May 4, 2023

An unexpected cancer diagnosis

As a nonsmoker, Betty Schuldt’s stage 4 lung cancer diagnosis was surprising, but her supportive care team helped return her to an active lifestyle.

Betty Schuldt, from Portland, Oregon, credits expert care, a healthy diet, and the wraparound support of her cancer team for her successful outcome.

Betty Schuldt loves tennis and walking. Lately, pickleball has become her favorite pastime.

Although Schuldt has always been outgoing, she credits her team of highly skilled cancer care experts and the personalized care she received at Kaiser Permanente in Portland, Oregon, for the active life she lives today.

“I don’t think about cancer anymore,” she said. “I eat well, take my oral chemo, and I am out playing pickleball whenever I can.”

'Something wasn’t right’

In 2012, Schuldt was surprised to find herself out of breath and struggling with her daily activities. “I was not myself, and knew something wasn’t right,” she said.

Her primary care physician ran tests. A chest X-ray showed a fluid buildup in the tissue between her lungs and chest wall. Advanced testing revealed Schuldt had stage 4 non-small cell lung cancer, a common type of lung cancer, which accounts for more than 80% of cancer cases. Most often, it develops slowly with few or no symptoms.

As a nonsmoker, Schuldt was shocked. Fearing the worst, she asked how long she had to live. Instead of prescribing a timeline as expected, her pulmonologist’s answer was pivotal in giving her hope. “She said it was too early to know — that there were things we could do,” Schuldt said.

Surrounded and supported

Ongoing advancements in cancer therapies, along with an interdisciplinary approach to care, have allowed patients, like Schuldt, to achieve longer-term success with a prolonged life expectancy, says Sandeep Mashru, MD, her current oncologist.

When we convey to patients our multidisciplinary team, which is a whole-person approach, they feel supported.

When Schuldt was first referred to the cancer care team, her care plan was managed by a case manager. Since that time, Kaiser Permanente has implemented nurse navigators in the Northwest who serve as advocates for a patient’s care — from initial consultation through treatment. Nurse navigators are part of an integrated team that includes oncology specialists, pharmacists, pathologists, radiologists, counselors, and other specialists who work together to provide a patient-centered approach.

“When we convey to patients our multidisciplinary team, which is a whole-person approach, they feel supported. Patients are also supported with the ability to have convenient, reliable communication with their team,” said Dr. Mashru.

Schuldt was ready to do whatever she needed to beat cancer. Her initial oncologist, Robert Ellis, OD, was optimistic about her treatment and started her on a new drug therapy that proved effective.

“He was my biggest cheerleader,” Schuldt said. “Every time my husband and I came out of an appointment, we were energized.”

Her care team helped her manage the treatment’s side effects, which were minimal, and she learned how food and exercise could help her body heal.

Another setback — and path to recovery

Over time, Schuldt learned the cancer had spread to her brain. She began targeted radiation, but the side effects became too hard on her emotionally and physically.

“It’s important we not only treat our patients, but that we listen to them,” Dr. Mashru said. “Betty’s quality of life was slipping due to the treatment’s side effects. Although her cancer was in remission, we knew we needed to look at new treatment options.”

The radiation had reduced the tumor enough that surgical removal was the next step. Follow-up tests showed that no cancer remained, and she recovered well.

At this point in her treatment, Schuldt sees Dr. Mashru about every 6 months. She says she is 95% back to where she wants to be.

“I honestly believe that having a fabulous care team, along with plant-based eating, exercise, and the support of my husband, is what made my treatment so successful,” she said.