Sydney Barned, MD: Living Nearly a Decade With Stage IV Lung Cancer, Thanks to Precision Medicine

In 2017, almost a year after moving from Jamaica to the United States to begin her medical residency in Washington, DC, Dr. Sydney Barned was focused on her career as a physician. At 33 years old, Sydney was a lifelong athlete who trained in ballet, swam, and ran track, and had never smoked. The last thing on her mind was a diagnosis of cancer.

Sydney’s symptoms began with persistent wheezing during the first few months of residency. She assumed that her symptoms were related to a lingering respiratory problem from walking pneumonia she had earlier in the year. After her pulmonologist ruled out asthma, a chest X-ray revealed an abnormality in her lung. As a physician, Sydney felt something wasn’t right and requested a follow-up CT scan. The scan showed a mass pressing on her airway; additional testing confirmed a diagnosis of non–small cell lung cancer.

“The irony of my diagnosis is that I used to lecture my friends about smoking as a teenager,” Sydney recalled. “I was the one who scolded people about lung cancer, and then I was the one diagnosed with it.” Although smoking remains the leading risk factor for lung cancer, the disease is increasingly being diagnosed in people who have never smoked, particularly in younger women.

Initially, physicians thought that Sydney’s cancer was stage I and potentially curable with surgery. A follow-up procedure revealed cancer in her lymph nodes, upgrading her diagnosis to stage III, and a subsequent biopsy of the lining surrounding her lung confirmed stage IV disease. Molecular testing of her tumor identified an ALK gene rearrangement, a genetic alteration that produces a cancer-driving abnormal protein and could be treated with a molecularly targeted therapy designed to inhibit its activity.

Within months of starting treatment with a first-generation ALK inhibitor, Sydney’s wheezing disappeared. She completed her residency while serving as a chief resident and began working full time as a physician. She married her longtime partner just 2 weeks after her diagnosis. She resumed traveling, exercising, and making time to spend with family and friends. While the first-generation ALK inhibitor, on average, controls the disease for less than a year, Sydney responded very well to the drug and her cancer remained well controlled for more than 5 years.

Sydney underwent routine CT scans every 3 months and brain MRI scans every 6 months to monitor for signs of disease progression. In 2022, the scans detected 3 small brain metastases. Fortunately, years of advances in cancer research had already produced a newer generation of ALK-targeted therapies that could better cross the blood–brain barrier, a protective membrane that keeps most drugs from entering the brain. Sydney started treatment with a second-generation ALK inhibitor, and her 3-month follow-up scan showed her disease had stabilized, and the brain metastases disappeared.

Nearly a decade after her lung cancer diagnosis, Sydney’s disease remains well controlled with ALK-targeted therapy alone. “In more than 9 years of living with stage IV lung cancer, I’ve only taken pills,” Sydney said. “I haven’t needed chemotherapy, radiation, or surgery.”

Today, Sydney is a practicing physician, caring for hospitalized patients, including many with cancer. Sydney has experienced cancer from both sides of the stethoscope. That perspective has shaped how she treats her own patients. She encourages them to speak openly about symptoms and treatment side effects so they can receive the care they need.

Sydney’s experience has also made her a passionate advocate for lung cancer awareness. “Anyone with lungs can get lung cancer,” she said. “I find that most people still are very unaware of that.” Sydney hopes her story will help dispel the misconception that lung cancer is exclusively a disease of people who smoke. “When Iwas diagnosed, I felt like a unicorn,” she added. “I was the youngest person in the room most of the time. Now, unfortunately, that’s not the case.” Sydney would like to see more research into what is driving this shift. “We’re getting more and more non-smokers who are being diagnosed with lung cancer,” she said. “We need research into the other risk factors for lung cancer so we can figure out what to do to slow this down.”

Her message for policymakers is direct. The therapies that transformed her prognosis exist because of decades of investment in research. “I wouldn’t be here if it wasn’t for the research that was done over a decade ago,” Sydney said. “I was diagnosed at 33 and now I’m 43. Lung cancer research has given me more years with my family, my friends, and my patients. Research funding is necessary because it gives people like me the chance to keep living.”