The year 2022 was a difficult one for Candice Ward, a mother of three and grandmother of two. She began the year mourning the tragic death of her 27-year-old son, who passed away after suffering a heart attack, and she ended it having an emergency bronchoscopy at City of Hope on Christmas Eve.
“I couldn’t breathe, so I went to the emergency room a few times. My last time there, the doctor told me it looked like I had a mass blocking my airway and that I should get it checked out,” Ward recalled.
Ward’s pulmonologist referred her to City of Hope. While performing her bronchoscopy, Waasil Kareem, M.D., an interventional pulmonologist and assistant clinical professor in the Division of Pulmonary and Critical Care Medicine, spotted a mass in the airway of the lower lobe of Ward’s left lung. “They removed a tumor the size of a grape,” she said.
Pathologist Fang Fan, M.D., Ph.D., determined the mass to be mucoepidermoid carcinoma, an uncommon form of lung cancer that can originate in the airways. The diagnosis was confirmed by Michelle Afkhami, M.D., a member of City of Hope’s molecular pathology team.
Dozens of Chronic Health Issues
This was not the first time Ward had received discouraging medical news. At just 45 years old, she has been diagnosed with a large number of chronic health issues — 19 in all — that have impacted her quality of life.
Ward detailed her ailments: “Fibromyalgia, neuropathy, two slipped discs in my back, arthritis, asthma, a hiatal hernia and pulmonary embolisms. I’ve had COVID three times and pneumonia two times. I used to need an oxygen tank 24 hours a day.”
In addition to these conditions, Ward was diagnosed with two different types of cancer prior to receiving her lung cancer diagnosis.
In 2012, she discovered that she had uterine cancer while receiving treatment for fibroids. After undergoing a partial hysterectomy, she was declared cancer free. Then, in 2017, she was diagnosed with breast cancer and given 18 months to live. Unwilling to accept this dire diagnosis, Ward came to City of Hope for a second opinion. She underwent surgery with Veronica Jones, M.D., assistant professor in the Division of Breast Surgery, followed by chemotherapy and radiation. Her treatment was successful, and she beat cancer for the second time.
Now, Ward was facing her third cancer diagnosis in 10 years. The good news was that the tumor was Stage 1, meaning that surgery alone could be curative. Medical oncologist Victoria Villaflor, M.D., section chief of Head and Neck Medical Oncology, referred Ward to Dan Raz, M.D., M.A.S., co-director of the Lung Cancer and Thoracic Oncology Program, for surgery.
Although Ward was nervous, Raz made her feel confident that the procedure would be successful.
“Dr. Raz is awesome. He’s so down to earth, and he breaks everything down to you in a way you can easily understand. He’s really knowledgeable about what he does, and I love his confidence. I know he wouldn’t steer me in the wrong direction,” Ward said.
Raz, in turn, says of his patient: “We formed a connection the first time we met. I wanted to make sure that she got the best possible treatment, and we worked together and with her other City of Hope physicians to make sure that happened.”
Finding the Best Option
Before proceeding to surgery, Raz considered Ward’s existing ailments. Noting that Ward was on oxygen and in a wheelchair at her first appointment, Raz said “she was initially referred for radiation therapy instead of surgery because there was concern that she would not be able to handle surgery because of her breathing issues.” (Her issues were due to recent blood clots in her lungs, severe pneumonia from COVID and the tumor that had been blocking part of her left lung.)
Raz thought surgery would be a better option. “When I assessed Ms. Ward, I wanted to give her the best opportunity for a cure with surgery,” he said. “It turned out that she no longer needed oxygen, and we got her started on a walking program.” Raz assessed her lung function after these interventions and decided that it was adequate for Ward to be able to withstand surgery. As an additional precaution, Raz had the interventional radiology team place what's called an IVC filter prior to surgery to prevent further blood clots to the lung, which can be fatal. The filter was removed a few weeks after surgery.
“The tumor was in the airway of the left lower lobe, close to where the left upper and lower lobe airways branch,” Raz explained. “This is treated with surgery to remove the left lower lobe of the lung” to make sure the cancer is completely removed. Raz called Ward’s procedure “pretty straightforward” and said he was able to achieve negative margins. He now considers Ward’s prognosis “excellent. Her chance of a cure with the surgery she had is high.”
A Smooth Recovery
“I was pretty out of it for about a week after the surgery, but now I feel so much better. I can breathe better, and I’m doing physical therapy to help with my recovery,” Ward said.
Between her bout with breast cancer and her lung cancer treatment, Ward has spent a lot of time at City of Hope over the last several years, and her experience has been overwhelmingly positive.
“Everyone at City of Hope is great. I’m not the type of patient that just takes what the doctor says and does it. I have a lot of questions and discussions with my doctors about my care, and I have personal relationships with them,” she said.
“I’m more than just my chart there. I can call and talk to my doctors any time. They make the time for me. That’s very much appreciated for someone like me.”
Raz is a fan of Ward as well. “She has overcome so many obstacles in life, both personally and health-wise, at such a young age — having had breast cancer, blood clots to the lung and now this rare form of lung cancer,” he said. “Yet she has faced these challenges with a positive attitude and a great sense of humor. I am very optimistic that her cancer has been cured with the surgery, and I am so happy about that.”
Staying Upbeat
Between the unexpected death of her son and her various health struggles, Ward has every reason to be angry with the hand life has dealt her. Instead, she has managed to remain positive, choosing to live in the moment instead of dwelling on her past or what might happen in the future.
“I have not stopped doing anything I used to do before my cancer. If I decide I want to go to a party, a Sunday dinner, a concert or even a comedy club, depending on how I feel, I’m going to go. If I feel like I need to be in my walker today, I’m going to be in my walker today. But I’m still going. That’s how I live my day-to-day life,” she said.
“When you’re sick, there are times where you’ll get sad, you’ll get depressed, you’ll be mopey, but you have to deal with those things as they come and continue to live your life. If you don’t, it will drag you under.”
Now enjoying time with her family and helping to raise her grandchildren, Ward is committed to living life to the fullest, no matter what obstacles she faces along the way.
“I’m interested in quality of life, not quantity. If I live each day to the best of my ability, I’m good with that,” she said.
“I’m doing the things I want to do today.”