FOR NEARLY TWO YEARS, Albert Khoury had been sick on and off. His doctor thought his coughing and difficulty breathing were symptoms from bouts of pneumonia. Just three days into the new year in 2020, the lifelong Chicago resident felt feverish and had unbearable back pain. He started sneezing and coughing up marble-sized clumps of blood in his mucus. His doctor again suspected pneumonia prescribed an antibiotic and ordered a CT scan—his second scan in the span of a year.
The Power of Persistence
Khoury felt nervous as he got weaker over time. A fitness enthusiast who typically ran three miles a day, Khoury found himself struggling to catch his breath just a quarter mile into a run. “I thought I had COVID,” says Khoury, who was 52 at the time. COVID-19 had started to garner national headlines, but most Americans remained unsure about its symptoms and how it spread. On Feb. 14, he had a CT scan, which showed a mass in his lung. His doctor referred Khoury to a pulmonary specialist, who suspected a fungal infection. He suggested Khoury take an expectorant to clear mucus, but he also referred him to an oncologist for further testing.
But with the nation hunkered down as COVID-19 infections soared, Khoury couldn’t get in for an appointment. His visit was delayed until late June—more than four months after the CT scan revealed the mass. A bronchoscopy, which examines the bronchial passages of the lungs, revealed he didn’t have COVID-19, pneumonia or a fungal infection, but a form of cancer called invasive mucinous adenocarcinoma in one lung.
Khoury underwent four rounds of chemotherapy. In September, further tests revealed the cancer had spread to his other lung, making it stage IV cancer. Doctors told him he only had months to live.
Khoury began seeing another oncologist, who continued treatment with 12 more rounds of chemotherapy. Still, the cancer continued to grow—causing his lung to collapse.
An affable man with a quick and easy laugh, Khoury remembers prioritizing his usual routine—while continuing to look for other treatments. “I said, ‘You know what? I’m not going to let this cancer stress me out,’” he says. He went to the gym, hung out with friends and family, and continued to frequent the local pizza joint with his oxygen tank in tow. During treatment, he reported to work with the Chicago Department of Transportation, where he has been a cement finisher for 22 years. His coworkers were “amazing,” he says, donating to cover medical expenses and making work accommodations.
With the cancer still not responding to chemotherapy, Khoury’s doctors recommended stopping treatment and offered him hospice care. This time, he was told that he had just weeks left to live. Even with the news, Khoury, same as always, got up and went to work the next day. He was determined to explore other treatment options, eventually convincing doctors to take a chance on a rare transplant surgery that would save his life.
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“Messing With the Wrong Person”
Being on a ventilator for so long prior to surgery weakened Khoury’s diaphragm and made his rehabilitation more difficult. He recalls he could barely walk a few feet at first. After six weeks at the hospital, he went to Northwestern-affiliated Shirley Ryan Ability-Lab for another six weeks before moving home and continuing rehab at an outpatient facility for three months.
“Believe me, it wasn’t easy. It was very, very rough, but you want to live, you got to deal with it. That’s how it is,” Khoury says.
Joseph praises his uncle’s determination and positive outlook. “Even when things were looking grim or certain hospitals or doctors didn’t have any options for him, he still had hope and belief,” he says.
“I said, ‘I’m going to give the cancer a hard time. I’m not going to let it take advantage of me. You’re messing with the wrong person,’” Khoury says.
Khoury, now 55, is getting back to his normal life. He plans to return to work this summer. He goes out to dinner and watches Cubs games on TV with family and friends. He’s also back at the gym, and while he’s not lifting quite as much weight as he used to and has traded running for walking, he isn’t complaining. “I’m not like before, but you know what? That’s good enough for me,” he says.
Part of his new normal is sharing his story in hopes that others with his type of cancer can benefit from transplant surgery. Northwestern has updated its protocols for treating patients with mucinous adenocarcinoma of the lung. It also has launched a registry to track outcomes of other patients who undergo a double lung transplant. The registry includes patients with Khoury’s rare cancer subtype, along with those with any type of cancer currently confined to the lungs. Chae and Bharat report that others with the same disease have come to Northwestern to explore getting the procedure—something that makes Khoury incredibly happy. Northwestern has also shared information with other hospitals that are exploring double lung transplants for people with mucinous adenocarcinoma of the lung.
When offering advice to other people with lung cancer, Khoury stresses that it takes perseverance to keep seeking new treatment options, especially when so many doors seem to be closing. “I just tell everyone, ‘Just be strong,’” he says. “You never know. Miracles could happen to anybody.”
Article by Thomas Celona associate editor for Cancer Today.
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