Is it Just a Cough? What Barry Manilow's Early-Stage Lung Cancer Diagnosis Can Teach Us

As Barry Manilow's recent lung cancer diagnosis reminded us, a persistent cough, chest pain, shortness of breath may be more than just annoying symptoms. In this episode, we explain the signs you shouldn’t ignore, what testing and treatment may look like, and how hope is still part of the story.  https://bit.ly/4szFIia

In this Episode:

• 02:21 - Tips for Longevity from People in their 90's - Naomi Rose & Physical Fitness
• 04:48 - Avocado Salsa: Marriage of Guacamole and Pico de Gallo
• 05:47 - Barry Manilow's Lung Cancer Diagnosis
• 07:05 - Review of Lung Anatomy, Lung Cancer Overview, Differences between NSCLC and SCLC 
• 09:32 - What Increases Our Risk of Lung Cancer?
• 10:35 - Lung Cancer Signs and Symptoms to Watch For
• 12:49 - Treatment of Lung Cancer - Reasons for Hope
• 15:46 - Cancer Survivorship: How to Lower Your Risk of Cancer Returning and Signs not to Ignore
• 18:57 - Discussion with Charlie: Historical Smoking, Persistent Cough
• 24:04 - 27 y.o. Alexa Bekkerus Self-Written Obituary - How She Found Peace Dying with Metastatic Breast Cancer
• 29:21 - Outro

Chapters

• 0:00 Intro
• 2:21 Tips for Longevity from People in their 90’s – Naomi Rose & Physical Fitness
• 5:47 Barry Manilow’s Lung Cancer Diagnosis
• 7:05 Review of Lung Anatomy, Lung Cancer Overview, Differences between NSCLC and SCLC
• 9:32 What Increases Our Risk of Lung Cancer?
• 10:35 Lung Cancer Signs and Symptoms to Watch For
• 12:49 Treatment of Lung Cancer – Reasons for Hope
• 15:46 Cancer Survivorship: How to Lower Your Risk of Cancer Returning and Signs not to Ignore
• 18:57 Discussion with Charlie: Historical Smoking, Persistent Cough
• 24:04 27 y.o. Alexa Bekkerus Self-Written Obituary – How She Found Peace Dying with Metastatic Breast Cancer
• 29:21 Outro

Transcript

Hello and welcome to Everyone Dies. This week's discussion is about lung cancer, something people may worry about but many don't really fully understand. We're going to break it down in a clear, simple way.

What the lungs do, who's most at risk, the warning signs that you shouldn't ignore, and what treatment can look like. We'll also talk about what life after treatment can feel like and why there's still room for hope and support along the way. Whether this topic touches your life personally or you're here to learn, we're glad you're with us.

So relax and settle in for our podcast about serious illness, dying, death, and bereavement. Because even though everyone dies, no one has to face it unprepared. I'm Marianne Matzo, a nurse practitioner, and I use my experience from working as a nurse for 47 years to help answer your questions about what happens at the end of life.

And I'm Charlie Navarette, an actor in New York City, and here to offer an every-person viewpoint to our podcast. We're both here because we believe that the more you know, the better prepared you are to make difficult decisions in a crisis. Remember that this podcast does not provide medical nor legal advice.

Please listen to the complete disclosure at the end of the recording. In the first half, Charlie continues his series about advice from 90-year-olds on longevity and living well in our Recipe of the Week. In the second half, we continue our series about everything you've always wanted to know about cancer but didn't have anyone to ask with a discussion about lung cancer.

And in the third half, Charlie has an obituary written by a 28-year-old, Alexa Barekas, who died in March from metastatic breast cancer. Hi, Charlie. Hello, Marianne.

You got a cold? I don't think it's a cold, though I am coughing. Uh-oh. What might that mean? Well, you'll have to listen to the second half.

Oh. Yeah. And since the discussion today is about lung cancer, hopefully nothing along those lines.

Exactly. Yes. Yes.

So, in our first half, Susan Fitzgerald profiled people in their 90s and published their tips for longevity and living well. Since I'm quickly heading toward my 90s, I'm looking to make improvements in my health. We continue this week with Naomi Rose, age 89, whose defining characteristic is physical fitness.

Naomi Rose was not happy when she moved into an independent living community in Princeton, New Jersey, with her husband more than 10 years ago. She loved her old home and her friends nearby and kept an active schedule, but it was becoming hard for her husband to get around the two-story house. She now says moving was a good decision.

Quote, I have a lot of friends here my age who are entertaining and fun to be with, says Rose, whose husband died in 2013. It's much easier to stay social in a community like this one. I always have plans.

They often include some form of exercise, such as a brisk walk every morning and regular games of pickleball. She only recently gave up tennis because, quote, I couldn't get to the ball anymore, she says. I'm lucky because I'm in pretty good shape, she adds.

If I couldn't walk, that would really cramp my style. Rose still drives so she can attend the theater and concerts. She also plays bridge and gets together with friends often.

Although she enjoys a glass of wine with dinner, she watches what she eats, avoids sweets, and pays attention to the scale. If her weight goes up, she moderates her food intake until it comes down again. Rose's only major medical problem has been atherosclerosis, which means narrowed heart arteries.

She had two stents inserted in her heart several years ago. She has a retired math and computer science professor and says she was always good with details. Quote, I never kept a calendar.

I used to be able to remember everything, she says. Now I write everything down. Rose, who turns 90 in June, doesn't dwell on age-related changes that she is experiencing.

I have been lucky, that's all I can say. Our funeral lunch dip, in honor of Naomi Rose's healthy lifestyle, is avocado salsa, which is a mix between guacamole and chunky pico de gallo. This dip makes an amazing salsa all on its own, scooped up with some tortilla chips for a great dip.

Bon appetit! Please go to our webpage for this week's recipe of avocado salsa and additional resources for this program. This is the part where we ask for your financial support. Your tax-deductible gift will go directly to supporting our non-profit journalism so that we can remain accessible to everyone.

You can donate at www.everyonedies.org, that's every, the number one, dies, or at our site on Patreon, under Everyone Dies. Marianne? Thanks Charlie. Barry Manilow, age 82, announced on December 22nd that he'd been diagnosed with lung cancer.

He said that he had six weeks of bronchitis, followed by a relapse where he was sick for another five weeks. His doctor ordered an MRI and a cancerous lesion was found on his left lung. In his press release, he said his doctors don't believe the cancer has spread, and at that point, surgery was the only treatment planned.

Manilow started smoking at age 9, getting up to three packs a day of non-filtered cigarettes. He quit smoking at age 39, started again, and eventually started vaping nicotine. In 2020, he was diagnosed and treated for throat cancer and has a history of bronchial pneumonia, vocal cord disorder, heart problems, and hip surgery.

In this ongoing series about cancer, we have gone in-depth into the basics of cancer that apply to most types of cancer. So if you've missed those shows, you probably want to go back and listen to them if you want to know more about cancer staging and the specifics of treatments. Our focus today is on lung cancer, and so we'll start with a quick review of the lungs.

So we have two lungs, a left and a right. The lungs are separated into lobes. Our right lung has three lobes, and the left has two lobes because our heart's on our left and then takes up room where the other lobe would have been.

When we take a deep breath, air goes down the trachea, the windpipe, which divides into two tubes that enter each of the lungs, then into smaller branches called bronchioles, and at the end of the bronchioles are tiny air sacs called alveoli. The alveoli job is to absorb the oxygen we breathe and remove the carbon dioxide from the blood as we breathe out. So simply put, the job of the lungs is to take in oxygen to pass on to the blood and remove the carbon dioxide from the blood and out of our body.

Now there are two main types of lung cancer. There's what's called non-small cell lung cancer and small cell lung cancer. About 80 to 85% of lung cancers are non-small cell lung cancer.

The main types of non-small lung cancer are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These subtypes which start from different types of lung cells are grouped together as non-small cell lung cancer because their treatment and prognosis, meaning the outlook, are often similar. About 10 to 15% of all lung cancers are small cell lung cancer.

This type of cancer tends to grow and spread faster than non-small cell lung cancer. In most people with small cell lung cancer, it is already spread beyond the lungs at the time it's been diagnosed. Lung cancer is the leading cause of cancer death in the United States, accounting for one in five of all cancer deaths.

Most people diagnosed with lung cancer are 65 or older. A very small number of people are diagnosed younger than 45. So the average age of people diagnosed is about 70, so it tends to be older people who get lung cancer.

So what increases our risk of lung cancer? Smoking tobacco is the leading cause, and about 85% of lung cancer deaths in 2025 were likely caused by smoking, and many others will be caused by exposure to secondhand smoke. Lung cancer in people who don't smoke can be caused by exposure to radon, secondhand smoke, air pollution, or other factors. Workplace exposure to asbestos, diesel cell exhaust, and other chemicals can cause lung cancer in some people who don't smoke.

Some lung cancers can be found by screening, but most lung cancers are found because they are causing symptoms. The actual diagnosis of lung cancer is made by looking at a sample of lung cells in the lab. The best thing you can do if you have possible signs or symptoms of lung cancer is to see your healthcare practitioner.

Don't ignore them. Go see your healthcare practitioner. So what should you look for? Common symptoms of lung cancer include persistent cough, chest pain, shortness of breath, and coughing up blood.

And we can divide those into early symptoms and later symptoms. So for the early symptoms, lung cancer often does not present symptoms until it's advanced, but some early signs may include a persistent cough. Now this is a new cough that doesn't go away or worsens over time.

Chest pain, discomfort or pain in the chest area, which may worsen with deep breathing or coughing. Shortness of breath. This is difficulty breathing or feeling winded during normal activities.

Wheezing is a whistling sound when breathing, which may indicate airway obstruction. Think of it like if you blow on a whistle, there's that obstruction in the whistle that makes the sound. That's what the tumor could do in lung cancer.

And coughing up blood. Even small amounts of blood in the sputum can be a concerning sign. So if you cough and you look at your handkerchief or your Kleenex and you see blood, call your doctor.

And then there's advanced symptoms. As lung cancer progresses, additional symptoms may develop, including unexplained weight loss. Losing weight without trying can be a significant indicator of cancer.

Fatigue or tiredness. This is that persistent tiredness that does not improve with rest. Hoarseness, changes in your voice or difficulty speaking clearly.

Bone pain. If cancer spreads to the bone, it may cause pain in those areas. Swelling of the face or neck.

This can occur if the cancer affects blood flow to the upper body. Now there are a wide range of options available for treatment of cancer. As with most cancers, surgery is considered first.

Surgery to remove cancer might be the option for early stage non-small cell lung cancer. It provides the best chance to cure the disease. Still, lung cancer surgery is a complex operation that can have serious consequences.

So it needs to be done by a thoracic surgeon who's a lot of experience operating on lung cancer. Also, there are tests to see if you're healthy enough for surgery. Surgical options include removing the entire lung, which is called a pneumonectomy.

Or an entire lobe, which is called a lobectomy. Part of the lobe, segmentary or wedge resection. And I put a link in the show notes that goes over these different types of surgeries because I've had so many patients who really didn't know what their surgery was or they might know, oh, I had a pneumonectomy but not know what that means.

So look in the show notes and you can go into more detail there. There are also links in the show notes that go over in detail chemotherapy, radiation therapy, and immunotherapy for both non-small cell lung cancer and small cell lung cancer. We have podcasts about each of these options and there are links in the show notes so you can listen to those.

Your oncologist will discuss the options available for you based on the cancer cell type, the stage, which includes if the cancer has spread, your current health, and your goals of care. This is where your treatment plan is personalized for you. For some people with lung cancer, treatment may remove or destroy the cancer.

Completing treatment can be both stressful and exciting. You may be relieved to finish treatment but find it hard not to worry about cancer growing or coming back. This is very common for everyone who has had cancer.

For other people, lung cancer may never go away completely. Some people may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to control the cancer as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.

When you have completed treatment, your oncologist will still want to watch you closely. It's very important to go to your follow-up appointments. During these visits, your oncologist will ask you if you have any problems and may do exams and lab tests or imaging tests to look for signs of cancer returning or treatment side effects.

For all lung cancer survivors, it's important to let your oncologist know about any new symptoms or problems because they could be caused by cancer or by a new disease or even a second type of cancer. There are things you can do to lower your risk of cancer growing or coming back. And first, if you smoke, quitting is important.

Quitting has been shown to help people with lung cancer live longer, even if the cancer has spread. It also lowers the chance of getting another lung cancer, which is especially important for people with early-stage lung cancer. I've had so many patients that I've cared for with lung cancer who say, well, I've already got the lung cancer, there's no point in quitting now.

But there is a point in quitting now. It helps the chemotherapy be more effective, and it helps prevent other problems down the road. So don't take a defeatist attitude to that.

Really think about quitting smoking. Second, the possible link between diet and lung cancer growing or coming back is not clear. Some studies have suggested that diets high in fruit and vegetables might help prevent lung cancer from developing in the first place, but this needs to be studied further.

The same is true for physical activity. More research is needed to know if being more active can lower the risk of lung cancer coming back or of dying from lung cancer. But to protect your general health, going for a daily walk and eating your fruits and vegetables will help you stay healthy.

Lastly, dietary supplements are not regulated like medicines in the United States. They do not have to be proven effective or even safe before they are sold, although there are limits on what they're allowed to claim they can do. If you're thinking about taking any type of nutritional supplement, talk to your healthcare team first.

They can help you decide which ones you can use safely while avoiding those that could be harmful. Lung cancer is a serious diagnosis, but knowledge, early action, and individualized treatment can truly make a difference. Whether treatment removes cancer, helps control it, or becomes part of an ongoing care, no one goes through this path alone.

Follow-up appointments matter. Reporting new symptoms matters. And taking meaningful steps, like quitting smoking, supporting overall health, and talking openly with your healthcare team about concerns and choices can help you live as fully and safely as possible.

If you or someone you love is facing lung cancer, reach out, ask questions, seek support, and remember that your experience and your life will hold value, purpose, and hope. If this episode was helpful, please share it with someone who might need it. Visit us for more resources and join us next time as we continue this series to help you better understand serious illness and the choices that support living well, whatever your diagnosis may be.

Charlie, any questions or thoughts? Well, I just remember when, gosh, how old was I? Six? I'm going to say around six. My dad, yeah, he really smoked a lot. It was something like up to a couple of packs a day.

And, you know, as you were, you know, everything you said, his doctor said to him, I think you really need to, I'm not even sure he told my father to quit 100%, but that he really needed to cut back and explain why, you know, all the, you know, bad things this was doing to him. And, you know, and he quit. And I want to say he quit cold turkey.

That's just the type of person my father is. But yeah, I just, I just remember that. And just smoking was just always so casual all the time.

And, you know, I've enjoyed watching old films and so much smoking going on all the time. And now I look at it and, you know, someone like, you know, Humphrey Bogart. I mean, he died.

I mean, you know, from that, just, you know, constantly smoking. Now what a different time. Yeah, really different.

I'm sorry, what? Well, I was going to say it's different, but yet it's still the main cause of cancer death. So it's, you know, we've gotten better as a society, but we still have, we still haven't completely gotten rid of the smoking piece. No, not at all.

You know, do the thing too. I mean, you had mentioned coughing. And I don't know out in Oklahoma, but here, I mean, flu has just been everywhere.

I mean, you know, I had my flu shot. I had a pneumonia shot. What's that other shot? RSV, RVS, RSVP.

That is what you mean to me. Oh, sorry. Yeah, I've just had all of that.

And there's, and they're just still times I'm coughing. Nothing like, you know, a serious cough or anything. But I just start to cough.

I don't get that. I mean, I had to check just to make sure everything's okay. And yeah, I mean, doctors didn't find anything, but it's just weird.

Just coughing just seems to be in the air. Well, you also had that really bad cold back over Thanksgiving. Oh, yeah.

And you could have some, what's called airway reactivity in that you're not completely, you know, your throat's not completely cured yet. So you could do, you know, they have like what they call throat coat. It's called throat coat tea that, you know, that you can drink to help calm down your, that reactivity in your throat.

I'm sorry, what is it called? Throat what? Throat coat, like a coat you would put on. Okay. And, you know, that's where the, you know, all those little boxes of tea are in the grocery store.

I think it's green. That could help calm down your reactivity, you know. And I'm telling you that because you said you already went to the doctor.

And so if you've gone to the doctor and it's, you know, nothing beyond like what probably is for years for you the result of that really bad cold that seemed to go on forever. Yeah. Right.

Yeah. Oh, yeah. And this is already January and I still do the occasional coughing.

Yeah. Yeah. So you can calm the reactivity down that way.

You know, acupuncture can also do that if it gets really, really annoying. But it takes time for that reactivity to go away. Yeah.

I mean, I'm, you know, I'm careful with it. You know, I still go about, you know, my daily life. But yeah, I guess, I guess it's what it is as you begin to approach 90.

So there you are. Okay. For our third half, Marianne mentioned an obituary written by 28-year-old Alexa Bergeras, who died in March from metastatic breast cancer.

This is her story. I am Alexa Elizabeth Bergeras, aka Alex. I was born on 3-14-1997, and I died in my home on 3-3-2025.

I was 27 years old. My mama is Cindy Train, and my dad was Lauren Bergeras. My childhood was spent with my brother Cody on our farm and lake, and we found endless ways to entertain ourselves.

Maybe some of the stuff we did with the horses was a wee bit dangerous, but we lived through all of it, and I had a wonderful childhood. Cody and I graduated from Pelican Rapids High School, and both of us went off to Concordia College for our undergrad degrees. From there, I went to Madison, Wisconsin for pharmacy school.

I came back to Pelican Rapids and started work for Thrifty White Pharmacy in Purim. I had some amazing friends along the way through my childhood and college years, and I'm grateful for their love and support, fun times, but more importantly, their friendship. On January 15, 2020, I was diagnosed with breast cancer.

Mayo Clinic determined it had metastasized to my bones and gave me a 22% chance of making it five years. At 22 years of age, I was given a death sentence. The beginning of my grown-up life, yet the start of the end of my life.

Up until this, I had hardly ever been sick a day of my life. Now, all of a sudden, my life was on a ticking clock. I made peace with all this.

Then I had the decision to make the absolute best of the time I had left. Mom, Cody, Rachel, and I took every opportunity to go on amazing trips to Italy, Greece, Mexico, Florida, Nashville, Washington, D.C., ski trips, and Hawaii, twice. These were fun and memorable times, but at the end of the day, what I really cherished most was spending time with my family.

If we weren't on a trip, I loved being at my home with my dog, Oliver, my horses, my mama, and of course, my bro, Cody and Rachel, his amazing wife, and Beth and Roy. We would all sit around the table playing games, laughing, eating, and this brought me so much joy. Being with family and playing games is perhaps what I'm going to miss the most.

I was so fortunate to stay healthy for so long and give credit to the doctors at Mayo Clinic for the reason I lived as long as I did. Four years and nine months of good health. In December, my oncologist told me the chemo was no longer working and that I was going to die in less than six months.

The cancer had moved to my lungs. Not a surprise as I felt something was happening. We took one last trip to Hawaii in January, and shortly after that, I was put on oxygen and was in and out of the hospital.

God makes every person on purpose for a purpose. For whatever reason, I fulfilled my purpose on earth that God intended for me and said it was time for me to come home. God said, I will never leave you or forsake you, and he didn't.

He truly blessed my life with a family that loved and cared for me, and I was so fortunate. My mama promised me she would be with me to the very end, and she was as she held me in her arms until I took my final breath, and now I'm in the arms of Jesus, free of pain and able to breathe again. I lack for nothing in my life and left this earth with no regrets.

What I want to leave you all with is this. From the day of your birth, death comes walking towards you, sometimes fast, sometimes slow, but he will catch up to you at some point. Life is made up of moments.

Don't miss them, because you will never get them back again. Treasure every day. In a way, knowing when you are going to die is actually a sort of blessing.

It gives you time to get things right in your life. You never assume you're going to have another day. Jesus and I had many talks over the years, and I know for sure that I'll spend eternity in heaven with all the people and animals I loved.

I guess I'm supposed to end this with people and family who passed before me and who are left behind. I'd rather say I am now with all the people that passed before me and you who are still living. Well, see you one day.

Love, Alex. Please stay tuned for the continuing saga of Everyone Dies, and thank you for listening. You can find more episodes from our series about grief on Spotify, Apple Podcasts, or your favorite podcast app.

Follow and subscribe to the show. Share it with someone who needs a little hope today. This is Charlie Navarette.

And from composer, musician, and singer Barry Manilow, for a Jewish guy, I've recorded a lot of Christmas albums. And I'm Marianne Matzo, and we'll see you next week. Remember, every day is a gift.

Always seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast. If you think you may have a medical emergency, call your doctor or 911 immediately.

Everyone Dies does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by persons appearing on this podcast at the invitation of Everyone Dies or by other members is solely at your own risk.