It’s been a bit since I’ve shared a proper update, but like most of you, life has been moving full force. For the first time in 15 years, Josh and I have successfully gotten all four of our kids in school. This fall has been a new and welcome whirlwind for our family. I’m trying to live like the other part of my life {lung cancer} doesn’t need my attention.

Back to school

Mandatory back-to-school photos. Rush started his freshman year of high school. Rhet Thomas is in 6th grade, Ridge is in 4th grade, and our Ryan Kate is in Kindergarten.

Recap

When I was first diagnosed in 2022, surgery for my Stage IV lung cancer wasn’t even an option. Josh and I traveled to Mass General, Dana-Farber, and MD Anderson, and the answer was the same everywhere: no surgery.

Now here we are in 2025, I’m still here (still breathing!), and Dr. Antonoff enters the chat.

It turns out that right here in my own backyard is one of the top thoracic and cardiovascular surgeons in the country, specializing in thoracic oncology. She’s leading the charge in surgery for stage IV lung cancer, especially for patients with oligometastatic disease, people like me who fall into that “maybe, just maybe” category of hope

Please enjoy the video. My MD Anderson oncologist is on B9. Josh clearly isn’t amused. To be fair, he’s heard this before.

On March 21st, I underwent a thoracotomy upper lobectomy, easily the most intense surgery I’ve been through. It was a tough experience, both physically and emotionally, but I felt completely at peace knowing I was in the hands of Dr. Antonoff at MD Anderson.
This surgery wasn’t meant to be a cure; the goal has always been to lessen the disease burden in my body.

The Nurse’s Favorite (Eventually)

It should come as no surprise that I became a nurse favorite; well, maybe not on the very first day. I woke up from surgery with a chest tube, a Foley, and a lot of Dilaudid. I was desperate to change into my jam-jams, but my nurse said no.

This was a clear moment for negotiation. She explained that the foley could come out the next day, and I could wear my own pajamas then. I felt strongly I could do it now. She gave in and called the doctor, and we made a deal: I had two hours to pee or it would go back in. Josh was with me at this point, and we all agreed.

When he stepped out to meet his sister (MD Anderson is pretty big!), I took the opportunity to get up, use the restroom, change into my own clothes, freshen up, and get cozy back in bed.

When my nurse returned, I proudly announced I had “peed!” She wasn’t impressed and conveyed her concern that I got up by myself while still carrying the chest tube; she promptly set the bed alarm.

Josh did not film this; he was on edge, watching my chest tube very closely. It got a yank or two. I tried to explain how long the tube is in my chest and that it would take some effort to remove it, but he took it upon himself to handle the chest tube duty.

The Road to Recovery

Surgery was on a Friday; we were home by Monday. I’d love to say it was smooth sailing from there, but that wasn’t the case. My pain tolerance is high (just ask anyone), but I was truly hurting. Thankfully, within about three weeks, I was almost pain-free. Around that time, my pathology results came back. Dr. Antonoff had removed my entire right upper lobe, along with five lymph nodes near my hilum. We knew I had progressed, but I wasn’t prepared to hear I now had a new mutation.

The original tumor, the one I thought was mostly dead, was still over 20% active and full of millions of cancer cells. Two of the five lymph nodes tested positive. I now carry the EGFR p.L718V mutation, an “acquired” mutation that can develop after treatment with third-generation TKIs, such as Tagrisso, and can lead to resistance. Basically, this mutation prevents osimertinib (Tagrisso) from binding effectively to the EGFR protein.

At the same time, I was facing fatigue and a lack of endurance unlike anything I’d ever experienced. Coupled with the pathology results, my anxiety and depression deepened. I was scared, crying often, and constantly on edge. My mind raced in a hundred directions, and just being around people felt exhausting..

But in these moments, I am still learning to still my mind and let God’s truth drown out the noise of fear and doubt.

No matter how far away I feel, He is always near.

Summer flew by, and I returned to work at the end of June, and like always, work was an instant mood changer. It’s another blessing, my career is something I love deeply. I don’t know of another profession that is as flexible and rewarding. Thank you, God, for allowing me to do what I genuinely love.

With the advice of my medical team, I began infusions of Pemetrexed and Bevacizumab every three weeks, starting in late May. The most recent guidelines recommend platinum-based {Pemertrexed} with or without an EGFR bispecific antibody {Bevacizumab} for patients who have progressed on osimertinib {Tagrisso, oral medication I have been on since July 2022}. To date, I have completed eight rounds. I am grateful to report that I experience very few side effects.

Today

Now we live and wait; we will always be on the lookout for signs of progression. If needed, I may undergo a biopsy to confirm which mutation is driving my cancer and evaluate if I am a candidate for any clinical trials. Currently, trials are testing new drugs against the EGFR p.L718V mutation.

October 28th, I had my routine brain MRI and chest CT scans:

Brain MRI: No new signs of progression. The five small metastatic lesions remain unchanged from July, and they are smaller than in January after Gamma Knife radiation. Thank you, God, for this.
Chest CT: My right upper lobe is still gone, but there is a small 6mm nodule in my left lung. I’ve had this nodule since June (measuring 4mm then). Not every nodule is metastatic. The only way to confirm is through a biopsy, which is very challenging due to its size and location. I will need to have a PET scan in December, or I might wait until after Christmas. Please God, heal my body, let there be no signs of cancer.

Living in the Present

I’m here. I am more of a homebody than I ever imagined, and I am genuinely appreciating this season of life. My oldest is in high school, and my youngest is in kindergarten. When I was first diagnosed, one of my first doctors told me that five years would be “realistic,” and that I should “prioritize” around that. I did a lot of math back then, especially since Ryan Kate was just two.

I remember when we found out we were expecting Ryan Kate, I did a little math then too and realized we would have a freshman & a kindergartner.

Every milestone since then is a checkmark in my mental bucket list: high school, checked; kindergarten, checked. I don’t believe that the doctor’s estimate was accurate. Thanks to advancements in treatment, the outlook for people like me has improved dramatically. As my doctor at MD Anderson said, “Karly, you are technically still on first-line therapy.” We haven’t played all our cards.

I’m trying to soak in every moment. Having four kids is not for the faint of heart. Josh and I juggle a thousand things daily. Most nights, I pray over my children, running each of them through my mind and whispering, “You are so easy to love.” I hope they can feel it.

I also think about Josh, who is proof that good people still exist. He loves me unconditionally and has taken care of me long before cancer arrived.

Thank you, God, for Josh.

My faith can’t bear the weight of my cancer, but God’s faithfulness can.

Most days, I do my best, maybe not every day, but most. I still get pretty fatigued, and my endurance isn’t what it used to be. I try not to make excuses, though sometimes I just want a nap.

During my hour-long commutes to work, I listen to podcasts or audiobooks. Matt Chandler (pastor of the Village Church) is one of my favorites. He’s wrapping up an eight-week series on the Communicable Attributes of God. Recently, he talked about faithfulness:

“Faithfulness is God’s unwavering reliability to be who He says He is and to do what He has promised, regardless of human failure or circumstance.” - Matt Chandler

That was a light bulb moment for me. It’s not my faithfulness that makes Christ trustworthy; it’s God's.

It is God’s faithfulness, not ours, that sustains us.

Savoring The Moment