The first time a Pan-Mass Challenge (PMC) cyclist rode in her honor, a weakened Susan Cardinal sent them a good-luck text as she prepared for surgery. Just one year later, this Dana-Farber patient plans to be waiting excitedly at the Provincetown finish when the PMC team riding for her finishes its two-day journey on Aug. 6.
For Cardinal, a stage IV lung cancer patient treated in Dana-Farber’s Lowe Center for Thoracic Oncology, the 38th annual PMC will be memorable on a few different levels. Team Siena was formed this winter at Siena Construction, where her husband, Art, and brother-in-law, Mark Fitzgerald, both work. Including Fitzgerald, the team is comprised of six Siena employees and Joe Howard, MD, a physician at the Child Health Associates practice where Cardinal works as a pediatric social worker. It was Howard who rode for Cardinal last year.
“The quality of life from where I was a year ago is just incredible; back then, I wasn’t even aware that the PMC was happening,” says Cardinal. “Now I tell my family that while it may be their mission to do as much for me as possible, my mission is to be as independent as possible.”
Cardinal knows that signs of independence, such as returning part time to her job, driving, and spending time with young sons Frankie (10) and Jack (5), count on fundraising support generated by the PMC. In 2016 the event raised $47 million for research and patient care at Dana-Farber, bringing its cumulative total since 1980 to more than $547 million.
At one point, Cardinal didn’t know for certain she would even make it to this summer. When she was diagnosed with small cell lung cancer in July 2016, the cancer had also spread to her liver. Already the recipient of a kidney donation (from her father) in 1999, she had surgery in August and then six rounds of chemotherapy.
Dana-Farber researchers have discovered that a small number of people are born with a DNA mutation in the EGFR gene called T790M, which has been identified in some families suffering from lung cancer. Such individuals can develop a resistance to some standard lung cancer care, and when Cardinal’s tumor underwent genetic testing as part of the Dana-Farber Profile Project, it was discovered that she had an EGFR mutation. This was a surprise, her oncologist Geoffrey Oxnard, MD, explains, because the mutation is usually seen in patients with a different type of lung cancer, adenocarcinoma. Cardinal started treatment with an EGFR inhibitor drug, and she has had what Oxnard calls a “tremendous” response.
“Cases like Susan’s teach us that there may be a blurry line between small cell lung cancers, seen usually in smokers, and lung adenocarcinomas, usually seen in non-smokers,” says Oxnard, an expert in treating EGFR patients. “From Susan we can learn the importance of perseverance and the potential value of genomic testing as a way of creating treatment options when choices seem limited.”
Fitzgerald, who is married to Cardinal’s sister, Julie, will be riding in his first PMC this year. As he traverses the Sturbridge-to-Provincetown route alongside Howard, he will be thinking of Susan as well as his mother and brother – both of whom died of lung cancer.
“When Siena CEO Terry Hayes formed a team to honor Susan this winter, I signed up right away,” says Fitzgerald. “I’m encouraged by how much things have changed in terms of treatment options since my brother died at age 30, and I’m sure that has a lot to do with the PMC. I want to do anything I can to help make a difference – for Susan and every patient.”
This will be the goal of more than 6,200 cyclists when the PMC gets under way on Aug. 5, and Team Siena has added special touches to its colorful PMC shirts for further inspiration: logos for Siena Construction and Child Health Associates, Susan’s initials, and several cardinals in flight for help up difficult hills.
The biggest motivator, however, will be what’s waiting at the end: their families and friends, including young Frankie and Jack Cardinal.
“I want to keep plugging away at this, as much as I can,” Susan says. “Spending time with the boys is the best thing, and it doesn’t get better than this.”
Learn more about how we treat lung cancer at Dana-Farber.