Veteran shares lung cancer story in hopes of helping others

October 11, 2021
Caroline Perez and her husband
Caroline Perez never imagined her toughest battle wouldn’t be in the military. It was fighting stage 4 terminal lung cancer. Photos provided

Caroline Perez, 66, comes from a family of fighters. The Army veteran grew up in a household with seven siblings where military service ran deep over several generations. The mother of five couldn’t have imagined her toughest battle wouldn’t be in the military. It came after she was diagnosed with stage 4 terminal lung cancer.

“I was a wreck and devastated. It was hard to hear I had terminal cancer. It’s still hard now,” Perez said.

Cancer was nothing new to Perez, despite never having been diagnosed with it herself. She lost one brother from cancer stemming from Agent Orange, another brother from glioblastoma and a third brother from lung cancer. One of her sisters also had lung cancer but survived.  

Caroline Perez with her family. 
Caroline Perez with her family.

Perez grew up in the town of Cross, South Carolina, which boasts a population of just over 4,000 people. She was surrounded by tobacco farms and tobacco use in the rural community, including several family members who smoked. She remembers when she first lit a cigarette at the age of 16 – then again regularly after turning 17. “I had a couple of friends who did it too, and that helped to influence me.”

After graduating high school, Perez shipped off for the Army, following her older sister who she looked up to. For the next eight years, Perez served as a telephone operator in the Army, stationed in Spokane, Washington, and then served abroad in Germany. The Army was where she met her husband of 40 years but also where smoking became more prevalent in her own life.

“It was unusual if you didn’t smoke in the military,” she said. “If you smoked, you got to have smoke breaks. At the height of my smoking, I was going through nearly a pack of cigarettes a day.”

Perez smoked for more than a decade of her life. That all changed, however, when she turned 29 and became pregnant with her first child. “I had an obligation to quit. It was difficult, but I did it, and I never turned back.”

Coming to grips with terminal cancer

Life was good for Perez following her time in the Army. She and her husband had five children, three girls and two boys, and now have 11 grandchildren. Perez enjoyed being a stay-at-home mom, even if it meant money was tight. But life as she knew it forever changed Labor Day weekend in 2016.

“I had been feeling sick for a while. I thought I had a kidney infection and tried to treat it myself,” she said. “Eventually I went to my primary care doctor at the Ralph H. Johnson VA Medical Center. He wanted to do a scan to make sure I didn’t have kidney stones. That’s when they found something that didn’t look right and referred me for more testing.”

Further testing revealed what no one can truly prepare for – Perez was diagnosed with stage 3 non-small cell lung cancer that had already spread to her lymph nodes. She underwent surgery at the at the VA Medical Center, followed by months of chemotherapy and radiation at MUSC Hollings Cancer Center.

“After treatment, I just tried to heal and put my life back together,” Perez said. “Even after treatment, I was still coming in to have scans and blood work done every few weeks.”

During her treatment at Hollings, Perez’s oncologist Carol Sherman, M.D., told her about a clinical trial being offered, testing a drug called Alectinib that showed promising results for some lung cancer patients. However, due to a heart condition called long QT syndrome, Perez was disqualified from participating. 

“I hope my story brings more awareness to cancer and that people need to take their health into their own hands. If people were more aware and knew what to look for, I think more lives could be saved.”
— Caroline Perez

Despite the disappointment, Perez marched on and learned to live life as a cancer survivor. Perez enjoyed quality time with her family and got as involved as possible with her church. As the months turned into years, Perez was hopeful the cancer would remain in remission. However, that all changed again in 2019.

“After my brother died from glioblastoma, I returned to Charleston and saw Dr. Sherman in December of 2019,” Perez said. “I told her about pain that I was having that my primary care doctor thought was just scar tissue. Dr. Sherman wanted to do scans just to be safe.”

Those scans once again revealed what Perez was afraid of – the cancer had returned and now was categorized as stage 4 terminal lung cancer. “My kids are scared because I am their mom. They don’t want to lose me. Sometimes I get scared myself, but I have a lot of faith. I believe in God. I believe what the end is going to be. I’m not walking in this alone. I feel settled and happy.”

Following the diagnosis, Perez was told the drug Alectinib, which was offered in the trial she didn’t qualified for back in 2017, had now been approved. Perez was prescribed Alectinib and took it for the next two years. “It was amazing. It really helped the pain I was having.”

Sherman said this is another example of the importance of clinical trials. She said without that trial, this much-needed option for certain lung cancer patients wouldn’t be available today.

“All of the therapies we offer in oncology come about based on the results of clinical trials,” Sherman said. “Thanks to these trials, patients are able to access new drugs that appear promising and provide additional benefits beyond the standard of care.”

In late 2020, nearly two years after beginning on Alectinib, Perez’s scans showed the cancer was circumventing treatment and growing. She endured months of radiation and chemotherapy again, but despite that, she remained optimistic.

“Every day, I just feel so grateful to have another day. Even on my worst days, when I can’t get out of bed, I feel grateful to be alive. Cancer makes me look at life completely different and appreciate the small things.”

Serving as an inspiration to others

Perez knows all too well the obstacles veterans living in rural areas face. She feels grateful to have Hollings and the VA in Charleston, so close, but knows others don’t have that luxury.

“It is easier for people in rural areas to fall through the cracks and miss screenings and not be aware of warning signs,” she said. “The chances of getting treated is slim to none.”

She hopes her story changes that along with a new project at Hollings being led by pulmonologist Nichole Tanner, M.D., and oncologist and co-investigator John Wrangle, M.D. Thanks to new funding from the Veterans Affairs VA Lung Precision Oncology Program, Hollings is helping to expand access for lung cancer screenings and improve treatments for veterans living in the Southeast.

“Every day, I just feel so grateful to have another day. Even on my worst days, when I can’t get out of bed, I feel grateful to be alive. Cancer makes me look at life completely different and appreciate the small things.”
— Caroline Perez

“While the larger VA medical centers can offer screening and access to medical oncologists and precision oncology trials, there are many veterans serviced by smaller VA medical centers who have not had access to screening,” Tanner said. “We want our veterans to have access to the same cutting-edge thoracic oncology trials and treatments that we have available at our National Cancer Institute-designated cancer center affiliates. This program leverages what we do at Hollings and makes it available to our veterans.”

Perez still is receiving maintenance chemotherapy at Hollings. She doesn’t know how much time she has left, but she is at peace with her diagnosis and content knowing that she can now help others through their cancer journeys.

“I hope my story brings more awareness to cancer and that people need to take their health into their own hands. If people were more aware and knew what to look for, I think more lives could be saved.”

About the Author

Josh Birch
MUSC Hollings Cancer Center

Keywords: Cancer