Multidisciplinary approach helps young woman battle lung cancer

Jamie MillerFor 20-year-old Jamie Miller of Cedar Rapids, Iowa, the end of 2014 was filled with promise for the new year: She was a student at Kirkwood Community College, had just gotten a new job, and had recently moved into a new apartment. She was looking forward to the future.

Cancer wasn’t in her plans.

That changed after the first of the year. Jamie was always tired, and then she started getting sick. She coughed a lot and had headaches. Jamie also had difficulty sleeping through the night and eventually went to a local emergency room, where she was diagnosed with pneumonia. An X-ray also found something else: Jamie had a mass in her lung. A CT scan later showed two masses—one in the lower lobe of her right lung, specifically on the bronchial tube, and another on her liver.

The mass on the liver was benign, but the one on her bronchial tube was a carcinoid tumor.

“When they came in and told me I had a tumor, the first thing I thought was ‘cancer,’ and I started bawling,” Jamie says. “I was so scared, and there was something else—it was a very strong feeling, but I just can’t explain it. I was very, very scared, but then I told myself not to worry because you can’t change anything. I’m pretty religious, so I knew God would bring me through this.”

Jamie spent more than two weeks at a Cedar Rapids hospital in January 2015, where surgeons tried to remove part of her lung. Pneumonia kept them from completing the surgery, however, and Jamie was referred to University of Iowa Hospitals & Clinics, where she met Kalpaj Parekh, MBBS, director of general thoracic surgery.

Parekh says the tumor in Jamie’s lung had created a blockage that didn’t allow her to expel mucus, leading to a respiratory infection that later evolved into pneumonia. When the Cedar Rapids surgeon attempted the first surgery, the tumor proved to be too complicated, so he ended the surgery without removing the tumor, which ultimately led to Jamie’s referral to the UI.

Jamie’s first surgery at UI Hospitals & Clinics occurred in late March. Pulmonologists cored out the tumor endoscopically and cleaned the pus from the pneumonia. Jamie returned about five weeks later to have the remainder of the cancer removed by Parekh and his surgical team.

Jamie then spent part of her summer undergoing chemotherapy—not to get rid of any remaining cancer, but to prevent it from recurring, Parekh notes.

Jamie says she’s optimistic, but tries to remain realistic, too.

“This chemo is for fast-moving cancers, and this carcinoid tumor was a slow-growing cancer, so I don’t know if it will work,” Jamie says. “I’m willing to try.”

Parekh is confident about Jamie’s future and calls her prognosis “excellent.”

“In my opinion, she has had the best possible outcome,” he says. “The team at Iowa pulled everyone she needed together to get rid of this cancer—intensive care, pulmonology, oncology, anesthesiology, and surgery. It really highlights how we are geared to tackle the more complex cases through a multidisciplinary approach.”

Although she is well aware of the truth of her diagnosis, Jamie says reality hasn’t really hit her.

“It still just doesn’t seem real,” she says. “For me it’s just an ‘obstacle course’ part of life, something I’m just having to go through that not everyone has had to go through. I grew up with diabetes so I was kind of prepared for this. I was diagnosed with diabetes when I was 6 years old so I’m used to dealing with medical issues. I guess I haven’t let it hit me, because then I’d break down. I just want to get through it and then look back on it.”

— Molly Rossiter
Fall 2015