The Power of Partnership

Advancing breakthroughs in RET-positive lung cancer require collaboration. At The Happy Lungs Project, we support researchers and fund research with the goal of keeping those who are currently living with RET positive non small-cell lung cancer alive, and find dependable treatments for long-term survival.

Below, we highlight the missions of several key nonprofits with which we partner – RETPositive, RET Renegades (program of LUNGevity), LUNGevity, GO2 for Lung Cancer, and Biomarker Collaborative. We also highlight a groundbreaking genetics study with 23andMe that could transform lung cancer care.

RETPositive – Raising Awareness and Driving Research

RETPositive is a community-driven nonprofit organization that supports patients and caregivers affected by RET-positive cancers.

RETpositive aims to improve the quality of life and life expectancy of RET-positive cancer patients by raising awareness, providing community support and advocacy, and funding medical research, including both RET Lung and Thyroid cancers. RETpositive’s commitment to empowering patients through knowledge and resources directly aligns with The Happy Lungs Project’s mission.

 

RET Renegades – A Patient-Led Movement

RET Renegades, supported by LUNGevity Foundation, is a patient-founded initiative that connects those with RET-positive lung cancer to life-changing information and support. By amplifying patient voices and collaborating with researchers, RET Renegades has created a powerful network that fosters hope and innovation. At The Happy Lungs Project, we are inspired by RET Renegades’ grassroots approach to building community and advancing science.

LUNGevity Foundation

LUNGevity Foundation, the nation’s leading lung cancer organization, is transforming what it means to be diagnosed and live with lung cancer. LUNGevity seeks to make an immediate impact on quality of life and survivorship for everyone touched by the disease—while promoting health equity by addressing disparities throughout the care continuum.

• Through research, we use an innovative and holistic approach to finding lung cancer earlier when it is most treatable; advance research into new treatments so people may live longer and better; and ensure a diverse, vital pipeline of investigators for the future of the lung cancer field.
• Through advocacy, we foster groundbreaking collaborations to ensure all people have access to screening, biomarker testing, and treatment breakthroughs.
• Through community, we educate, support, and connect people affected by lung cancer so that they can get the best healthcare and live longer and better lives.

Comprehensive resources include a medically vetted and patient-centric website, Patient Gateways for specific types of lung cancer, a toll-free HELPLine for personalized support, international survivor conferences, and tools to find a clinical trial. All these programs are designed to help us achieve our vision—a world where no one dies of lung cancer.

GO2 for Lung Cancer – A Comprehensive Advocacy Partner

GO2 for Lung Cancer puts people with lung cancer at the center of everything we do. We’re the go-to for one-on-one assistance, supportive connections, treatment information, and finding the best care close to home. We’re the place to go to learn about the latest research and special initiatives that increase survivorship.  We’re the source for improving health policies and leading public awareness to shift this disease from one of stigma to one of hope.

Together, GO2 and The Happy Lungs Project work to ensure that patients with RET-positive lung cancer receive access to cutting-edge care and resources.

Biomarker Collaborative – Expanding Knowledge Through Collaboration

The Biomarker Collaborative is a global, pan-tumor, multi-stakeholder organization under the direction of ICAN, International Cancer Advocacy Network.

The BC strives to encourage all stakeholders in the cancer arena (molecular testing labs, industry partners, academic medical centers, community oncology practices, and healthcare providers) to introduce patients to the most appropriate biomarker-specific patient advocacy organization.  In addition to matching incoming patients with the most relevant patient organizations, the BC educates patients and care partners about molecular profiling/comprehensive biomarker testing and leads discussions on potential collaborative research projects. Happy Lungs’ partnership ensures that RET-positive lung cancer research is a focal point in broader biomarker initiatives.

Groundbreaking Collaboration with 23andMe

As we advance the fight against lung cancer, genetics plays an important role in understanding the disease. The Happy Lungs Project, in collaboration with Troper Wojcicki Philanthropies and 23andMe, a leading genetic health and biopharmaceutical company, and 20 lung cancer advocacy organizations, recently announced a groundbreaking study: the Lung Cancer Genetics Study.

The focus of the Lung Cancer Genetics Study is to better understand the genetics of people with lung cancer in order to improve detection, risk reduction, and care. While recent developments in tumor genetic testing and targeted therapies have provided hope and years of survival to many lung cancer patients, lung cancer remains the number one cause of cancer deaths in both men and women in the United States. Yet, much remains unknown about the disease and its causes. The de-identified data from the study will be made available to approved researchers, and access to the scientific database will be available to nonprofit researchers and institutions at no cost.

Together, We Create Change

Collaboration is at the heart of progress in the fight against RET-positive lung cancer. Each of our partners brings unique strengths and perspectives that contribute to advancing research, funding, and patient care. At The Happy Lungs Project, we remain dedicated to improving outcomes for RET-positive lung cancer patients. Together with our valued partners, we are creating a future where hope is within reach for everyone facing lung cancer.

Hi Friend –

I am sorry you are faced with this diagnosis! I know first-hand, it stinks! But, I hope the following information brings a little hope or help to you.

First off, remember that your journey is yours alone, so try not to take on anyone else’s story. I try really to avoid and ignore statistics. When I was diagnosed, my youngest daughter was only seven years old, and I was told I had a 25% chance of being alive in five years…and here I am today, very alive and very healthy and it’s been over five years! Miracles happen!

Every cancer case is different based on many known and unknown factors about your physical and mental make-up. People surprise the doctors all the time! Today, you are alive, and once you wrap your head around all of this, you will fight it and hopefully even find some “good” in ways you probably can’t even imagine right now. I definitely appreciate the moments, the people, and the experiences in my life in a way that I never did before. Of course, I also struggle at times with feeling sad, angry, alone and reactive, so give yourself grace. This is hard!

But there is hope, and there are things you can do to help yourself. Below is a list of things that have given me hope, and some sense of control, as I’ve navigated my own cancer journey. I hope they do the same for you.

Also, always check with your insurance; they sometimes surprise me by covering wigs and some integrative treatments (sometimes with a prescription that you can ask for from your oncologist). Also, if you are going to a cancer center, check to see if they have an integrative care center that offers many of the support services below.

Feel free to contact me at info@happylungsproject.org. I’m happy to help.

With love and light,

Ilana

I think about my kids and my husband a lot when I say this. Just trying to trust the universe that no matter what happens, all shall be well.

Managing Physical Symptoms

Pain Management

Managing cancer pain is a critical aspect of improving the quality of life for RET-positive cancer patients. Proper pain control can significantly enhance daily functioning and overall well-being, leading to greater overall enjoyment of life. Taking a regular “life assessment” can help tailor pain management strategies to your evolving needs, ensuring that the approach remains effective and responsive.

Options for managing cancer pain include medications, such as analgesics and opioids, which should be used under the guidance of a healthcare professional. Non-pharmacological methods like physical therapy, acupuncture, and relaxation techniques can also be beneficial. It’s essential to tailor pain management strategies to each patient’s needs and preferences to ensure optimal relief, allowing patients to experience fewer side effects from their cancer treatments.

Fatigue and Energy Levels

Fatigue is a common symptom among cancer patients, including those with RET-positive cancer type. It can impact daily activities and overall quality of life. This disease can often lead to decreased overall enjoyment of daily activities.

Combating fatigue involves a combination of rest, a balanced diet, and regular exercise. Ensuring adequate rest and sleep is crucial for energy restoration. A diet rich in nutrients and low in processed foods can help maintain energy levels. Gentle exercises, like walking or yoga, can improve stamina and reduce fatigue over time. These strategies can significantly affect a patient’s ability to maintain a more active life.

Respiratory Issues

Respiratory issues can be a concern for many RET-positive cancer patients, especially those with lung involvement. Managing breathing difficulties is essential for maintaining a good quality of life.

Breathing exercises, such as diaphragmatic breathing, can help improve lung function and reduce shortness of breath. Oxygen therapy may be recommended for patients experiencing significant respiratory distress. Consulting with a respiratory therapist can provide tailored strategies to manage these symptoms effectively, which can improve the patient’s life.

References and Resources

1. 1. https://www.cancer.org/research/acs-research-highlights/lung-cancer-research-highlights/improving-quality-of-life-for-lung-cancer-survivors.html
   2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171319/
   3. https://www.fightcancer.org/what-we-do/patient-quality-life

Your donation matters. Please make a gift today to support lung cancer research and save lives.

Some Facts About RET Fusion Positive NSCLC

RET-positive non-small cell lung cancer is caused by an abnormal re-arrangement or fusion of the RET gene, which codes for a tyrosine protein kinase cell membrane receptor. This alteration leads to abnormal activation of the cell membrane receptor, basically resulting in the “on-off” switch getting stuck in the “on” position and causing tumor growth.

RET gene fusions occur most commonly in lung cancer (non-small cell lung cancer), but other RET alterations like RET mutations are also common in inherited and sporadic medullary thyroid cancer, and can occur in other types of cancers like ovarian, breast, pancreatic, and colorectal cancers, among others.

RET lung cancer accounts for approximately 37,500 lung cancer cases worldwide and 4,000 cases in the U.S.

RET rearranged lung cancers are more frequent in lung cancers, and they occur when the RET gene joins another gene and creates a fusion that leads to uncontrolled cell growth and cancer. There are different types of RET rearrangements, and investigators are currently studying the characteristics of each one in cancer development and treatment.

The most common RET fusion gene partner is KIF5B, and the second most common is CCDC6.

One of the research projects that has been funded by Happy Lungs Project, led by Dr. John Heymach, is focused on the study of the variations in RET fusion partners and how these RET fusions may impact the sensitivity of these tumors to RET inhibition by RET targeted therapies. Establishing a comprehensive landscape of RET fusions and mutations in lung cancer that are associated with selective RET inhibitor resistance will allow clinicians to better determine effective and personalized therapeutic approaches.

Why do non-smokers get lung cancer?
Dr. John Heymach, M.D. Anderson Cancer Center

RET Lung Cancer and Non-Smokers

Some studies have shown that RET rearranged lung cancer patients had more poorly differentiated tumors and tend to be young female patients (≤ 60 years). There is also reported a higher frequency of female non-smokers harboring RET fusions.

In the publication by Wang et al. (1) the investigators showed that RET fusion non-small cell lung cancer patients presented more poorly differentiated adenocarcinoma lung cancer, meaning that the cancer cells looked abnormal and not arranged in the usual way under a microscope when compared to healthy normal cells.

They examined 936 RET fusion non-small cell lung cancer patients and showed that there is a tendency of these RET lung cancer patients to be younger (≤ 60 years; 72.7% of the patients in the study), never-smokers (81.8%) and to have smaller tumors (≤3 cm).

In 2020, Qiu et al. (2) reported that RET non-small cell lung cancer patients have unique genetic characteristics and poor prognosis are found in female patients with lung cancer harboring RET non-small cell lung cancer. As other studies have shown, they reported that RET lung cancer is more frequently found in women.

In a study by Feng et al. (3) involving 167 RET non-small cell lung cancer patients, authors found that RET rearrangement was common in females (65.1%) and never smokers (82.2%).

Genetic and Environmental Risk Factors Contributing to the Development of Lung Cancer in Non-Smokers

According to the American Cancer Society, in the U.S. 20 percent of lung cancers occur in people who never smoked or smoked fewer than 100 cigarettes in their lifetime. Lung adenocarcinoma is the most common lung cancer diagnosed in non-smokers.

Investigators are currently studying the risk factors of lung cancer in non- or never-smokers, but it seems that the cause may be a combination of factors rather than a single cause.

One of the main factors can be a genetic alteration in the tumor, also known as a “somatic” mutation or alteration (meaning, mutations that may occur in a cell that are not inherited,) that drives the development of cancer. Besides RET rearrangements, EGFR, ALK, and ROS1 somatic alterations have been more frequently found in non-smoker lung cancer patients. If any of these somatic alterations are found, then treatment with a targeted therapy – rather than chemotherapy – is preferred.

A large epidemiologic study by Zhang et al.(4) characterized lung cancer in people with no history of smoking. The study found that a majority of these lung cancer tumors arise from the accumulation of mutations caused by natural processes that happen inside the body. They also described different subtypes of lung cancer in non-smokers that could potentially have different approaches for treatment.

Besides the genetic factors, there are other environmental factors that can increase lung cancer risk, such as exposure to secondhand tobacco smoke, exposure to radon gas, or air pollution. Repeated exposure to carcinogens such as asbestos or heavy metals can also increase the risk of developing lung cancer.

Treatment of Lung Cancer in Non-Smokers

Lung cancers in non-smoker patients frequently present a somatic alteration such as RET, EGFR, ALK or ROS1. A somatic alteration is a genetic mutation that occurs in a cell after conception, driving disease like cancer without being inherited or passed to offspring. If any of these somatic alterations are found, the treatment with a targeted therapy (specific tyrosine kinase inhibitors rather than chemotherapy) is preferred for lung cancers. For the treatment of RET-positive advanced lung cancer, selective RET inhibitors are the preferred first-line treatment option.

Immunotherapy, which involves the use of the immune system cells to fight cancer, has revolutionized lung cancer treatment – but some clinical studies have shown that the treatment tends to work better in smokers than in non-smokers (5). Some explanations of this are that non-smoker tumors present lower immunogenicity, with lower tumor mutation burden and low PD-L1 expression (a molecule that acts as a “brake” to keep the body’s immune responses and is the target of some immune checkpoint inhibitors). If the tumor has low PD-L1 expression, then immunotherapy is not likely to help.

In conclusion, RET-positive lung cancer stands out with its distinct characteristics, particularly in non-smokers, younger patients and women. Understanding these unique genetic markers not only sheds light on the causes of this disease but also paves the way for more effective, personalized treatments.

As research continues to evolve, there’s growing hope for targeted therapies that can improve outcomes and enhance the quality of life for those affected by RET-positive lung cancer. For patients and their loved ones, staying informed about these advancements is crucial in navigating the journey with this complex disease.

For current RET-positive lung cancer patients seeking cutting-edge treatments, exploring ongoing clinical trials could offer new opportunities for personalized care. Learn more and find a match here.

Newly diagnosed with RET-positive cancer? You might also be interested in Steps to take after a RET-positive lung cancer diagnosis.

RET Cancer Links and References

1. Wang R, Hu H, Pan Y, et al. RET fusions define a unique molecular and clinicopathologic subtype of non-small-cell lung cancer. J Clin Oncol. 2012;30(35):4352-4359. doi:10.1200/JCO.2012.44.1477
2. Qiu Z, Ye B, Wang K, Zhou P, Zhao S, Li W, Tian P. Unique Genetic Characteristics and Clinical Prognosis of Female Patients with Lung Cancer Harboring RET Fusion Gene. Sci Rep. 2020 Jun 25;10(1):10387. doi: 10.1038/s41598-020-66883-0. PMID: 32587276; PMCID: PMC7316706.
3. Feng J, Li Y, Wei B, Guo L, Li W, Xia Q, Zhao C, Zheng J, Zhao J, Sun R, Guo Y, Brcic L, Hakozaki T, Ying J, Ma J. Clinicopathologic characteristics and diagnostic methods of RET rearrangement in Chinese non-small cell lung cancer patients. Transl Lung Cancer Res. 2022 Apr;11(4):617-631. doi: 10.21037/tlcr-22-202. PMID: 35529790; PMCID: PMC9073740.
4. Zhang T, Joubert P, Ansari-Pour N, et al. Genomic and evolutionary classification of lung cancer in never smokers. Nat Genet. 2021;53(9):1348-1359. doi:10.1038/s41588-021-00920-0
5. de Alencar VTL, Figueiredo AB, Corassa M, Gollob KJ, Cordeiro de Lima VC. Lung cancer in never smokers: Tumor immunology and challenges for immunotherapy. Front Immunol. 2022 Aug 24;13:984349. doi: 10.3389/fimmu.2022.984349. PMID: 36091058; PMCID: PMC9448988.
6. CDC.gov
7. https://www.yalemedicine.org/conditions/lung-cancer-in-nonsmokers
8. https://www.cancer.org/cancer/latest-news/why-lung-cancer-strikes-nonsmokers.html
9. https://www.cancer.gov/news-events/press-releases/2021/lung-cancer-never-smokers

Benefits of Oncology Acupuncture

Incorporating oncology acupuncture into cancer treatment plans represents a promising frontier in supportive care. Backed by evidence-based research, acupuncture offers tangible benefits in pain relief, symptom management, and emotional well-being for cancer patients. As the medical community continues to explore complementary therapies, acupuncture stands out for its potential to enhance overall quality of life during and after cancer treatment.

For those navigating the challenges of cancer and cancer pain, acupuncture not only offers relief but also embodies the ancient belief that healing is a journey of restoring balance – a journey where every small improvement in well-being matters deeply.

Benefits of acupuncture for cancer can include:

1. Pain Management:

One of the most significant challenges for cancer patients is managing chronic pain, whether it stems from the disease itself or treatments like chemotherapy, radiation, immunotherapy, and surgery. Multiple studies have shown that acupuncture can effectively reduce cancer pain intensity and improve pain control. For instance, a systematic review published in the Journal of Clinical Oncology highlighted acupuncture’s role in alleviating cancer-related pain and improving patients’ overall well-being.

2. Nausea and Vomiting:

Chemotherapy-induced nausea and vomiting (CINV) are common and debilitating side effects that can severely impact a patient’s quality of life. Research, including a meta-analysis in Supportive Care in Cancer, indicates that acupuncture significantly reduces both the frequency and severity of CINV when used alongside standard anti-nausea medications.

3. Fatigue:

Cancer-related fatigue is pervasive and can persist long after treatment ends. Oncology acupuncture can support fatigue through multiple angles; sleep improvement, mental clarity, and stress are all factors leading to fatigue and can be supported by acupuncture.

4. Anxiety and Depression:

The emotional toll on cancer patients can feel profound and all-encompassing at times, with many patients experiencing heightened levels of anxiety and depression. Acupuncture treatment has been shown to have anti-anxiety and antidepressant effects by promoting relaxation and releasing endorphins.

5. Improved Sleep:

Ensuring patient have quality sleep is incredibly important during and after treatment to allow the body to heal. Oncology acupuncturists often ask the following questions regarding sleep: How many hours of sleep do you get each night? Do you have difficulty falling asleep or staying asleep? Do you wake up rested? Do you wake up due to night sweats?

All of these questions establish a differentiation to help formulate a treatment plan. It is often a goal to finish daily tasks without feeling fatigued. Acupuncture can support not only insomnia but also improved quality of sleep

6. Boosting Immune Function:

Acupuncture can support the body’s immune system by not only stimulating the body’s immune response but also regulate the body’s stress response and calm inflammation in the body. From a Traditional Chinese medicine perspective, acupuncturists often say “everything is connected”. If sleep is improved, stress is able to decrease, digestive health improves for increased nutrient absorption, we will see immune function increase.

7. Supporting Digestive Health:

Common side effects from cancer treatment or secondary medications from cancer treatment negatively affect the digestive system. Constipation, diarrhea, acid reflux, bloating and hemorrhoids are all common complaints acupuncturists regularly hear. Through acupuncture, education on acupressure points patients can do at home, along with food therapy recommendations, many symptoms can be managed.

It is recommended to communicate with your oncology acupuncturist to develop a treatment plan that coordinates with your cancer treatment. Staying ahead of symptoms with acupuncture and ancillary care not only improves quality of life but can encourage patients to continue their cancer treatment.

Understanding Oncology Acupuncture

Acupuncture, a practice originating from Traditional Chinese Medicine, involves inserting fine needles into specific points on the body to stimulate the nervous system. It can be a valuable tool to manage cancer-related symptoms like pain relief and treatment side effects. In the United States, there is significant research growing in the field of integrative oncology and acupuncture. It is not only complementary medicine, offered in private acupuncture clinics but also integrative medicine, practiced in hospitals, rehab clinics and cancer centers.

The Society of Integrative Oncology defines integrative oncology as “a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and lifestyle modifications from different traditions alongside conventional cancer treatments.” Some of these therapies include acupuncture, physical therapy, massage, nutrition, talk therapy, esthetics, and movement therapy. All integrative oncology practitioners have advanced education in their field in oncology, and they work in collaboration to ensure the patient receives comprehensive care.

Oncology acupuncturists work alongside oncologists and other oncology-focused practitioners. Their role is to support patients with any concerns or side effects (like chronic pain) that may affect the mind and body while working in a collaborative effort alongside the oncology team.

Oncology acupuncture uses evidence-based research, a practitioner’s clinical experience and the patient’s personal concerns and values to formulate an individual treatment plan. Those who would benefit from an advanced trained acupuncturist are either going through cancer treatments or have gone through cancer treatment and are seeking support in treating side effects.

 

Acupuncture Treatment: What to Expect

During the initial session, the acupuncturist will visit with the patient to learn a complete medical history. Patients will then receive an acupuncture treatment as well as a treatment plan that may include food therapy recommendations, mind-body and meditation suggestions along with movement/lifestyle modifications. Similar to physical therapy, many concerns require a series of sessions to see improvement. 

Do’s and Don’ts of Acupuncture for Cancer Care

While acupuncture is incredibly safe when performed by a licensed acupuncturist, there are some contraindications that must be considered during and after cancer treatment.

1. If lymph nodes have been removed or damaged due to treatment, it is imperative this is communicated to your acupuncturist. If you are at risk or have been diagnosed with lymphedema, your acupuncturist will want to know this so they can modify treatment. Do not receive a style of acupuncture called “dry needling” or “trigger point acupuncture” in the quadrant of which lymph nodes have been removed or damaged.

2. Communicate with your oncology acupuncturist if you have a low platelet count.
3. Although risk of infection is incredibly low, if your white blood cell count is low and/or you are experiencing acute leukopenia, consult with your acupuncturist prior to your appointment to ensure it is safe to receive treatment.
4. Ensure you eat prior to receiving acupuncture. Acupuncture treatment can lower blood pressure due to its relaxation effects. If a patient is fasting, there is a greater chance of experiencing low blood pressure.

Find an Oncology Acupuncturist Near You

There are many licensed acupuncturists in the United States and around the world. Consider the following tips to ensure patients and caregivers find an acupuncturist that has advanced oncology training.

1. The Society for Integrative Oncology has a database search engine to help find any of their members in a city near you.
2. Be certain the acupuncturist you go to is a licensed acupuncturist and practices under their state’s medical board.
3. Ask the acupuncturist if they have completed advanced training in cancer care.

If you or someone you know is considering acupuncture as part of cancer care, consult with healthcare providers experienced in integrative oncology to ensure safe and effective treatment tailored to individual needs.

 

Guest Author Bio

Mari Galle, DACM, LAc

Mari Galle, DACM, LAc is the oncology acupuncturist and Director of Integrative Medicine at Cancer Rehab & Integrative Medicine. She is the co-founder and Executive Director of Moving Beyond Cancer Collaborative, 501(c)3 nonprofit. Mari has advanced oncology training from Memorial Sloan Kettering Fundamentals of Oncology Acupuncture. Mari holds a Doctorate of Acupuncture and Chinese Medicine from the Pacific College of Oriental Medicine where she focused on oncology acupuncture. She has worked with the oncology population for a decade and understands personally and professionally the need for comprehensive cancer care. Mari incorporates her background in the sciences combined with Traditional Chinese Medicine and training as an oncology specialized patient navigator to provide care to her patients. She uses acupuncture, food therapy, lifestyle recommendations, and relaxation techniques like meditation and Qigong to aid in healing. A member of the Society for Integrative Oncology and the Society of Acupuncture Research, she enjoys collaborating with other integrative oncology practitioners. Mari is based in Austin, Texas.

mari@mbccollaborative.org

References

JAMA Oncol. 2020;6(2):271-278. doi:10.1001/jamaoncol.2019.5233

Here is a list of important questions to ask your doctor if you have RET lung cancer. Getting accurate information, and sometimes a second opinion, can give you a better understanding of your specific lung cancer and the best treatment plan for you.

Understanding my Diagnosis

1. How will having RET-positive lung cancer affect my body?
2. What does it mean to have a RET gene mutation?
3. How does RET-positive lung cancer differ from other types of lung cancer?
4. Can my other medical conditions interfere with RET lung cancer?

Treatment Options

1. What are my options for treating my RET lung cancer?
2. What is targeted therapy, and how does it work for RET-positive lung cancer?
3. Is radiation therapy right for me? How will this treatment affect my quality of life?
4. Is a clinical trial right for me? Are there any clinical trials available for me?
5. Is surgery an option for me? If so, what does it involve?

Managing Side Effects

1. What side effects can I expect from treatment?
2. How can I manage these side effects?
3. Are there support services available for addressing my side effects?

Prognosis and Expectations

1. How effective is my treatment protocol for my type and stage of cancer?
2. What is my prognosis given my current treatment protocol?
3. How might my prognosis change with new treatments or clinical trials?
4. What factors can influence my prognosis?

Lifestyle and Support

1. How will my diagnosis affect my day-to-day life?
2. What lifestyle changes should I consider?
3. Where can I find support groups?
4. I am a smoker. Should I quit smoking?

Long-term Outlook and Follow-up

1. What is my prognosis in the long-term?
2. What follow-up care will I need?
3. What are signs of recurrence I should watch for?

Financial Support

1. Can I get financial assistance with medical bills?
2. Is financial assistance available for the non-medical costs associated with my treatment, such as transportation, lodging, and home care?

Additional Considerations

1. What other specialists should I see, like a nutritionist, physical therapist, or others?
2. Are there any alternative or complementary therapies and/or treatment options that might help?

Asking questions is critical when dealing with a RET-positive lung cancer diagnosis. Always reach out to your healthcare provider and your care team with any concerns, and remember that support is available. Being proactive and staying informed can make a significant difference in your cancer journey after a lung cancer diagnosis.