I can't tell you what's wrong with me, but I know something's wrong,’” she said.

She was given antibiotics for a potential sinus infection and began to feel better – until she finished the prescription and immediately began to feel flu-ish again. A painful mouth led her to the dentist, who found an infection. An oral surgeon removed an infected and cracked tooth and started her on antibiotics. Once again, she felt better – until she finished the antibiotics.

“Finally, I went to my family doctor. I had developed a little bit of a cough by then, so he sent me for a chest X-ray – and that’s when they found the mass,” she said.

Assembling a first-rate team of lung specialists

Swick was diagnosed with lung adenocarcinoma, the most common form of lung cancer. She began interviewing doctors at different hospitals to see where she felt most comfortable and was quickly impressed with Mariam Alexander, M.D., Ph.D., and Eleanor Hardy, PA, at MUSC Hollings Cancer Center.

 

“Dr. Alexander – she was just ready to get stuff done,” Swick said. “I hadn’t even said I was staying (with MUSC) yet, but she was already like, ‘Let’s get this.’ I really liked that.

“Dr. Alexander and Eleanor – oh my God, they're fabulous. Eleanor was constantly checking up on me, even during her honeymoon.”

Still, it was scary to hear her diagnosis, particularly because the tumor was growing rapidly. At her initial biopsy, the cancer was estimated as stage 2, but by the time she began treatment, it had been definitively identified as stage 3B. Doctors use staging to classify how large a tumor is or how much the cancer has spread, and a stage 3 cancer has grown larger or spread more than a stage 2 cancer.

Furthermore, because it was wrapped around a pulmonary artery, she couldn’t have surgery. And, as if that weren’t enough, her initial appointment with radiation oncologist Brian Lally, M.D., was sidelined by a serious side effect called superior vena cava syndrome, or SVCS. In SVCS, the tumor presses against the vein carrying blood from the upper body back to the heart, partly blocking the flow and leading to pressure building up in the face and upper body.

“My face was swollen. My arms were all swollen. It was really bad,” Swick said.

Vascular and interventional radiologist Stephen Stringfellow, M.D., inserted a stent to get the blood flowing again.

“Once they put the stent in, I felt like a new person,” Swick said.

 

She met Lally while in her hospital bed after the procedure. He immediately put the family at ease with his confidence – and a bit of teasing.

“Lally shoots it straight. I'll never forget the day he came into my hospital room. It's so great because I was supposed to see him to get mapped (for treatment), and I couldn't make it. So he wound up coming to my hospital room with his nurse, Aubrey,” she said.

Daughter Sarah Martin, who was there with her sister, picked up the story.

“He started with, ‘Who’s the favorite daughter?’ And we both shot our hands up,” Martin said. “I'm actually in her phone as ‘Favorite Daughter.’ I did that years ago. And then he says, ‘OK, so who's in charge?’ And we both put our hands up. And I said, ‘Put your hand down. I live with her. I'm the caregiver.’ And so he wound up giving us both his personal cell phone number and said if y'all have any questions to call him.”

He meant it, too.

Swick had to be hospitalized several times over the course of treatment, and Martin learned that Lally really did want to know.

“I actually called him when she was in the hospital because the time before that, I had only told Aubrey, his nurse, and I got an earful about it,” she said. “The next appointment, he goes, ‘You don't call me? You call my nurse?’ So the following week, when she went to the hospital, I called him on the weekend, and I said, ‘Sorry to bother you – just wanted to let you know, mom's headed back to the hospital.’ He wound up calling me after she was tested in the hospital to give me the results of her scans because at the hospital, they have lots of patients, people to round on, and he was just trying to ease my fears.”

Words of hope

Looking back, Swick and Martin realize that the doctors were quite encouraging from the outset. Swick had smoked when she was younger – she classified herself as a moderate smoker – but she had stopped smoking almost 15 years ago and revised her lifestyle.

“I was exercising. I was running. I was eating clean. I've been doing that for the last 10-plus years,” she said.

Cancer treatment can be physically taxing, so going into it strong and healthy is a big advantage.

"I love to run. It's a peaceful thing for me – get out there, and it's just me and the road. I love to just listen to the trees or my music or a book and just run."

Denise Swick
lung cancer survivor

“The doctors did tell her that with her lifestyle, the way that she had been living the last 10 years, that going into it, she had a good chance. They were very positive and hopeful,” Martin said. “Thinking back on it now, we ignored a lot of that at the beginning, mainly because we were just so shocked. She was a full health nut for the last 10 years, so it was a big shock, and at the beginning, we didn't exactly hang on to all those positive, nice things that they were saying – but looking back now, they weren't wrong.”

As Swick regains her strength, she hopes to get back to running in the new year.

“When I was in the military, I used to hate running,” she said. Now, it’s a different story. “I love to run. It's a peaceful thing for me – get out there, and it's just me and the road. I love to just listen to the trees or my music or a book and just run.”

But getting to this point has been filled with setbacks. She was sent home the day of what should have been her first chemo treatment because insurance hadn’t approved it. She had to have a temporary bronchial stent inserted to keep her airways open after suffering a collapsed lung – and the stent insertion itself had to be delayed because a sudden irregular heartbeat meant she couldn’t be put under general anesthesia.

Lung Cancer Screening

Lung cancer screening is encouraged for high-risk groups to find cancer at an early stage, when it is more easily treatable. Talk to your doctor about lung cancer screening if you:

• Are age 50 - 80 and;
• Have a 20-pack year history of smoking and;
• Smoke or quit smoking within the last 15 years.

The bronchial stent – although it kept her airway open – was irritating to her body, and she endured a hacking cough from August until November, when it could be removed.

And then, just as her chemo and radiation treatment came to an end, she developed a serious case of pneumonia and had to be hospitalized, where she then contracted methicillin-resistant Staphylococcus aureus, or MRSA.

“She got so sick, so fast,” Martin said.

“I was in the hospital for another week,” Swick said. “I lost some weight during chemo and radiation, but I lost a whole lot during the pneumonia and then recovery – I've lost over 50 pounds.”

Once Swick was released to go home, Martin enforced a strict quarantine to allow her mother’s immune system to grow stronger before receiving visitors.

“It wasn't an easy decision. It was hard on all of us,” Martin said. “Because for someone who thrives around people and family, keeping her isolated from them was difficult enough. But keeping her isolated while she was still so sick, when she really could have used that positive reinforcement, that mood lifter – that was a long month. I swear, the day my sister got to come over, she reached over that chair and hung on to my mom for a good five-minute hug.”

With her chemo and radiation complete, Swick is now on an immunotherapy regimen. Immunotherapies are treatments that help the body’s own immune system to respond better to cancer, and studies have shown that lung cancer patients who receive immunotherapy after chemotherapy and radiation do better.

Multidisciplinary care

One of the hallmarks of care at Hollings is its multidisciplinary approach. At weekly tumor boards, lung specialists from surgical oncology, radiation oncology, medical oncology, precision medicine and more get together to discuss cases.

But the collaborations aren’t limited to predetermined times. Doctors and providers in the cancer center – and across MUSC, when patients need specialty care from other divisions – check in with each other all the time, and they work together across multiple locations. Lally recalled speaking with Hardy on the weekend about Swick’s case.

“We worked as a team throughout, nurses and providers across the disciplines,” he said.

Interventional pulmonologist Travis Ferguson, M.D., was instrumental in, first, placing the bronchial stent so that Swick could continue radiation treatments and, later, in caring for Swick when she was admitted to the hospital with pneumonia.

Swick adored Ferguson. “He’s the cat’s meow,” she said. But, she added, “I connected with all of my physicians.”

“With every single one of them, I had a unique connection because they care. They listen. They don't rush you in and out. They'll shoot it to me straight, every single one of them. They’ll tell you, ‘No, you can’t do that,’ or ‘You’re just going to have to wait and be patient.’”

She had that connection with nurses, too, especially Hope Holbrook, who cared for Swick when she was admitted with SVCS. She even came to check on her when Swick was admitted another time, even though Holbrook wasn’t assigned to her.

“She is an angel,” Martin said.

“I truly believe God was holding my hand through this whole process, and that he's not done with me yet. So my faith stayed strong."

Denise Swick
lung cancer survivor

And care at Hollings goes beyond treating the main diagnosis. Physical and occupational therapists, psychologists and social workers are also on call.

Swick especially benefited from the palliative care team. Palliative care – not to be confused with hospice care – is focused on improving quality of life and providing symptom relief for people with serious illnesses, including cancer.

Swick credited palliative care nurse practitioner Lauren Neese with helping to monitor and relieve side effects from her many medications – and especially for helping to wean her off the strongest pain relief.

“The best thing they did was help me get off that fentanyl patch,” Swick said.

“I think my favorite question that palliative care asked every week was, whenever the chaplain could get on the video call, she would ask, ‘How can we pray for you this week? What do we need to pray for this week?’” Martin added. “And that was the world of difference, especially for her.”

Indeed, Swick said her strong faith helped her to get through this past year.

“I truly believe God was holding my hand through this whole process, and that he's not done with me yet,” she said. “So my faith stayed strong. There were some times where it was a little wonky because, you know, you're feeling bad. You're like, ‘What now?’ But my faith is still strong. I believe that he's not done with me yet.

“My story is meant to be told for a reason.”

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