This is the fourth story in a series that marks the 20th anniversary of the publication of papers on the role of EGFR mutation in lung cancer. This multimedia series is guest-edited by Suresh S. Ramalingam, a lung cancer expert, executive director of Winship Cancer Institute of Emory University, and editor-in-chief of the journal Cancer. The series explores the process of discovery of EGFR mutations in lung cancer, the learning curve for using the drugs that target those mutations, and the unparalleled impact on patients with lung cancer and other diseases.

Christy Erickson was seven years old when her mom lost a three-year battle with breast cancer.

“Most of my memories of her are of her being in some form of treatment,” said Erickson, who is currently a stay-at-home mom of two teenagers in Macon, Georgia.

Erickson standing on the sidewalk wearing pink pants and a denim jacket
Christy Erickson

Erickson grew up knowing that she might face the same fate as her mom. Breast cancer had a stronghold on Erickson’s family tree, so discussions of mastectomies and BRCA testing were common in her childhood home.

In 2000, when Erickson was 25, she visited a breast specialist to discuss her potential risk for breast cancer. She feared that she would put her soon-to-be husband and future children through the same difficulties that she had experienced with her mom. Although Erickson had tested negative for BRCA mutations, the specialist recommended that she receive a baseline mammogram that day.

During the appointment, an ultrasound uncovered a pea-sized lump in one of her breasts.

“That was just like a ding for me, because when my mom found hers, she had a pea-sized tumor, and 10 of 12 lymph nodes were already malignant,” Erickson said to Deborah Doroshow, associate professor of medicine, hematology, and medical oncology at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai.

Doroshow, who is also a historian of medicine, is a member of the editorial board of the Cancer History Project. Doroshow’s conversation with Erickson is available on the Cancer History Project podcast.

Although Erickson’s lump was deemed benign, she elected to have a mastectomy the following year as a preventative measure.

“Between prayer and having the surgery, I felt like I did whatever I could do,” she said. “There was this sense of, ‘Okay, I don’t smoke. I’m not in any other risk factors that I know of. I should be fine.’”

Just a few years later, however, in 2006, a scan from an unrelated procedure revealed spots in her lungs. Erickson had given birth to her first child only a year before.

Erickson stands with her daughter Evelyn, who's wearing a graduation gown.
Erickson with her daughter Evelyn at her high school graduation.

She received a biopsy at a local hospital in Macon. Health professionals there thought Erickson likely had lung cancer. So many tumors dotted her CT scan images that the hospital workers estimated she only had a few months to live.

But biopsy results from Mayo Clinic in Arizona came back negative for cancer. Erickson was told to simply have regular screenings and keep an eye on her health.

“It was hard and strange at the same time, because I didn’t have a single doctor directing what was going on,” she said.

A local internist provided Erickson some medical direction, but she was not given a concrete plan for which doctors to see and how often to get screenings. “It was just like, ‘Oh, if you ever need us, we’re here,’” Erickson recalled.

A decade later, in 2016, Erickson visited another local physician for gastrointestinal issues, who prompted her to seek help managing her lung issues. She reached back out to Mayo Clinic.

Erickson connected with the same pathologists who worked on her case in 2006, and eventually traveled to Arizona to meet with a thoracic surgeon. Erickson later returned for biopsies in both lungs.

Some of her tumors turned out to be malignant.

Erickson assumed that she would find an oncologist at Mayo Clinic and regularly fly across the country for treatment. But a physician there suggested that Erickson meet with an oncologist much closer to home—Suresh Ramalingam at Winship Cancer Institute of Emory University.

Right before Erickson’s first appointment with him that fall, her genetic testing results came back and revealed that Ramalingam was not merely conveniently located.

“It turned out that I had the EGFR and the T790M mutation,” Erickson said. “And he’s like the person. He would be the most appropriate oncologist, really anywhere, for me to see, and we had no idea until I was actually in his office.”

Erickson began a treatment regimen with osimertinib (Tagrisso), which Ramalingam has been studying in the phase III LAURA trial (The Cancer Letter, June 7, 2024).

“It’s been so helpful that I can always find out what’s going on in the world of EGFR lung cancer. He can tell me from an expert’s point of view. He’s in the thick of all of this research,” Erickson said. “It just gave me a lot of trust and a lot of hope, and also just a sense of knowing that I’m in the right place.”

Still, receiving a lung cancer diagnosis after dedicating years to prevention measures pushed Erickson down an emotional spiral.

“It was kind of a crisis of faith, and a crisis of, ‘What am I going to do, and what’s going to happen to my children?’” Erickson said. She described the feeling as a scene in an old-time cartoon.

“I walked around, waiting for the piano to smash me into the ground because I just thought, ‘I can’t get away from it. I’ve done everything that I can do, and I can’t get away from it,’” Erickson said.

But her condition remained stable with osimertinib. Her tumors did not shrink, but they also did not grow. Erickson has now been taking the medication for eight years.

“There was sort of a point in that [first] year to year and a half that, I think, in my mind, I went to, ‘Okay, well, I’m still here. If I’m not dying, I better go live,’” Erickson said.

That attitude shift pushed her to think about her lifelong dreams.

“I’ve embraced this sense of if there’s something that I want to go do, or I want to try, who cares if it sounds crazy, or ridiculous, or out of my league?” Erickson said.

Erickson sitting on her motorcycle holding her helmet in one hand and the other hand in a rock 'n roll gesture: Index finger up, middle fingers down, pinky up, thumb in.
Erickson on her Harley-Davidson motorcycle.

She started by persuading her husband to let her get a Harley-Davidson motorcycle.

He would surely be against the dangerous pastime since they had two children, she thought. “So, I sat and wrote an essay about why I wanted to ride,” Erickson said. “We were sitting down one night, and I just handed him the papers, and I said, ‘I need you to read this.’”

Realization hit him as he began to scan the papers. “After reading the whole thing, he looked up and said, ‘Are you going to play the cancer card to get a motorcycle?’” Erickson recalled.

“If it works, I am,” she responded. And it did.

“I remember the first appointment with Dr. Ramalingam after I had gotten the motorcycle, and he just howled laughing,” Erickson said. “But he was proud of me. I could tell that he was proud that I was taking my life and enjoying it.”

Erickson has recently picked up another extreme hobby: strongman competitions.

During a vacation in Hilton Head, South Carolina in spring 2023, she found a local gym advertising the sport. Erickson had recently begun working with a trainer in her hometown, but knew an exercise-free week would make her rusty.

So, she went to the Hilton Head gym and met with a trainer, who asked about her medical history. Erickson began to explain her health situation.

“He just kind of froze. It turned out the more we talked, he also had a very unusual form of cancer and had gotten into strongman as a way of defying the sense of ‘It’s over, and I don’t know what I’m going to do, and I’m afraid,” Erickson said.

Erickson pulls on a thick rope attached to a UPS truck not in frame. Another UPS truck is behind her.
Erickson pulled a UPS truck as the final event in her first strongman competition in Oct. 2023.

“It was one of those opportunities where it felt like—almost like with Dr. Ramalingam—that this is the right person,” she said.

Erickson continued her strongman training when she returned home, with the intent of exercising that way for fun. But one month later, she asked her coach, “Could I compete and not embarrass myself?”

“Hell, yeah!” he responded.

That was all the encouragement she needed.

Last October, Erickson competed as a novice in her first strongman competition. She found freedom in being viewed as a regular, cancer-free competitor. But she also acknowledged the importance of showing others what is possible as a cancer survivor.

Throughout the process, Erickson has become more open about living with cancer.

“Maybe it’s helpful to see a cancer patient—stage 4 lung cancer—pulling a UPS truck,” Erickson said, reflecting on the competition’s final event. “I think there’s value in other patients seeing patients further along than them continuing to thrive.”

A note from Ramalingam:

I have seen Christy not only benefit from EGFR TKI therapy, but also go on to pursue her passions in life in addition to caring for her young family. We have exchanged notes on parenting since my children are around the same age as hers.

The incredible ability of targeted therapies to improve lives of patients such as Christy is a major step forward in our fight against cancer and provide hope for an even better future.

This conversation is available as a podcast, above.

Transcript

Deborah Doroshow: Hi, Christy. Thank you for joining us. You’re joining us from the Atlanta area?

Christy Erickson: Yes, from Macon, Georgia.

Today, we’re just going to have a conversation about some of your experiences. And I’m wondering if we can start off with just hearing a little bit about you and who you are.

CE: So, I would say, I am a mom of two. And that was a big deal in all of the experiences that I’ve had with cancer. I’m married. We will be married for 24 years this fall. And I have worked as an admin assistant for a university president, legal secretary, and my latest job has just been stay-at-home mom/cancer fighter.

How old are your kids?

CE: My oldest is 18 and youngest is 15.

Raising two teenagers is certainly a full-time job.

CE: Definitely.

And what do you do for fun?

CE: So, two things that I’ve started, actually, since my cancer diagnosis. One is riding a Harley-Davidson motorcycle, which is something that I’ve wanted to do my whole life.

My husband and I talked about it, and we had decided that I wouldn’t do that while the children were young, just because of the dangerous nature of that. And as we get into talking about my diagnosis, and how that happened, when I was diagnosed and started treatment, I kind of initially had a very difficult time with it mentally.

And then sort of hit this point where I thought, “Well, I’m still here and I’m relatively healthy. You know, if I’m not dying, I want to go live.”

So, I got a Harley, started riding that. And then most recently, I have started training and competing as a novice in strongman competitions.

So, it has been one of those things where I’ve kind of embraced this sense of if there’s something that I want to go do, or I want to try, who cares if it sounds crazy, or ridiculous, or out of my league? Go; go do it.

I also like to quilt, I like to sew.

Is that one of your quilts behind you?

CE: This is actually one that an aunt gave me when I graduated high school.

But I do love to make quilts. I like the idea of being able to make something that somebody will wrap up in and, you know, once you’ve made it, it’s always there. So, I have really strange interests from one extreme.

They’re just varied.

Well, I know that you had sort of a roundabout, meandering, interesting introduction into thinking about cancer, and I’d love to hear about that.

CE: Yeah, so, I would say, cancer first affected me and my family when I was seven years old. My mom died of breast cancer. And she had, what, to me, seemed like kind of a long journey with that.

She was diagnosed when I was four, and died when I was seven. So, most of my memories of her are of her being in some form of treatment or up and down from that.

And we had a strong breast cancer history in my family. So, that was always something growing up, but I knew we’d have to keep track of it, I knew that there was a possibility that I would have a prophylactic mastectomy. These kinds of things were taught to me and discussed. By the time I was probably 12 and 13 years old, I knew that this would be a possibility.

And as I got a little older, BRCA testing came onto the scene.

And so, about the time that that was starting to be more available, I got engaged to marry my husband, and, of course, we wanted children.

And I became very motivated to find out what I could do, what was my risk. Because I didn’t want to marry and have children and have that potential to put them through the same thing that I had seen as a child.

And so, we met with a geneticist at Emory and she was amazing. We sat down—my dad had made basically a family tree chart of the women in the family that had had breast cancer and then some of the other cancers that we thought were kind of secondary to what we were concerned with. And so, when we sat down with the genetic counselor, she looked at that chart and just shook her head.

And she said, “There is absolutely something in your family that’s genetic, but I don’t think that you’re going to end up being positive for BRCA1 or 2. This doesn’t look like the pattern, the secondary cancers didn’t match up, some of the things that are associated along with BRCA1 and 2, we didn’t have evidence of.”

So, she said, “I think you’re going to be negative. But I don’t think that means that you’re free and clear. I think there’s probably something that we just don’t know. We don’t have a test yet to identify what may be in your family.”

What year was that?

CE: That would have been 1999. I met with a breast specialist again, my fiance was with me. So, this would have been early 2000. And so, when I was there, we decided to do a mammogram, and they ended up doing an ultrasound and found a pea-sized lump that they wanted to needle biopsy that day.

And that was just a like ding for me, because when my mom found hers, she had a pea-sized tumor and 10 of 12 lymph nodes were already malignant. So, that kind of gave me this sense of all of the screening and all of the do-it-yourself checks—all this might not be adequate in our situation.

Had you gotten back the results from the genetic testing at that point?

CE: Yes, they were negative. And so, we decided, let’s do a baseline with a mammogram. And then that went to the ultrasound. But the idea was, let’s figure out what sort of surveillance or what’s the best action plan.

And so having met with the breast specialists, we kind of came to the decision of, I could come every six months for surveillance, and we would just keep an eye on everything.

The lump that they found that day was not malignant. It was completely benign. But I think, to me, the idea of it being the same size, and that I hadn’t been able to feel it, my OBGYN hadn’t been able to feel it, you know, it was like, “Oh, boy.”

And so, as we talked through it, she said, “You will need to come every six months, and we’ll do screening for you or you have the mastectomy. And we don’t worry about this anymore.” And it wasn’t an easy choice, but because of my history—I also had an aunt who died of cancer in my childhood, and we thought that that was possibly related to breast cancer, also lung cancer.

So, in my head, I’m thinking, “You know, this is not an easy decision.” But when I asked, I said, “Well, if I come in on the sixth month and we do a screening and we find cancer, what am I going to do?” and she said, “You’ll have a mastectomy and start treatment.” And it was like, just do it and get it over with.

So, I was married that October of 2000. And had the mastectomy in January, the following year, so, 2001. And it was a difficult surgery, with several reconstructions. It was hard, but it seemed, to me, worth it, because I thought, “Okay, I’ve done what I needed to do.”

Erickson with her husband, son, and daughter all dressed for a formal event.
Erickson with her husband, son, and daughter.

Between prayer and having the surgery, I felt like I did whatever I could do, and there was this sense of, “Okay, I don’t smoke. I’m not in any other risk factors that I know of. I should be fine.”

And so, that was kind of the initial kind of impact that I think I had personally and with my family with cancer. And so, again, there was this time period of trying to get all of the reconstruction done and kind of stable, and I had my first child, I had my daughter in 2005. And shortly after that, I started having gallbladder attacks.

And so, this gets to this roundabout way of finding what was happening. But I went to the emergency room, and they got scans. When they saw what was going on, I had a blocked bile duct. So, I had my gallbladder removed.

But in that abdominal scan, at the top of the scan, they could see my lungs. And so, they said, “Well, there’s some stuff in your lungs that looks kind of strange, we’d like for you to follow up and have some scans done.”

So, I went to have that set of scans done, a chest CT. And when I got the results back from the chest CT, the doctor said, “Well, there are definitely some spots in your lungs. But there’s something in your neck, we need to get looked at.”

So, they wanted me to go back in and do another round, it was like every time they would look for something, they would find something at the top end of whatever. And I just remember telling some friends, “I’m not going. I’m not doing any more of this. You know, every time I go, they find something else. And the only place left is my brain, and I don’t need to find anything there.”

But the two women from church that had kind of taken me under their wing took me out to lunch the day before I was supposed to have that next scan done. And they said, “You know you have your daughter, you want to have more children. Yes, it might be nothing, but you need to know what you’re dealing with.”

So, I went in the next day, and it was an ultrasound that they were going to do with my neck and found out that I had a blood clot in my jugular vein. So, they put me in the hospital for that. And while I was there, I decided, we already have you in the hospital—they were treating me for the blood clot—and they said, “Let’s do a biopsy and try to figure out what’s going on with your lungs. You’re already here. You know, we know that there’s something there.”

I had the lung biopsy here in Macon. And my husband and my parents, it’s interesting, I can tell that the news was incredibly difficult for them, because they remember it in different ways. And different parts of that hit them differently. But they were told that I had lung cancer, and that I probably only had months to live because of the amount of tumors that were visible in my lungs. I think that was the initial conversation, and that either my parents or my husband were going to have to tell me that news.

[The doctor] talked to them before telling you?

CE: Mhm. And so, then it ended up that they weren’t sure that it was cancer. We would wait for the tumor board to meet and review, and they had that and still weren’t sure.

So, my biopsy samples were actually sent to Mayo Clinic in Arizona. But in between all of this, you know, we’re hearing that it’s metastatic cancer from somewhere else. “We don’t know where, but it’s all in your lungs—this is bad.”

And I just remember my husband telling me, “You know, you have cancer, and it’s really bad.” And I said, “No, I don’t.”

I remember everybody that tried to tell me that it was almost like, you know, petting me on the head, like, “It’s okay.” I kept saying, “No, I’m not dying.” I just had this sense that I would know.

So, we had all these conversations about “What if,” and “How do we move forward?” And we finally got the report back from Mayo Clinic that said, at that time, they weren’t diagnosing me with cancer. It was atypical adenomatous hyperplasia.

And I was able to actually speak to one of the pathologists on the phone, who explained to me, you know, at that time, he said, “This may or may not turn into cancer. There’s not anything we can do to treat it. You just need to watch it, have screenings.”

So, having gone through the shock of being told that I had cancer and the whole time saying, “No, I don’t. No, I don’t,” there was this huge relief to be told, “Oh, well, go on, live your life, do what you want to do. Just go and have these screenings.”

We did keep up with, you know, every couple of years for a while, and then they kind of got spread out a little bit more.

What a roller coaster.

CE: It was hard and strange at the same time because I didn’t have a single doctor kind of directing what was going on. And so, my local internist tried to help guide some of that thing, but it was a lot of… I wasn’t given a concrete plan of “This is what you do, and this is how many years, and this is who you should check in with.” It was just kind of like, “Oh, if you ever need us, we’re here.”

Fast forward to 2016, I was having some stomach kind of digestion problems. I saw a GI specialist here. Everything checked out fine. But he also brought up, “Hey, you know, who’s driving the bus with your lung stuff? What’s going on? Who’s keeping a track of it?” And I told him, I said, “Really, nobody. I’m supposed to go, but I don’t have…” My pulmonologist had retired. And I didn’t have a referral or an update to somebody.

The GI doctor sat down, and he said, “You know, you need somebody to kind of manage this.”

So, we started trying to find somebody locally for me. And then in the back of my head was, you know, when I spoke to the pathologist for Mayo Clinic, 10 years prior, he said, “If you ever need anything, give us a call.” And so, I thought, “Well, I’m just going to call and see if they’ll see me.”

That was how we kind of started this last group or whatever of visits. So, I flew out to Arizona and met with a thoracic surgeon at Mayo Clinic. And we talked through my history, and I sent them all the scans that I had had.

There was no obvious growth, but they looked different. There was no pattern that they could see and what was happening, but I just constantly had spots in my lungs. So, we decided to schedule a biopsy. This was going to be my second lung biopsy that I’d had, so I knew what I was in for.

Was your first biopsy one where they went down your throat?

CE: No, through my back.

So, I flew home, because we had to wait for, you know, all the insurance approval and all that and get everything scheduled and then flew back out for the lung biopsy. And I had a lung biopsy through the back again.

The same two pathologists who had worked on my case 10 years ago were still there and remembered—I think it was because I was so young and it was an unusual case—they remembered having done my biopsy 10 years ago. So, they were not overly concerned because the size of everything was still very, very small.

And my thoracic surgeon said, “Test everything. Test every piece of tissue that I got out. We need to know what’s going on with this lady.”

And it turned out that it was malignant. I did have lung cancer.

When she told me that, when the thoracic surgeon told me that, she said, “We’d really like to do another biopsy on the right side. We want to see, is this all the same thing? Is there something?”

And she said, “So, you’re gonna have to do this again.” And I just went, “Can we do it while I’m out here?” And everybody in my family thought that was so brave, but it was really just to get it over with.

I knew if I came home and had to think about having another lung biopsy surgery, that it would be hard to make myself get back on a plane to come do that again. It was kind of just like, “We’re here, get it over with.”

So, three days later, I had a right-side biopsy.

And can I ask, Christy, was it the kind that a surgeon does, or where they just put a needle in your back?

CE: No, I have the incisions. It was the thoracic surgeon. So, I had the chest tube, all of that business all three times.

Well, those are big deals. How did it feel recovering from those biopsies?

CE: It’s not a fun recovery. I have a hard time with pain medicine. I tend to get just incredibly nauseous from pain medicine.

So, I remember even one night. This was after the second biopsy, but I mean, still, the second biopsy was still three days after the first one in that case. And there was one night where my nurse came in, he said, “Your blood pressure is sky-high.” I mean, he could tell that I was just in really bad pain.

And he said, “I want to give you morphine,” and I just started crying. And I said, “You can’t give me morphine. It will make me so sick.” We found that out when I had the mastectomy. And I had such a bad reaction to it that my doctor said, “You’re not technically allergic to it, but let’s put it on your allergy list from here on out. We don’t want you doing this again.”

So, the care that I got, particularly from the nurse that night—he just was so empathetic. He said, “I’m not going to give you morphine, but we’ve got to find something to take care of this pain.” And so, he said, “I’ll be back.”

He left and came back in the room. And he said, “Well, I called and woke your doctor up.” This was like, I don’t know, two or three o’clock in the morning. And he said, “We’ve come up with a plan.”

I don’t know what they gave me. But it didn’t make me nauseous. So, he said, “We’re going to try a couple of things, and kind of layer and see how we do.”

But having to have those back to back was especially hard.

This may be TMI, but then people who have had surgery know this, but trying to get your bowels moving again after you’ve had surgery… Well, to have to have these procedures in three days, and nothing was doing what it was supposed to do.

So, I still remember the morning that I was finally able to go to the bathroom. They had me walking around at that point. And I wheeled myself, or my IV pole, and I’m walking down to the nurse’s station, and I went, “I went to the bathroom!” And they all just said, “Yeah!”

I wish it wasn’t such a common problem.

CE: It is, and I still have such fond memories of the nurses that I had during that stay. And probably because I was there for, I mean, it ended up being about a week once I had had both procedures. And so, it was just such a funny—I mean, it’s embarrassing to tell it, but it also just tells you that our nurses and our health care want good for us and want us to do well.

It was just hilarious. Everybody was just cheering, like, “Yeah, you can go home!”

Fixing somebody’s constipation is a huge triumph.

CE: I mean, they had me drinking hot prune juice. It was just, it was a struggle.

So, that was just one of those kind of hilarious moments where I realized every part of my recovery was important and was significant.

So, I recovered from that surgery, flew back home to Georgia. And they told me that they would send the samples off for genetic testing, which is something that wasn’t available, as far as I know, 10 years prior, when I’d had the first biopsy.

I left the hospital after those biopsies knowing, “Okay, some of these tumors are cancerous. Does it mean that they all are? Do we have any idea how it started?” So, not a lot of information until the genetic testing came back.

But as we were waiting for that to come back, we were trying to figure out, “Okay, I need an oncologist, number one.” And so, we kind of thought that I would just travel back and forth to Arizona, I would see somebody at Mayo. We were kind of working that out.

And I got a call from one of the oncologists at Mayo, and she said, “We are happy to see you, we are happy to continue your care. But there is this oncologist at Emory. We would like for you to just go and meet with him. We’re still waiting on genetic test results. So, we really don’t know what we’re dealing with, but why don’t you just go kind of feel him out. He’s close to you. See how it goes.”

They referred me to Dr. Suresh Ramalingam at Winship. By the time I had my appointment with him, my genetic results had come in, the testing results. And it turned out that I had the EGFR and the T790M mutation, and he would be the most appropriate oncologist really anywhere for me to see.

We had a huge laugh about that. And my family, it just felt like, I mean, to me, definitely, a God-directed situation, that not only would I not have to travel by airplane to go see my oncologist. But, “Hey, I just want you to go see this man and see if you get along with him and what y’all think.” And it turns out, he’s the person that I need to see.

So, I started with him, met with him in late September of that year, early October, and we talked. I mean, of course, he’s an amazing doctor. I started on Tagrisso as my first line of treatment.

I agree that he’s an amazing doctor. I would love for our audience to hear a little bit about why.

CE: So, he is in the group of scientists and researchers who were doing all this research and actually developed Tagrisso, which is the targeted therapy that works on the exact particular genetic mutation that I have.

So, when I say, literally, he was the person that if you could have chosen the most appropriate doctor for me, he was the most appropriate doctor for me. And we had no idea until I was actually in his office that that correlation was there.

What was it like talking with him and getting to know him?

CE: Oh, he’s amazing. He’s so incredibly caring. He also, you know, in the eight years, almost, now that I’ve been on Tagrisso, I feel like he and I have built a rapport and a relationship. Because I go every three months for scans and labs, and I either see Dr. Ramalingam, or I see somebody on his staff. But then he’ll always come in and say hello. I feel like he has walked with me.

He’s been more than just a doctor. He’s been a cheerleader. He’s been an encourager. It’s been so helpful that I can always find out what’s going on in the world of EGFR lung cancer. He can tell me from an expert’s point of view.

He has the latest research, the latest information. I always felt like when he told me something I knew, “Okay, this is correct. This is the most up to date.” He’s not reading this from somewhere else, or hearing it. I mean, you know, he’s in the thick of all of this research that these doctors and scientists are doing.

So, it gave me a lot of confidence to be able to know my doctor knows what he’s dealing with. And, I mean, it just gave me a lot of trust and a lot of hope and also just a sense of knowing I’m in the right place.

There are so many wonderful cancer centers in our country. And so, I know people who have gone to various places, and I always say, “Find the place that has the strongest correlation that you can to what you’re actually dealing with. And find a person that you trust, and that you have good rapport with.”

I think that’s so important.

You mentioned that, before you met with him, you had been told everything from, “Don’t worry about this,” to “You have a few months to live.” What was that conversation like when you talked to Dr. Ramalingam for the first time about what you could expect in the future?

CE: I still remember it. When we talked about it, he said, “If you’re a praying person, pray for 12 to 18 months for this medicine to work.” It felt like my head was gonna explode. That didn’t mean that I had 12 to 18 months to live. But it was a “We don’t have the next pill.”

So, in my mind, I left knowing there’s a possibility that this might not work at all, there’s a possibility that it could work for a short amount of time, and then the cancer could mutate and not work.

But when we continued to talk, it was somewhere 12 to 18, 18 to 24. But immediately I started thinking about the ages that my children are and what I’m not going to be here to see. I think he did the best that could be done to give me that information, and try to do it in a gentle way.

He said, “You know, this is not cut in stone. There aren’t enough people for us to really have an idea of how long it can work.” He told me there were people that were still on it from trials. So, I felt like he did a good job of giving me a realistic timeline.

But then he said, “We don’t know. We don’t know what the outside length of time is. Because we have people who are still on it.” So, I remember coming home and thinking, “Well, how do I get in that group?”

It was incredibly difficult psychologically and mentally, I think, to process that.

When I talked about how, before getting married and having children, I decided to go through with this mastectomy and ended up having four reconstructive surgeries and this long drawn out thing, I felt like, “Okay, I’ve done everything I needed to do, you know, I don’t have to worry about cancer.”

To go from that to, “Oh, by the way, you have cancer anyway,” it was, I mean, kind of a crisis of faith and a crisis of what am I going to do and what’s going to happen to my children. I’d describe it as, I think I was walking around for probably a year, like the cartoons where the person’s walking, and all of a sudden a piano is hanging by a rope over their head and somebody cuts the rope and the piano smashes down and crashes on them.

I think I walked around, waiting for the piano to smash me into the ground, because I just thought, “I can’t get away from it. You know, I’ve done everything that I can do, and I can’t get away from it.”

During that first year, I was still, every three months, going to see Dr. Ramalingam. We were doing labs and doing scans. And none of the tumors shrank, but they also didn’t grow. Everything remained stable. And Dr. Ramalingam said, “You know, this is good. I consider this to be, you know, a good response. That everything is stable is good.” None of my tumors… everything is less than a centimeter in diameter.

So, there wasn’t anything that we’ve had to kind of go in and try to remove. We haven’t done any other… no radiation, no infusion chemo, just the Tagrisso. He’d just say, “You know, if things change, we’ll deal with them as they come, but we’re gonna ride this bus as long as we can ride this bus.”

So, there was sort of a point in that year to year and a half, that I think in my mind, I went to, “Okay, well, I’m still here. It’s stable. We’ve mostly figured out the side effects, which, I mean, are terrible to begin with.” But, you know, it was unpredictable. But we kind of got most of that figured out.

And I just thought, “Well, I’m still here. I need to go do whatever it is.” I mean, it was literally a thought of, “If I’m not dying, I better go live.” And so, that shift in my attitude, I think, became a huge thing.

I started thinking about things that I wanted to do. One of them being: have a Harley-Davidson motorcycle and ride. I became so emotional about that. And I knew that my husband would be against it, because at that point, we had two children. I thought, “I just have to talk him into this.” So, I sat down and wrote an essay about why I wanted to ride.

We were sitting down one night, and I just handed him the papers. And I said, “I need you to read this.” He started it, and, like, a paragraph in, I think he realized what this was going to be.

He just looked over at me, and then went like this, and then kept reading. He read the whole thing, and he said, “Are you going to play the cancer card to get a motorcycle?” And I said, “If it works, I am.”

So, it did work. I bought my Harley, started riding. And I think there was this—not a fatalistic kind of a thing. I was still incredibly careful. I mean, I am incredibly careful on the bike. I realize that things can happen. But rather than feeling like, “Well, I’m dead anyway,” it was a, “I want to make the most of the life that I have while I have this health.”

Because unless you knew that I had lung cancer, you wouldn’t look at me and expect it. I mean, for all intents and purposes, I still felt like a healthy, vibrant person. So, I think being able to ride really gave me a huge boost.

I remember the first appointment with Dr. Ramalingam after I had gotten the motorcycle, he just howled laughing. He thought it was so great. He said, “Obviously, be careful, wear a helmet.” But he was proud of me. I could tell that he was proud that I was taking my life and enjoying it.

So, that kind of willingness to try things has just sort of really blossomed since I was diagnosed.

That’s great. I’m wondering, maybe from the time of your diagnosis and throughout, how did you talk to family and friends about what was going on?

CE: It was really difficult. To me, the biggest question was what to tell my children.

I was seeing a counselor at that time. And that was enormously helpful just to have somebody who could kind of help me process all the information that I was getting, but also process that I don’t have control over this. If I can’t control it, how can I best put it and frame it in my mind so that I can handle it and still live?

The thing that we decided on in terms of my children was don’t tell them anything that we don’t know to be fact. So, we told them that I had lung cancer. We told them that I was on a pill that was to keep the cancer stable. And I would tell them I’m going for more scans. And all that time, each time the scans came back stable, I would say, “Everything is stable. It’s all still there. But it’s not growing. We just keep going.”

But I never told them any sort of timeline because—and this was one of those things where my counselor really helped me frame how to approach that conversation—because the timeline wasn’t a strictly-known fact. At their ages, we decided there’s no reason to tell them, “Well, maybe 12 months, maybe 18, maybe 24 months.” Oh, but there are some other people…

They were very young at the time, right?

CE: Right, right. And so, that was the only thing that we held back from them.

As they got older, it became normal for me to go for these scans. I think as they matured, they learned to appreciate, “Okay, it’s really good when mom comes home and everything is stable.”

We just talked about, you know, being grateful for my doctor, being grateful that there was a medication that could treat it, and we just stuck with the facts. We didn’t handle the speculation or the unknown in terms of timeframe.

But one of the biggest, one of the hardest conversations related to that was when my daughter was in eighth grade. We moved our kids from one school to another.

The summer before her eighth grade, she was doing some math tutoring at the new school. And one day, I said, “Hey, sweetie, go on out to the car, I’ll be right there.” And so, her math teacher and I were… I said, “I need to talk to you about Evelyn’s math and what’s going on.”

He’s the principal of their school. And then the vice principal, dean of students was also there with us, and I said, “We’re trying to decide what math track to put Evelyn on. And it’s a difficult decision for me, because we’re discussing things that will be, what class will she take by the time she’s a senior?” And I said, “I won’t be here when she’s a senior in high school, there’s just, I mean, there’s no… In my mind, that wasn’t a possibility.”

And so, I said, “I’m counting on y’all to help me make this decision now, but also to be a community and to be people who will love and help guide my children, because I don’t expect to be here, to see this, to see her graduate, to see her, you know, get into calculus.”

That was an incredibly difficult and sobering conversation. There was zero part of me that thought that there was any chance that I would still be alive this long. That was based on how long we thought of the possibility of Tagrisso working and also the understanding that we don’t have the next-level treatment. And I have so many tumors that if and when they start growing, it’s just going to be in a mess.

So, to fast forward, this past spring, I got to be at her high school graduation. And I got a text from her principal that day, and several other teachers who I’ve gotten to be close to, and they had all had just a big kind of praise and prayer that morning. So, not only was it a celebration of the students graduating, but there was a true sense of just joy and amazement and gratefulness that I was there.

To know that those people that I had shared that with five years ago were able to celebrate with me this huge milestone. Now that the kids are older, they understand. We’ve talked about the genetic history and connections in our family. We have since discovered that—and this is based on some other family members being tested—the breast cancer connection that the geneticists saw in my family turns out to be a PALB2 mutation, and I am negative for it.

So, first, I was able to tell my daughter, “You won’t have to have this prophylactic mastectomy. You’ll have the normal testing that every, normal-risk woman will have. But whew, you don’t have to worry about this.”

We had told the children that when they were 18, we would allow them to be tested. When they were 18, we would let them make the decision. Do they want to be genetically tested for the EGFR mutation that I have?

My daughter was looking at getting ready to graduate high school, go off to college, kind of start her life. And she says, “Mom, I want to go be tested.”

That was scary. Whether or not she’s tested doesn’t change whether or not she had the mutation. But for a momma’s mind, once you know, you can’t unknow.

We talked a lot about it. Her science teacher at school actually did a huge unit on genetics and biology, and invited me to come in and share some of my family history as a case study so that the students could see, real-world, how this works in a family. How do we do this testing?

The more that they talked about it, the more my daughter said, “I want to know.”

So, we have had her… she’s gone through genetic testing and came back negative. And we were at an art competition when…So, my daughter was 18, which meant the genetic counselor didn’t call me or speak to me, they called my daughter.

I got a call from my daughter that day, and she was incredibly emotional. I could hear in her voice and she said, “I got my testing back,” and she was crying. I just thought, “Oh, no.”

She said, “I don’t have your mutation.”

I just started screaming. I ran across the parking lot to one of my friends who—this was an art competition with the school where they go—this was for my son. I just ran across the parking lot towards my friend screaming.

She knew that we were waiting on results, but she didn’t know what was going on when she saw me. And I just ran straight to her and just jumped. We both just started hugging. And I said, “Evelyn’s negative!”

We both just were screaming and crying. And, you know, thank you, Lord. We had this just crazy… I mean, people were in the parking lot like, “What in the world is going on?” The sense of relief, I didn’t even care how ridiculous you know, there wasn’t even a thought of propriety. It was just such a relief.

My son was in the car with me. So, he saw me just jump out of the car and run screaming across the parking lot. So, they know that it’s a big deal. He has said when he’s 18, he wants to do testing also.

That 18 thing has just been one of those things, as I said, when I’ve discussed with my counselor, we’ve just decided to let them make that decision when they have become, officially, an adult. We needed some sort of criteria.

I want it to be their decision and not something that I decided or my husband and I decided on our own.

We really want them to be old enough and mature enough to make that decision. Because, again, that can be a life altering piece of information to get. But we’re one down.

Wow, what a story. When you were diagnosed, I think we were starting to understand a bit more about the fact that one in five people who get lung cancer have never smoked cigarettes. I’m wondering if that’s a question that you have gotten from friends and acquaintances, and, sort of, what people’s awareness is these days?

CE: Yeah, that’s a good question. I will say I knew because of the family history that we had, and even though it was breast cancer, in my mind, the connection was always made. You know, don’t start smoking. It’s dangerous for your health.

I smoked one Clove cigarette when I was in college, so I can’t say that I have literally never smoked. But I was trying to study for an exam, and somebody told me, “Well, this will at least help you stay awake.”

So, I smoked one and I was like, “Yeah, I don’t need to do that.” I mean, I was awake, but this was not a good trade-off for me.

In terms of medical and life history, I’m considered a non-smoker in terms of cancer risk. And that was such a huge question the first time that I was hospitalized. We had the biopsy, and they were trying to figure out, is this cancer? What is this? Where did it come from?

We knew I was a non-smoker, there was a question of, could it be histoplasmosis? Maybe I’m saying that right. Had I been in a cave? Had I lived around bats?

One of my best friends—I’m already smiling because this is so “her.” We were all just racking our brains. What kind of environmental factors? Where had I been exposed to something that would do this to my lungs?

And so, she goes, “Oh, cake flour. You bake all the time. I bet it’s cake flour.” So, she’s like, “Test for cake flour.”

I mean, this sounds crazy now. But when I was growing up, we would go to vacation Bible school at my grandmama’s church—this very small country church on a river.

And they had—it’s so gross when I think about it as an adult, but it was just normal for us—they had this rock and concrete put together, this water fountain that was just water piped from the river, through the park, under the parking lot, into these water fountains, and they just constantly ran.

So, there was green slime and mold. We drank out of that stuff. We wanted to drink out of the fountain. So, I mean, I even remember thinking, “Was it from drinking out of that nasty fountain?”

Just to say that we were trying to come up with every possible—had I been around pesticides and things from a garden or a farm? I mean, just, it was so unusual, especially in the beginning, when I first started having these things happen, to have lung cancer as a female as young as I was and there not be some obvious reason or connection or whatever.

It’s an interesting question about smoking. Because I think that the average person thinks as long as they don’t smoke, they won’t get lung cancer. And the opposite of that is if you have lung cancer, you have to have smoked a lot.

There’s this sense of other forms of cancer being a little further along in the development of genetic testing and of treatment. And one reason for that is a sense of, “Oh, well, somebody has breast cancer, they didn’t do anything to cause it. Or somebody has bone cancer, well, they didn’t do…”

But so much of lung cancer historically has been written off as, “Oh, well, the person smoked, of course, what did they expect?”

And so, that’s been one of the things that, I think, my situation and being able to kind of shed some light on, there is a growing population of non-smoking young women who have lung cancer.

It’s taken a while for funding and interest and things for research and study to come along and develop what we have with lung cancer. And, I mean, I’m sure there are lots of reasons why. But my understanding is that that bias is one of the large reasons why lung cancer research is not as far progressed.

And so, now that they’re making these discoveries and finding these genetic links, I’m interested in it in terms of helping to educate people by saying, “Look for these patterns in your family and don’t write it off.”

My grandfather had lung cancer, and he smoked. So, nobody ever thought anything about it. Whether or not he had the genetic component, I don’t know for sure.

On the other end of that, obviously, there are people who are smokers, who would have this genetic mutation or this genetic predisposition. Instead of vilifying patients, I think it’s helpful to say, “There are a lot of things at work in causing lots of cancer, and let’s do the most we can to support patients and to support research and funding and treatment.”

And maybe not focus so much on, “What did you do to cause it?”

Couldn’t agree more. Wouldn’t it be nice if we didn’t vilify anybody?

CE: Right. And so, when you ask just general people—I don’t know how many times I’ve been in a situation where the first question that somebody asks, when they find out that I have lung cancer is, “Oh, how long did you smoke?”

To be able to say, “You don’t have to smoke to get lung cancer. And by the way, if you did, you weren’t cursed as a punishment, with lung cancer.”

I think part of that is that bias. And I think another part of it is, we want to think that we’re all okay. And, you know, “Oh, well, I don’t have to worry about that because I don’t smoke.” Like, “I can just check that off and just not worry about that anymore, and go on about my day.”

Unfortunately, that’s not the case.

Sounds like you’ve done a lot of education in your community about how we understand cancer. We need to do a lot more.

CE: I think that’s one of the reasons that I’m so happy for an opportunity like this.

And then there’s that balance for me of sometimes, I feel very open and comfortable talking about it. And then there are also little pockets of my life where I think I don’t want to go in and be the cancer lady. So, there’s always this sense of, when I go into a new environment, kind of feeling it out.

We talked off camera about strongman competition. And that was just such a weird random thing. But I had started going to a local gym and working with a trainer, just, you know, just 30-minute weightlifting sessions, nothing super hard, nothing crazy.

I had been doing that for a while and went on spring break with my family to Hilton Head and just thought, “Well, I need to find a gym. If I don’t go do something for a week, it’s gonna be awful when I come back.”

And I just found this gym that had strongman on their website, and I thought, “Well, that would be fun to do for a week. I’ll see if I can get somebody to work with me. But I don’t know anything about it. I remember seeing it on TV.”

Maybe it’s helpful to see a cancer patient—stage 4 lung cancer—pulling a UPS truck. I think there’s value in other patients seeing patients further along than them continuing to thrive.

– Christy Erickson

When I got there, they said “Yes, of course we have somebody that will work with you.” I got there. I met this trainer the first day we were there. You know, and he said, “I need to know—Is there any medical [history], anything?”

I thought, “Oh, here we go. You know, what do I say? How much do I share?” And I said “Well, you’ll see me use an inhaler. I do have lung cancer. Everything’s stable. I’m fine. I’m clear to do this. But I watch my heart rate and I gotta be able to breathe.”

He just kind of froze, and it turned out the more we talked, he also had a very unusual form of cancer and had gotten into strongman as a way of just kind of defying the sense of “It’s over, and I don’t know what I’m gonna do, and I’m afraid.”

It was one of those opportunities where it just felt like—almost like with Dr. Ramalingam—that this is the right person. And we had no idea until we got there.

So, I did that for that week, and then came home and started looking for somewhere that I could train. I didn’t know of anybody in my town, and I found somebody and started working with him. And this was April of last year, of 2023.

I had to tell him what was going on, because he was going to be working with me. He needed to know to keep track of Christy’s breathing. What happens is I get out of breath, and then my heart rate will get really high.

So, it’s just one of those things that we know to keep an eye on, and, you know, make sure that we’re good. And I told him, “I just want to do this for fun. I just want to train, and there’s no way I’d ever compete. I just can’t do any of that.”

I started working with him, and like, one month later, I said, “Could I compete and not embarrass myself?”

So he—I still remember the conversation—I asked him that, and he said, “Hell, yeah!”

So, I tell him all the time, like, all I needed was somebody to just tell me, “Hell, yeah.”

I signed up as a novice in a strongman competition here in Georgia. It was last October. And the final event in that was—I pulled a UPS truck.

So, my coach knows of my cancer diagnosis, and my family was there. Even my sister and brother-in-law drove in from Tennessee and came. It was a big deal.

But nobody else there knew. And there’s this sense of wanting to be taken as just a regular, normal person, and also feeling like, maybe it’s helpful for people to see a cancer patient—I mean, stage 4 lung cancer—pulling a UPS truck.

I think I’m more open with it kind of on an individual basis. I didn’t tell the meet directors or anything like that. But I think there’s value in other patients seeing patients further along than them continuing to thrive.

And that was the thing with Dr. Ramalingam. When I would go in he would say, “Well, we still have somebody on it.” Now, he’ll tell me when somebody comes in and they’re diagnosed and start Tagrisso, he’ll say, “We have a patient who rides a Harley and does strongman competition.”

There’s that opportunity to be that hope, and just give people another option to consider other than, “Well, I have this and I’m just gonna die; it’s gonna kill me.”

I don’t know. It’s been such a mental shift for me to be willing to try things that just seem ridiculous, but it’s like, “Well, when else am I going to try it?”

A lesson we can all learn from. I want to thank you so much for sharing your stories with me and all of us. You’re welcome back any time. I don’t think I could pull a UPS truck. That is pretty astounding.