Navigating a Friend’s Lung Cancer - Mike Troy

Описание: November 12, 2025 - Cancer Patient Lab Session 169
Full transcript: docs.google.com/document/d/1C2CK85cWugMFryG3N1a034npt82XiiuA6HUtZao5vjQ/edit?usp=sharing
Join the discussion: community.cancerpatientlab.org

“Standard of care approaches are nice to have, but you really have to think outside the box, because with advanced solid tumors, they're tough to deal with.

“Ever since I got involved, I first joined social media and started following a lot of the experts on Twitter or X, and reading the articles that they shared, to the extent that they were publicly available. At first I was consulting secondary sources, like Onclive with standard industry updates, and familiarized myself with the standard of care, what the outcomes were. I started following the trials in the space, and read a smattering of pre-clinical papers. From there, I started to attend conferences. I became aware of the issue of drug tolerance, persister cells, and in a field in which you rely on targeted therapies, there's this reservoir of cells, they're not sensitive to the target therapy, which end up giving rise to the resistant clones and ultimately leading to disease progression and death. Fixating on that problem, and then also looking to the other solid tumors and seeing the successes that you had with melanoma, with and in the hematological space, with these immunotherapies, and the fact that that really seems like the only way to drive these durable, lasting responses, even cures. The idea was, ‘How do you bring those into an immunologically cold tumor?’ At the NCI, Dr. Rosenberg has done a lot of work there, so I read about that. I've been going to conferences. I just came back from SITI. I got on the AI train a little bit later than most. At first it was just mostly reading publications, following the clinicians themselves, and seeing what they were discussing. From there, I was able to get enough familiarity that I could engage in an intelligent way with patients and clinicians.

“I don't think clinicians like advocates or having patients who are highly informed, especially if you're pushing the boundaries of what the standard of care is. When you look at the curves, a lot of people have the reaction, ‘I'm not going to get on this curve.’ That inevitably leads to a battle, because physicians want to be evidence-based, and although there are some alignments of interest, they don't have the same interests as the patients. The way in which they're balancing risks are totally skewed. If you're looking at combining two therapies, there's an x percent chance of getting a high grade adverse event. For the oncologist with medical malpractice or whatever that may be on the line, that is an overwhelmingly important concern. Whereas, if you're a patient, and you look at it, and you say, ‘the sort of risk-benefit ratio I'm weighing is basically certain death on the other side,’ it becomes a lot more appealing to go off the beaten path.” – Mike Troy

Meeting Summary

Mike Troy sought advice from the Cancer Patient Lab community for a close friend with lung cancer -- specifically stage 3b epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer. After twenty months on a targeted therapy with no evidence of disease, resistance had emerged at three bone sites. A "minimal residual disease" liquid biopsy (blood test) for circulating tumor DNA had found cancer cells for the first time. Mike wanted to discuss what tests and treatments should be considered next.

Mike is a lung cancer patient advocate for the EGFR Resisters and Young Lung Cancer Initiative. He became a lung cancer advocate after a number of people close to him were diagnosed with oncogene-driven lung cancers. Mike has delved deeply into the research and is an active contributor to lung cancer patient support groups.

Discussion topics include:

Why are care decisions for this patient hard to navigate?

Why should a caregiver get involved in advocating for a cancer patient?

What challenges will a caregiver face in advocating for the best options for a patient?

How can a caregiver effectively advocate for the most promising and personalized treatment options for a cancer patient?

What are non-standard tests that this patient should consider?

What are some innovative treatments this patient should consider?

The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.