In 2016, Stephanie Peace visited her dermatologist to have some skin lesions examined.

She never dreamed that simple visit would change her life forever, or teach her the meaning of true strength and the importance of being an advocate — not just for others, but for herself as well.

That skin lesion was just the tip of the iceberg. Under the surface, her body was being attacked by cancer, and she was eventually diagnosed with Stage IV lung cancer.

A beloved schoolteacher and mother of three, Peace was shattered but determined to find a way around this disease that threatened to wreck her life and take her away from everything and everyone she loved.

She never smoked. No one in her family had lung cancer. How could this happen to her? Sure, she had some shortness of breath, but she had attributed it to being a little overweight.

A battery of tests revealed spots on her bones and liver, fluid in her lungs and six brain tumors.

She was referred to FCS Fort Myers Cancer Center and medical oncologist Dr. Syed F. Zafar.

“Initially it was a little bit confounding as to what might be going on. We kept pursuing answers and we started unravelling the mystery further and further until we got them,” said Dr. Zafar. “Once we found the source of Stephanie’s problem, we dissected it genetically, and that helped us unravel this mystery and led us to a more effective care plan.”

Zafar explained that FCS did somatic testing on Peace’s cancer, a type of genomic testing of the individual cancer subtypes or alterations that might have developed and caused the cancer.

They found she has very rare rearrangement in her genetics, which led to her being diagnosed with Anaplastic Lymphoma Kinase (ALK) positive lung cancer, a form of non-small cell lung cancer caused by a mutation of the ALK gene. This genetic mutation causes less than 4% of lung cancer diagnoses.

After nearly five years since that initial screening for skin cancer, Peace’s journey still goes on with treatment successes.

Over those same five years, vast improvements have been made in the area of genomic testing. The field has transformed enormously. Since the early 2000s, researchers have discovered more and more genomic alterations, called driver mutations, in lung cancer.

Dr. Zafar describes these as alterations in the genome or the genetic footprint of the cancer that causes the turning on of the switch in the circuitry of the cancer that leads to cancer cell growth and propagation. According to Dr. Zafar, the cancer becomes “addicted” to that gene for its growth, and that leads to survival of the cancer cell.

These genomic alterations are called oncogenes. With time, researchers have identified a number of oncogenes and developed targeted treatment that is very individualized. The goal is to turn off that circuitry so that that cancer cell will essentially die off.

The earlier a patient can be tested, the higher the likelihood of success.

All lung cancer patients should be tested, according to Dr. Zafar, regardless of their history and especially in the early stage. Usually it is the oncologist who would request the specific genomic testing to lead the patient toward the appropriate treatment strategy.

“I think it’s very important for oncological providers and lung cancer patients to understand the genetic makeup of their cancer so it can guide them towards the appropriate and more effective treatment strategy,” he said. “Every treatment is individualized and personalized. So different lung cancer patients may end up receiving completely different treatments. It’s not a one-size-fits-all technique, and the more we learn about the genetic landscape of an individual’s lung cancer, the better treatment can be designed.”

She wants people to know that just because you have never smoked, it does not mean you can’t get lung cancer.

“Anyone with lungs can get lung cancer,” Peace said. “You can get it in your lungs just like you can get it in your breast, just like you can get it in your brain or in your colon. It’s going to attack where your body is the weakest.

She added: “Once it is determined you have lung cancer, it is so important to get genetic testing done and a genetic sequencing, because there are so many different kinds of lung cancer markers.”

Peace also said it is vitally important to have a good team around you, but you have to be your own biggest advocate.

“Dr. Zafar really worked hard at finding answers. He never had a problem with me getting a second opinion. But I still advocate for myself, “Stephanie says. “You have to fight with all you have.”