Docked within view of Tracy Johnstone’s Halifax apartment is a classic 35-foot sailboat named “Tenacity.” “That boat inspires me every day,” laughs 38-year-old Tracy*, who was diagnosed with a rare form of lung cancer in May of 2000, when she was only 35.

"I was living temporarily in Japan and had been traveling for business in Indonesia when I first became symptomatic,” Tracy recalls. “The Canadian Consulate referred me a clinic in Bali, where doctors diagnosed me with bronchitis and put me on antibiotics. When there was no improvement 2 weeks later, I returned to the clinic for a chest x-ray and was told that the image was completely normal.”

By the time her Indonesian business trip ended, Tracy was coughing up blood. Back in Japan, local doctors questioned Tracy about her trip. Because she had been traveling in remote areas, the Japanese physicians initially suspected tuberculosis or some form of tropical disease. Their hypothesis was logical: after all, Tracy was an otherwise healthy 35-year-old woman with no family history of serious illness. She was a vegetarian, a non-smoker, and an avid tennis player.

When a CAT scan and a new series of x-rays revealed lesions in Tracy’s chest, the Japanese doctors narrowed her condition down to two possibilities: lung cancer or lymphoma. They advised her to return to Canada for further testing. Within 24 hours, she was on a flight home to Halifax. Carrying only an insurance policy, a lap top, and a few items of clothing, as well as her CAT scan and some x-ray films, she went straight from the airport to a hospital, where she was admitted and ultimately diagnosed with a rare form of lung cancer.

Over the next 2 years, Tracy went through various chemotherapy and nuclear radiation treatments. Her cancerous tumors – one of which had grown around a major blood vessel outside the lung – would alternatively shrink and grow, shrink and grow, grow some more, and then eventually invade another blood vessel.

“At the beginning, I was told by my doctors that I was inoperable and incurable, that I probably would not respond to chemotherapy and that no one had survived my advanced stage of the disease. Eventually I was referred to my family physician for palliative care. At that point I realized my local doctors had basically given up, so I decided to think outside the box.”

Tracy’s quest for a surgeon cost every penny of her savings. She flew from hospital to hospital, nationally and internationally, logging over 70,000 air miles in search of someone with the expertise needed to save her life.

Two years after initiating her search, Tracy met Dr. David J. Sugarbaker, Chief of the Division of Thoracic Surgery and Dr. Phillip Devlin, a specialist in Radiation Oncology at Brigham and Women’s Hospital, an affiliate of Harvard Medical School. Dr. Sugarbaker acknowledged that he probably couldn’t remove the entire tumor due to the blood vessel it had encased. Nevertheless, he believed that surgery could potentially save Tracy’s life.

Tracy underwent surgery at Brigham and Women’s in June of 2002. After Dr. Sugarbaker cut away the bulk of the tumor, he performed a state-of-the-art brachytherapy procedure, in which a pouch containing 70 radiation seeds was wrapped around the tumor’s remains. Over the next 60 days, radiation from the seeds attacked the remainder of the tumor, but left the blood vessel unharmed.

Seven days after the operation and customized brachytherapy procedure, Dr. Joseph F. Polak, a Brigham radiologist and Director of the Department of Noninvasive Vascular Imaging, placed a stent inside Tracy’s blood vessel to alleviate compression that was still being caused by the reduced tumor.

“That surgery and the stent enabled me to resume a normal life,” Tracy says, “Two and a half months after surgery, I could play tennis again.”

Images taken of Tracy’s chest in December of 2002 showed no evidence of the tumor, and her lung lesions were destroyed by chemotherapy. All three doctors remain hopeful that no more cancerous cells will be found in her chest.

“If you have a rare cancer or a complex diagnosis, you need to find the highest level of expertise. That’s why I went to Boston,” Tracy explains.

“Without a doubt, my treatment at Brigham and Women’s has lengthened my survival and has improved my quality of survival. I’m thrilled to be doing as well as I am. I’ve also been very impressed with the continued contact I’ve had with my doctors in Boston, and with Dr. Devlin’s willingness to confer – on an ongoing basis – with my local doctors here in Canada regarding continued therapy.”

* The patient’s name and other details have been changed to protect her privacy.