As a federal probation officer, Ryan Fox brings empathy to her role working with prisoners and their families. Knowing there is often more to a case than meets the eye, she partners with lawyers, judges, and others in the court system to give inmates a fresh start and an opportunity to tell their stories.
She’s also living with stage IV lung cancer. But that’s not stopping her from enjoying her own lease on life, thanks to improvements in lung cancer treatment.
“Sure, I’ve got cancer — but I’m not going to let it stop me,” she says.
In Fox’s case, there is a lot to keep going. With master’s degrees in social work and criminal justice, she has held jobs in both hospitals and prisons. Having been on active treatment since shortly after her November 2017 diagnosis, she has never stopped working full time, fitting radiation and other treatments at Dana-Farber around her court schedule.
Fox and her wife, Colleen, have two children — 6-year-old Emmett and 4-year-old Sylvie — and a large network of extended family and friends. Whatever free time remains, Fox largely devotes to exercise and staying active. A six-time marathoner and two-time ultra-marathoner, she recently took up bicycling.
“Given my diagnosis, I’ve learned to be more focused on the present,” says Fox. “I want to stay healthy enough to enjoy the activities I love and continue to watch my kids grow up.”
In addition to her grit, a changing lung cancer landscape is making both of Fox’s goals possible. She and other patients are benefitting from research advances at Dana-Farber and elsewhere that allow physician-scientists like her oncologist Pasi Jänne, MD, PhD, to better understand and target the genetic alterations leading to lung cancer.
“There have been a lot of amazing changes in lung cancer therapy in the last decade, in part due to our increased scientific understanding of the disease,” says Jänne, director of the Lowe Center for Thoracic Oncology at Dana-Farber. “This is no longer seen as one disease. By doing a genetic profile of each patient’s cancer, we can tailor targeted therapy to best match that individual. Science drives the way to better treatment.”
These developments came into play for Fox after her November 2017 diagnosis. For several months before that, she had been experiencing intermittent discomfort in her groin, hip, and lower back, making running painful and difficult. An orthopedist could not determine the cause, so Fox’s primary care physician sent her for an MRI that revealed a large mass on her hip. A biopsy confirmed it was stage IV non-small cell adenocarcinoma, lung cancer that had advanced to other parts of Fox’s body.
Fox, who only smoked briefly in college and was in excellent health, was shocked but not done in by the diagnosis. She was referred to Jänne at Dana-Farber, who determined that her cancer was caused by a genetic mutation known as EGFR. He was leading a phase 1 clinical trial in which patients with the EGFR mutation took two oral EGFR inhibitors daily, for which Fox qualified.
“Here it is, two years later, and I’m still kicking,” says Fox with a laugh. “I feel so fortunate to have access to targeted, cutting-edge treatment, and be part of a trial with such minimal side effects. When I started losing a little of my hair, I just cut it short.”
New challenges, same focus
Not everything has been as easy as a haircut, Fox admits. Although a combination of the oral medication and radiation treatments initially shrunk the cancer in her hip significantly, it began growing again — requiring additional radiation in summer 2019. Fox remains on the trial, and under Jänne’s care.
She has also become committed to her latest endeavor. When lingering hip pain forced Fox to stop her road racing, her sister-in-law Nicky suggested she try bicycling — and, more specifically, the Pan-Mass Challenge (PMC) bike-a-thon benefitting research and patient care at Dana-Farber.
In both 2018 and 2019, Fox rode 168 miles over two days in the PMC. She experienced the joy of her kids high-fiving her as she rode in to the finish line, and proudly wore her “Living Proof” cycling jersey denoting her status as a survivor.
“For someone who always liked having a race to look forward to, and train for, the PMC was wonderful,” says Fox. “Before I rode it the first time, I had not told a lot of people about my cancer. This gave me a chance to be open — and send a message that you can be strong even with a stage IV diagnosis.”