In a five-part series, the Herald investigates controversies in cancer testing and treatment and reports on the moving stories of people afflicted with cancer. In the third part of the series, Herald health reporter Martin Johnston turns his attention to lung cancer.

Lung cancer patient John Ashton wants to challenge the stigma around the disease, which experts believe contributes to delayed diagnosis.

"The first thing people ask is 'do you smoke'. There's a sense that if you smoke it's your fault and I find that quite offensive," says Dr Ashton, who has never smoked and who is the patient ambassador of the newly formed Lung Foundation of New Zealand.

He suffered a persistent cough which after 10 months and a series of tests led to his diagnosis with lung cancer.

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Now 50, the married father of two boys at first thought he had caught a virus doing the rounds in September 2012 at Otago University, where he is a pharmacology lecturer.

When the cough hadn't gone by the summer, he saw a GP who changed his blood-pressure medication and tried him on asthma inhalers, to little effect. Several months later Dr Ashton, a runner, found he was out of breath and had pains in his arm and chest.

A cardiologist ran tests, including a chest X-ray. It was the abnormal lung nodules shown on that image which led to a CT scan, then a lung tissue sample and a diagnosis of lung cancer in July 2013.

Richard Boughtwood, who has lung cancer, tells of how life is looking more hopeful since he started taking a new medicine on a clinical trial

Two different regimens of chemotherapy followed. Neither produced any improvement.
In late 2013, Dr Ashton saw a Reader's Digest item about clinical trials in Australia. He contacted the researcher, who said that although he was not eligible for the trial, he should consider testing for gene mutations for which new treatments were emerging.

"I had a colleague in Auckland, an oncologist, Mark McKeage ... working on this. He had a small study going testing various [kinds] of lung cancer for different mutations - EGFR and ALK [epidermal growth factor receptor and anaplastic lymphoma kinase] and others. I enrolled in that."

Dr Ashton was positive for the ALK mutation and managed to get on to a drug company's compassionate programme for crizotinib, not then registered in New Zealand.

"Within nine days the coughing had stopped. ... After two months I was jogging for 50 minutes ..." CT scans showed the abnormalities were rapidly resolving.

"There were dozens if not hundreds of nodules. They are gone. It's clear. I'm in remission."

The Series

Yesterday:

Bowel Cancer

Today:

Lung Cancer

Thursday:

Melanoma

Friday:

Prostate Cancer