Facing ‘never-smoker’ lung cancer diagnosis, Bryant Lin curates one-of-a-kind fall medicine course

Aug. 25, 2024, 11:42 p.m.

In March, Stanford clinical professor Bryant Lin began to experience a relentless cough. His symptoms persisted for several weeks, even after initial treatments with prescription inhalers, steroids and antibiotics to treat what he thought was allergies. Eventually, Lin reached out to physician colleagues, who set him up with a chest X-ray in hopes of determining the underlying cause. 

Scans soon displayed a concerning large cloudy mass in his right lung, coupled with abnormal built-up fluid. Further tests found it to be 11-centimeter wide. Lin’s sample lung tissue was extracted for laboratory analysis.

Within a week, a diagnosis arrived: Lin had stage IV lung cancer that had metastasized, or spread, to parts of his bones, liver, skin and brain. 

Lin, the co-founder of Stanford’s Center for Asian Health Research and Education (CARE), dedicated much of his career advocating for research on lung cancer among Asian American non-smokers. Now, he faces the very disease he had long fought to reduce.

Lin openly shares about his cancer prognosis. A long-time physician educator, he plans to launch a course this fall, titled “MED 275: From Diagnosis to Dialogue: A Doctor’s Real-Time Battle With Cancer.” 

MED 275 will be unprecedented, Lin said, offering a personal exploration of the cancer patient experience through the lens of his own fight. Guest speakers from various departments of Stanford Medicine include Natalie Lui (cardiothoracic surgery), Peter Pompei (primary care), Ranak Trivedi (psychiatry) and Heather Wakelee (oncology). 

“I thought that this would be deeply impactful for students to hear a first-person account about a disease that is potentially terminal for me,” Lin said. “We’ll start out by talking about my story, my diagnosis, my symptoms.”

He plans on holding conversations with his primary care doctor to discuss key steps in modern cancer diagnosis. In the weeks after, Lin will cover a range of additional topics, from the epidemiology of “never-smoker” lung cancer, an affliction disproportionately affecting Asians, to targeted therapies, pre-cancer screening procedures, the role of caregivers and the often-overlooked but critical aspects of nutrition and spiritual support — of which Lin says he has been receiving plenty from family, friends and Stanford colleagues.

A headshot of Dr. Bryant Lin
Stanford clinical professor Bryant Lin, the co-founder of Stanford’s Center for Asian Health Research and Education, is launching a one-of-a-kind medicine course centering around his experience as a cancer patient. (Courtesy of Bryant Lin)

Lin’s diagnosis unfolded at an exceptional pace. He received a series of tests, including a chest X-ray, CT scan and a bronchoscopy, all within days.

“I’m very fortunate to be a doctor at Stanford with friends and people who will get me access quickly,” Lin said. “This process could normally take months.”

Most patients undergo a much more arduous and lengthy cancer screening process. Lin said he is acutely aware that his pre-established connections within the Stanford medical community played a large role in the urgent response speed. This disparity in access to timely cancer care presents a significant barrier for many patients, a reality that Lin is eager to address in the upcoming course.

Lui, surgical director for Stanford’s Lung Cancer Screening program, echoed similar comments regarding access to care related to lung cancer detection. Screening has traditionally been centered around heavy smokers, she noted. Even then, a large number of eligible individuals do not end up becoming screened, missing an important step in detecting early growth of the world’s deadliest cancer.

The cause of underperforming screening rates is “multifactorial,” with insufficient outreach to patients being a factor, Lui said. Now, the lines have been blurred with the rise of non-smoking lung cancer patients. 

“With this being the newest recommended cancer screening, there are just some complexities that make it harder to share and implement,” she said. “One of the factors is that primary care physicians are overwhelmed, and it is hard to squeeze in discussions about screening when there are acute problems to deal with.”

As new clinical trials begin for never-smoker groups, Lui hopes screening focus can soon expand to these populations to allow for broader coverage that catch lung cancer before severe symptoms show up.

Wakelee, division chief of Stanford Medical Oncology, worked closely with Lin. She was his oncologist when he learned about his diagnosis, and, prior to March, they planed out CARE’s own Cancer Moonshot project together. The upcoming initiative aimed to direct resources and clinical research toward lung cancer stemming from EGFR mutations, the same type that has impacted Lin and a large proportion of Asians with no past smoking histories. 

“We were already talking about this being a focus [of our community engagement], but Dr. Lin’s unfortunate diagnosis has made it even more personal for the whole CARE team,” Wakelee said. 

A career oncologist, Wakelee acknowledged the immense burden and fear individuals face when deciding whether to openly share one’s diagnosis. She applauded Lin for being public in his health journey, adding that such efforts can help reduce stigma while bringing cultural discussions around cancer to the forefront. 

“Cancer can happen to anybody,” Wakelee said, “and I think Dr. Lin’s actions send such an important message.” 

MED 275, offered on Wednesdays from 12:30-1:20 p.m. at Li Ka Shing Center, will be co-instructed by Stanford medical students Longsha Liu M.D. ’26, Richard Liang M.D.-Ph.D. ’25 and Steven Truong, a third-year M.D-Ph.D. candidate. All three enthusiastically volunteered to be teaching assistants (TAs) for the course after Lin approached them.

“This course will reveal the raw humanity and art of medicine through the unique perspective of someone who is not only an exceptional physician but also an inspiring patient,” Liu wrote to The Daily. “Dr. Lin’s decision to continue practicing medicine, teaching and advancing healthcare despite his diagnosis of stage IV metastatic lung cancer exemplifies unimaginable courage.”

Liang hopes that a series of engaging discussions will foster a storytelling dynamic in which everyone is encouraged to reflect on personalized cancer care and the art of medicine. 

The course is for all students, “even if they are not going into medicine, to see how cancer impacts human beings who are fighting it,” Lin said.

“Cancer care is changing so rapidly now, it’s hard to keep up,” he added. “Now, every month, there’s a new discovery. I think this class will be a nice encapsulation of this.” 

Tom Quach '24 serves as the Academics Desk Editor for Vol. 261 and previously a startups beat reporter for The Daily's SciTech section. Tom also serves as Account Manager for The Daily's Business Team. He's from San Francisco, CA, and enjoys biking, building LEGOs and playing Mario Kart with friends on his spare time. Contact him at tquach 'at' stanforddaily.com.

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