At first, Jonathan Corey Barnes thought little of his tickly cough – or the fact he needed to clear his throat constantly.
It seemed so innocuous at the time and the 49-year-old father-of-one remains vague about when it first started.
When family and friends commented, Barnes dismissed their concerns. ‘I thought it was just allergies – and I never considered it might be a problem.’
In fact, that simple symptom was the first sign of something far more sinister.
Although he didn’t realize it at the time, that persistent cough was a symptom of lung cancer – the world’s deadliest cancer, responsible for more deaths than any other type.
And, by the time the Nashville firefighter did finally see a doctor, worried by a slew of other symptoms that began to stack up, it was too late for a cure.
His cancer was advanced and tumors riddled his body.
Today, despite his difficult prognosis, Barnes remains optimistic – and is speaking about his traumatic experience in a bid to warn others not to ignore common lung cancer symptoms like he did.
Jonathan Corey Barnes, who family call Corey, with his wife Sutton, 48, and their daughter Reese, 16, while on vacation in Florida
The American Lung Association and, in the UK, the NHS both recommend that adults who have had a cough for more than three weeks should see a doctor.
The most likely cause is a common cold, but a longer duration warrants medical evaluation to rule out secondary infections or underlying conditions.
If initial treatments are ineffective, after around eight weeks X‑rays and other scans may be needed to rule out serious underlying lung disease such as pneumonia, lung cancer or interstitial lung disease.
Experts also warn that if a long-term cough is accompanied by other red-flag symptoms – such as coughing up blood, unexplained weight loss, persistent chest pain, or shortness of breath – people should seek urgent medical help to rule out a sinister cause.
For Barnes, it was developing mysterious shoulder pain in October 2023 that finally saw him visit a doctor.
He had just worked a full day shift at the fire station and was just sitting down to watch television in the common area when it began.
A wave of nausea washed over him, too.
‘I had been sitting down for maybe 10, 15 minutes, when it started,’ he told the Daily Mail. ‘I started to feel sick, like you do when you are getting a cold too. I would get cold chill or be unable to stay warm.
‘I didn’t tell anyone when it started. But after an hour, I had to go home. It was too bad to stay at work.’
Barnes managed to sleep that night but when he woke up the next morning and the pain and sick feeling were still there, he drove to urgent care.
Shoulder pain is an incredibly common complication in the US, with almost 70 percent of adults experiencing it at least once in their lives.
While most of the time it is explained by benign causes, such as awkward posture or lifting heavy objects, pulling a muscle, in rare cases, it may be a warning sign of a life-threatening problem.
In the case of heart disease, pain from the heart can be ‘referred’ to the shoulder because shared nerve pathways cause the brain to misinterpret its origin – meaning a heart attack may present as pain in the shoulder, arm, neck or jaw.
Cancer can also occasionally trigger shoulder discomfort. Tumors in the chest – particularly certain lung cancers – may irritate nearby nerves or spread to the bones, leading to persistent shoulder pain, sometimes without any obvious injury.
Once Barnes sought medical help, things moved quickly.
He underwent scans that revealed ‘an area of concern’ in his upper left lung, although it was initially suggested he may have pneumonia.
He was prescribed an antibiotic and told to see a pulmonologist for another assessment – the next appointment was in six months.
‘I was assured that was what it was at the time,’ he said.
‘I had never had pneumonia before, but I did believe the doctor and think that was what was going on. I didn’t think it would be anything else.
‘I had never smoked before and I had no family history of cancer, so there was no reason to suspect it was anything untoward.
‘I am a firefighter, but I’d never worry about that raising my risk of cancer.’
He said he had heard about ‘the studies’ that suggested firefighters had a raised risk of cancer, but he and colleagues made light of them.
‘We have a different sense of humor,’ he added.
A large body of research has established that firefighters face a significantly higher risk of cancer than the general population.
Barnes on a trip to Disney World, Florida, last year. It was organized for his wife and daughter, who are both major Disney fans
The main driver of this is exposure to toxic fumes billowing from burning buildings.
Mesothelioma, which is a rare type of lung cancer related to asbestos exposure, bladder cancer, testicular cancer, skin cancers and blood cancers are all seen more commonly in firefighters.
And a landmark study of 30,000 firefighters by the National Institute for Occupational Safety and Health (NIOSH) showed as a firefighter’s cumulative ‘fire hours’ increased, their risk of lung cancer diagnosis and death went up.
Unprepared to wait for the pulmonologist, and with the pain and sick feeling persisting, Barnes contacted his primary care doctor, who got him an appointment for a CT scan on Halloween.
That revealed the mass in his lung about the size of a softball, and another on his left adrenal gland, an organ above the kidneys that releases hormones.
His doctors had to admit, this might not be pneumonia after all.
‘That was a little worrying,’ Barnes said. ‘We were hoping and praying that it was just pneumonia or that the two masses were unrelated. But we found out that was not the case.’
An MRI scan also revealed a sand-grain sized growth there. A fourth small tumor was detected in his aortocaval lymph node, too, a lymph node at the back of the abdomen.
Doctors took a biopsy of the tumor in his lung. By late November, they had the diagnosis: It was lung cancer.
It had spread, so it was incurable, and it was ALK-positive, a rare subtype driven by a specific genetic mutation that causes cancer cells to grow uncontrollably.
‘My heart sank,’ Barnes said. ‘I didn’t want to ask my doctor about the survival rate. But I have a cousin who’s worked at an oncology department for five years, she told me that I might only live for two years.’
About 230,000 Americans are diagnosed with lung cancer every year, while some 125,000 die from the disease every year.
In the UK, around 50,000 people are diagnosed and it claims roughly 32,800 lives annually, making it the country’s leading cause of cancer death.
Between four and five percent of these patients have the ALK-positive version.
It tends to affect younger patients and people who have never smoked, making it distinct from more typical forms of lung cancer.
Crucially, however, outcomes for this group have improved dramatically in recent years. A new generation of targeted drugs – known as ALK inhibitors – can slow the disease for years, with some patients now living far longer than was previously possible.
Barnes was offered one of these, lorlatinib, also known by the brand name Lorbrena.
The targeted therapy works by blocking proteins in cancer cells that allow them to grow – and it is proving remarkably effective.
Data released earlier this month by Pfizer showed that more than half of patients on the drug were still alive without their cancer worsening after seven years – an unprecedented result for advanced lung cancer.
By contrast, earlier treatments such as crizotinib, while effective, typically kept the disease under control for less than a year on average, with patients’ cancer progressing after around nine to ten months.
Barnes said he signed up for lorlatinib immediately.
He started to take the pill in December 2023, taking it once a day in the morning with a glass of water.
And, finally, there was good news. A second MRI in mid-January revealed the lesion on his brain had completely disappeared, while another full-body scan the following month showed his tumors had shrunk by more than half.
The plan now is to keep taking the medication every day for as long as it works – and the hope is that it will continue to keep his disease at bay.
Barnes, who hopes to see his daughter graduate college in 2028, is elated with the results.
‘It’s amazing,’ he said. ‘If you were to see me out, you would never think I have stage four lung cancer. It’s unbelievable, just mind–blowing.
‘It’s given me the hope that I’ll be here for all the things I, frankly, didn’t think I was going to be here for. I just had such a dim future before.’
