Some moments in life are priceless: a milestone birthday, a marriage proposal, the birth of a first grandchild. These are moments that Kim Belcastro thought she’d never live to see.
In March 2013, after weeks of struggling with back pain, Kim scheduled an appointment with a local doctor in her hometown of Nazareth, PA. She thought her back pain might somehow be tied to a kidney stone diagnosis that she’d received a few weeks prior. She wasn’t at all prepared for what happened next.
According to her doctor, Kim’s back pain was being caused by a fracture in her spine; she would need to undergo emergency surgery to repair it. During the surgery, there was yet another surprise; doctors spotted a mass on her spine. Surgical biopsies later revealed she had adenocarcinoma, an advanced form of lung cancer.
“I’ll never forget when I got the news,” she said. “I was shocked. My husband and I began preparing for the worst.
Kim was no stranger to the struggles of cancer. Her aunt, her grandmother and two of her uncles had died of cancer. But as a lifelong non-smoker, she was surprised to learn that she had lung cancer; let alone that it had already spread from her lung to her spine, adrenal gland, and lymph nodes.
According to the American Cancer Society, lung cancer in non-smokers is most often caused by second hand smoke or exposure to radon gas, carcinogens or pollution. In some cases, however, the cancer is caused by genetic mutations.
Adenocarcinoma is one of the most common type of lung cancers found in non-smokers. Like most cancers, it is deadliest when it metastasizes or spreads to other parts of the body.
Finding an oncologist she could trust
Kim knew she needed an expert in cancer treatment, but she initially opted to go to a local hospital because it was closer to her home. It only took one visit for her to know she’d gone to the wrong place.
The doctor at the local hospital told her it would take at least three weeks to get an appointment for a PET scan, a critical diagnostic procedure that would help determine which parts of her body the cancer had spread to. The doctor also told her she had less than 20 months to live.
“I didn’t like the way he said it; I didn’t like anything about it,” she said. “I knew I had more living to do.”
The next day, at the advice of a close friend, Kim called Penn Medicine. By the end of that week she had been paired with an experienced oncologist, Charu Aggarwal, MD, MPH, and received the PET scan that her local doctors would have waited weeks to schedule.
“With Dr. Aggarwal, it was such a pleasant experience. She told me that I was going to live much longer than that! I could tell she really cared about me,” Kim said.
The miracle of liquid biopsies
Dr. Aggarwal first needed to determine the cause of Kim’s cancer and the extent to which it had spread through her body; this would usually require a surgical biopsy.
To spare her from having to undergo another painful surgical biopsy, Dr. Aggarwal instead opted to use a liquid biopsy, a new diagnostic tool that helps doctors to better diagnose and assess cancer progression, and modify treatments so patients have fewer side effects.
This non-invasive method enables doctors to identify cancerous tumor cells or pieces of DNA from tumor cells that are circulating in the blood using only a small blood sample. Doctors can then recommend the most effective oral therapies for cancer depending on the genetic mutations present in the sample. Over time, multiple liquid biopsies enable doctors to identify mutations in the cancer and adjust treatments and medications to ensure the best possible outcome for the patient.
Kim would undergo four additional liquid biopsies that helped Dr. Aggarwal know when to adjust her cancer medications to keep her cancer at bay.
In between medication changes, Kim had undergone a round of chemotherapy and radiation, which took its toll on her physically. So, for five months, she opted to suspend chemotherapy treatment.
Then, in October 2016, the unexpected occurred yet again. A PET scan showed her existing tumors had grown and the cancer had spread further in her adrenal glands and her liver. Even more concerning, she now had eight tumors in her brain.
At this point, it was estimated that Kim had roughly six months to live.
Her family began preparing for the worst. Her son, who had recently gotten engaged, planned a speedy commitment ceremony in lieu of a later wedding date. And her daughter, who had been trying to conceive for some time, invested in fertility treatments with hopes of having Kim’s first grandchild before her health declined any further.
Unwilling to give up on her patient, Dr. Aggarwal performed another liquid biopsy. When the sample showed that Kim’s cancer cells had mutated again, Dr. Aggarwal adjusted her medication accordingly. The results were near miraculous.
“I have only one tumor in my head now, and I have no other detectable cancer in my body. It’s amazing,” she said.
Life today, two years later
This May, Kim turned 63 years old. She celebrated by spending the day at the spa with her sister, who she says has been very supportive throughout her entire cancer treatment journey.
She’s also getting back to many of the things she enjoys like participating in physical therapy and her cancer support group, and spending time with her girlfriends. More than anything, Kim says she’s grateful to be around for the important moments in her children’s lives. She hopes that by sharing her story, she will encourage others to seek the proper care before it’s too late.
“I truly believe in sharing my story with people. I think it’s important because I know people who have waited too long to go to the right place. If my friend hadn’t told me about Penn Medicine, I’m sure I wouldn’t be here today,” she said.
“My son has gotten engaged. My daughter had a baby, and I was able to hold the baby the day he was born. I know I wouldn’t be here to see my son get married, to see my first grandchild and to have this time with my husband if I hadn’t come to Penn Medicine.”
Kim looks forward to attending her son’s wedding in September.
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