Every year, more women die from lung cancer than from breast cancer according to the American Cancer Society. Early detection is the key to survival, as my friend Cindy Johnston can attest to. I met Cindy in 1998 when she was my sons’ choir director in elementary school. She was also my handbell choir director in church and became a personal friend. Knowing my late husband’s journey with lung cancer, Cindy contacted me when her doctors suspected she may have lung cancer. Her story gives me goosebumps. She had no symptoms. Here is her amazing story of a series of events that allowed early detection and treatment—and survival:

The Voice.

For many, including me, this is a popular singing reality competition. In the summer of 2023, “The Voice” became so much more. “STICK TO THE PLAN” and “I’VE GOT YOU”—the simple messages that served me well, likely adding years back to my life….

Summer of 2023 was the season for me to finally make time to tend to some chronic pain. I’d been managing a torn rotator cuff for several years, and more recently I had developed lower back issues that caused sharp pain in my left leg. I was scheduled to have shoulder surgery first in July, then in September was to undergo microsurgery to take pressure off lower lumbar nerves. Truthfully, the leg pain was more problematic than the shoulder, and I came very close to having the back surgery first and postponing the other for a year. One evening while seriously contemplating this, considering how to juggle all my obligations in a very busy life and feeling a little overwhelmed with all that lay ahead, I clearly heard the words, “Stick to the plan.” Yes. That was exactly the answer. Stick to the plan. A sense of relief came over me after settling this in my mind.

On July 26, the rotator cuff repair surgery was done by Dr. Bruce Douthit, a well-known orthopedic surgeon who’d done athletic injury surgeries for two of my kids and was a friend from church as well. It was a successful and uneventful surgery with me going home the same day. I began my recuperation, and all was going smoothly.

On August 1, I had a one-week post-op appointment. At the beginning and continuing until the end of the appointment, I had an elevated heart rate that caused consternation for Dr. Douthit in the arena of blood clots. The elevated heart rate persisted well into the evening, and ultimately, I returned to the hospital, visiting the ER. Blood test showed positive for blood clots, but the ER doc felt the elevation was likely due to the surgical incisions. However, to be certain, he ordered a CT scan of my lungs. The scan came back negative for clots, but a 2.1 cm nodule was present. The ER doc tried to downplay it so as to not worry me, recommending I contact my primary care physician for referral to a pulmonologist, citing that often these are nothing, resolving on their own. He suggested a repeat CT in three months.

Cue the Spidey senses.…

And cue my hero-daughter, Bethany Johnston M.D.

We began texting around 11:20 p.m., and when I told her the size of the nodule, her response was "Whoa, that's kind of big. It needs a biopsy.” When I got home, she had me pull up the radiology report in my records, and sure enough, the terrifying words “malignancy concerning” were at the bottom of the report along with a physical descriptor of the nodule, “spiculated.” Not good….

Lying in bed that night, numb, not knowing what to think, not praying, just being still, again, I heard a voice that said, “I’ve got you.”

The next day, August 2, Bethany had me reach out to UT Southwestern's lung nodule clinic, and I scheduled an appointment for August 22. In the meantime, Bethany reached out to the lung nodule clinic in Akron where she is an attending emergency room physician. She was able to schedule an appointment for Friday, August 4. She and her husband purchased a flight for me, and I left on Thursday, August 3, for Ohio.

Events continued at a dizzying pace. I met that Friday with Dr. Bauman, Pulmonologist, and he scheduled and performed on August 7 a bronchoscopy to needle biopsy the nodule and surrounding lymph nodes. Preliminary look at slides indicated malignancy.

MALIGNANCY. Again, that terrifying word. BUT—“I’ve got you…” my go-to anchor moment when fear crept in….

Next up - August 9 surgical consult with Dr. Nkem Aziken followed by a pulmonary function test which, as a singer, I passed with flying colors. Dr. Aziken immediately put me at ease and explained my options. Due to the size of the nodule, typical treatment in this scenario was to remove the lobe. Without hesitation I responded, “Let’s get it out.” He liked that answer. Scheduling was the next challenge. Dr. Aziken uses robotics for this type of surgery, but the OR with the equipment was booked save midday August 17. However, another surgeon had laid claim to the space though had not scheduled a specific candidate yet. The office scheduler got to work to try to secure that date for me, or I’d have to wait three weeks for Aziken to be available again.

The next day, August 10, I received a morning phone call with the pathology report that the nodule was indeed cancer, but the needle biopsies of the lymph nodes were clear. Hallelujah! Scheduled for that afternoon, a PET scan was still needed to confirm the health of the lymph nodes and see if any other cancer lit up. This was needed for the surgery to indeed be the next step as opposed to chemo. Dr. Aziken said that while final word would come from the radiologist, he would take a look at the scan. Having seen so many over his career, he felt could give us a reasonable preliminary result. A few hours later, he called sharing that no other cancer showed on the PET scan and the lymph nodes were clear. This was the news we coveted so that the surgery could proceed. There were many tears of relief shed.

The next morning, August 11, the radiology report officially confirmed Dr. Aziken’s words. A call shortly after told us that all hurdles were cleared for the robotics OR on August 17. We were a go to get this unwelcome squatter out of me. It was a profound moment when we realized I would be having cancer removal surgery before I would have ever seen anyone at the UT Southwestern Lung Nodule Clinic.

Game face daughter driving me to hospital on morning of surgery

The next five days were spent informing family and friends, updating my army of helpers caring for my home and animals in Texas, and making sure all affairs were in order. Of course, spending time with my precious one-year-old grandson, Jack, was a wonderful distraction to help pass the time to GO DAY!

Our heads most assuredly were spinning realizing that less than 16 days from when this appeared as a blip on a CT scan in Frisco, Texas, I was to have surgery to remove it in Ohio.

August 1 to August 17. Wowser. To God be the glory.

The surgery went well, and in the final path report, the mediastinum lymph nodes came back clear as did the pleura, the sac covering the lungs. Being Stage 1a3, no chemo or radiation was indicated. Given all that I went through, I’m in really good shape. I do have some mild surgical site discomfort, shortness of breath, and a kinked bronchial tube they believe will improve over time.

Time—the gift I was given back because of a series of events that started with that voice….

Because of the wonderful busy-ness of my life, a community choir I direct, my musical theater opportunities, a new grandchild coming in January, I seriously contemplated postponing my shoulder surgery for a year. But I didn't…. So thankful I heard, "Stick to the plan."

Beyond that, however, so many things had to happen. Had I postponed surgery, this would not have been found. Had my doctor not been concerned with a mildly elevated heart rate, this would not have been found. Had that elevated heart rate not persisted, this would not have been found. Had I not continued to monitor it throughout the day and not heeded my doctor’s concern, this would not have been found. Had the blood clot test been negative, this might not have been found as the CT scan may not have been ordered. I would have carried on with my rotator cuff recuperation, going about my life, not knowing something was brewing. So many things led us to this point.

I believe it was not by chance that my doctor daughter is on staff in Ohio, leading to my treatment happening so much faster than had I secured treatment in Dallas. Being an empty nester both in my home and my town, I needed to be with family during this time. And there is a ripple effect. A dear friend, mentor, and former choir colleague passed away on September 14. I was honored when his wife asked me to put together a memorial choir for his September 30 service, just six weeks post lobectomy. Had I stayed in Dallas for treatment, I likely would not have been physically able to serve his family in this manner. I am so very thankful I could.

One month post op with Jack at the Akron Zoo

I know how lucky, fortunate, blessed… pick a good word… that we are to be here instead of three or four years down the road with advanced metastasized disease. I have had moments of serious questioning of why I was granted this scenario, this early discovery, when so many are not. My dear friend, the writer of this blog, DeLayne, shared with me that in all her dealings surrounding the years of lung cancer of her late husband, Chris, she’d never once met anyone diagnosed at stage one. I pray I can honor this gift, that I earn this blessing. It feels heavy but another dear friend reminded me… His ways are mysterious. So I cling to “Trust in the Lord with all your heart and lean not unto your own understanding.”
[Proverbs 3:5]

And so the quiet voice comes back time and again… "I've got you."

Photo by Carol Guentherman, Living in Light Photography

I am grateful and humbled all at the same time. To quote my funny and intense daughter who sees things like this in her emergency room all the time and knows so much, "Holy smoke, we are lucky we caught this." Thank you, dear daughter, for taking the bull by the horns and getting the ball rolling to get me to Akron.

Yes, thank you, dear God, for the series of events allowing this early detection.

Be still and listen, Cindy. Just keep listening….