Dr. Carmine Simone
Chief of the Department of Surgery and Co-Program Director for the Surgery Health Service, Toronto East General Hospital

Joseph Neale, 23, is a man with big dreams. A prof essional singer and entrepreneur, Joseph is currently making strides in the music industry and hopes to share his talent with the wider world.  Joseph’s plans hit a major snag three years ago though, when just at age 20, he was diagnosed with lung cancer.  

Joseph first noticed a problem when he developed a persistent cough. “The only time I wasn’t coughing was when I was singing — as soon as I stopped the cough returned. I was coughing almost every second. No one could figure out what was wrong; I saw five different doctors before I got my diagnosis.” 

A singer’s intuition

Joseph’s diagnosis was of a non-small cell cancer called mucoepidermoid — an extremely rare, but treatable form of lung cancer. Dr. Carmine Simone is a thoracic surgeon at Toronto East General Hospital (TEGH) and operated on Joseph. “Joseph’s type of cancer is rare, but it’s also rare for a young non-smoker to get lung cancer. Eighty-five percent of lung cancers occur in patients with a smoking history, and in early stages are a-symptomatic. But Joseph, perhaps because as a singer he was so attuned to his breathing, he knew something was wrong straight away and took all the right steps.” 

Excellent odds

While distressed at the news, Joseph found solace in the knowledge that due to his active engagement with doctors his cancer was detected early — giving him excellent odds. According to Dr. Simone, this early detection also obviated the need for additional treatments, such as chemotherapy. That solace, however, was short-lived when Joseph discovered that despite advances in surgical innovation, he could still lose his entire lung. It was a prospect he found difficult to countenance. “The tumor was just 3cm in size but its location was bad, right in my bronchus. I was thinking, ‘I’m not going to be singing anymore so I don’t know if I can go through with this — I sing all the time, it’s my instrument’ — so I thought maybe I’ll just live with the cancer until I die.”

Making the decision

It was a bleak perspective, but it didn’t take long before Joseph’s positivity reemerged. “I started reading, anything to do with positive mindsets and success — it kept me on track.” Joseph’s biggest inspiration though, came with the birth of his daughter. Weighing in at 6 pounds 11 ounces, Jenesys irrevocably changed Joseph’s outlook. “I was going through my problems, but then all of a sudden all I wanted was to see her grow.” In consultation with Dr. Simone, Joseph opted to go ahead with the surgery — determined to beat the disease, and to sing again.

“I started reading, anything to do with positive mindsets and success — it kept me on track.”

Luckily for Joseph, Dr. Simone and his team at TEGH are leaders in the field of thoracic care, and are at the forefront of surgical innovation: “lung surgery is considered major surgery but can be done safely in most patients with early stage lung cancer,” says Dr. Simone. “Surgery continues to make advances with minimally invasive techniques, development of specialty surgical centres, better anesthetic techniques and post-operative care.” 

Early detection 

The prognosis for Joseph then, was excellent, and according to Dr. Simone, early detection was key. “The best chance at cure of lung cancer is early detection and surgical resection. Ontario is working on establishing a screening program [and] there is good evidence that lung cancer screening can detect early stage lung cancers and therefore be lifesaving,” says Dr. Simone. 

 But while Dr. Simone was confident of surgical success — there was no guarantee that Joseph would sing again.

Dr. Simone and his team, initially concerned that Joseph could lose his entire lung,  managed to preserve half as well as the nerve that sends messages to the vocal cords. When he awoke in the recovery room, teary-eyed nurses rushed to find Dr. Simone to tell him that Joseph — still in a state of post-surgical delirium — was singing

Learn more about Joseph Neale and his One Lung One Life Lung Cancer Campaign by clicking here.