Second of two articles

As a lung cancer patient, Ann Dudurich is both typical and rare.

The 49-year-old Unity woman never smoked, and that puts her in the fastest growing group of lung cancer patients in the nation. About 15 percent of people with lung cancer have never used tobacco, and women make up two-thirds of that group.

But as someone who is responding to a new pill called Tarceva, and is still alive 18 months after being diagnosed with the most advanced stage of cancer, she is highly unusual.

When she was first interviewed late last year, Ms. Dudurich had just finished reading "The Last Lecture," the inspirational book by Carnegie Mellon University professor Randy Pausch, who had died a few months earlier of pancreatic cancer.

His advice about being grateful for the gifts of life he had already received resonated deeply with her.

"I'm not bitter at all," she said. "His philosophy in that book are words to live by. You just appreciate what you've got."

A longtime asthma sufferer, Ms. Dudurich was used to getting periodic CT scans of her lungs. In March 2006, she was hit with a painful lung inflammation known as pleurisy, and got a lung scan for that.

That's when her lung specialist noticed a tiny spot on her lower left lung.

"I don't think it's cancer," he told her, "but it's got to come out."

The laparoscopic surgery removed a tiny section of her lung, and the surgeon said right afterward that the biopsy looked clean. But a couple of weeks later, the verdict changed.

She had lung cancer.

"I was really upset, really upset. But they thought since I was young and healthy and a nonsmoker that they were going to be aggressive and go for the cure."

That meant surgery, radiation and chemotherapy.

Her tumor was only a half-inch across. But Dr. Joel Greenberger, a cancer specialist at the University of Pittsburgh Cancer Institute, said that even when doctors find tumors tinier than that, current scanning technology can miss 100 million cancer cells that are still in the patient's body.

In June 2006, doctors removed the lower left lobe of Ms. Dudurich's lung. She then began once-a-week treatments with two chemotherapy drugs, and five-day-a-week radiation treatments.

Her body handled the treatments pretty well, but that wasn't the only challenge she was facing.

When Ms. Dudurich got her diagnosis, she was caring for her mother, who had congestive heart failure. She told her mother that she was getting treatment, but never uttered the word cancer.

As she went through her treatment, her mother steadily weakened, and as it turned out, her last day of radiation was scheduled on the day of her mother's funeral.

"I wanted to skip that day," she said, "but they didn't want me to miss a single treatment. They said, 'Come in early so you can be at your mother's funeral.' "

After her surgery, Ms. Dudurich had gone on disability from her job as a health reporter for the Greensburg Tribune-Review. The newspaper allowed her husband, Mike, who was a sportswriter there, to work from home before he took a buyout, and he became her chauffeur, cook and caretaker.

As she came to grips with her new life, she learned some valuable lessons.

"People at work I thought would call didn't, and people I didn't expect to did." she said. "You find out who the long-haul people are."

Still an exercise buff, she walked to and from her radiation treatments near her home.

"When you first go to radiation, you're sitting in a roomful of strangers, and then by the end of radiation you know everybody's story. Those people become your family because they know what you're going through."

Once her initial radiation regimen ended, she got a few weeks off and then went through additional, grueling chemotherapy sessions. Her salvation, she said, was an anti-nausea pill called Emend: "Best pill on the planet; I never even got a hint of nausea."

She did lose her hair, though, and took to wearing ski caps because she disliked wigs.

By January 2007, she was in remission, although she would face regular scans.

"I mean really, I'm going to go from scan to scan for the rest of my life."

Then came New Year's Eve of that year. In the middle of planning for a party, her radiation specialist called and gave her the bad news: there were suspicious spots on her left shoulder blade, some spinal bones and her right collarbone.

It meant more radiation, and worse, she was told in January 2008, she had stage 4 cancer, the most advanced level.

Her radiation specialist isn't unkind, she said, but "he pretty much comes out and tells you what you need to know. He doesn't soft-soap it.

"He said people in stage 4 in your condition live six months, maybe a year. If you're really lucky, maybe two years. When I started to cry, he got upset. It was just tough."

After her next round of radiation, her doctors wanted her to get chemo again, but she sought a second opinion at Pitt's cancer institute, and that was what led her to Tarceva.

Rather than being a general poison, as most chemotherapy is, Tarceva takes aim at a specific growth factor receptor that some patients have on their cancer cells.

She believes it has extended her life. The company that makes the drug even flew her to Florida in February to give a pep talk to sales representatives, who gave her a standing ovation.

But she is not unrealistic about her future. Tarceva officials told her they don't have that many other spokespeople, because earlier patient advocates "either had relapses and had to go back on to other treatments, or they died."

Her latest results show some small remaining bone spots and suspicious activity in some lymph nodes, but she is holding her own.

Last year, Ann Dudurich rode a tandem bicycle with one of her doctors on a 26-mile route in Westmoreland County for an event called "Ann's Ride," which raised about $8,000 for the American Cancer Society.

She is hoping to repeat the event this September.

"People ask me, 'Do you wake up every day thinking this is the day I'm going to get my cancer back?' and no, I never do. But you do learn how to live in the moment and enjoy every day you have and everyone you have.

"I know it really sounds corny, but it's true."