She did everything right.

Healthy. Active. A mother of four. A non-smoker.

And still—she had lung cancer.

In this episode of The Iconic Midlife, Roxy Manning sits down with investor, healthcare policy advocate, and lung cancer survivor Shira Boehler to unpack a diagnosis that wasn’t supposed to happen—and what it reveals about the gaps in modern healthcare.

At 43, Shira went in for a preventative full-body scan with no symptoms, no warning signs, and no reason to believe anything was wrong. What she found instead was Stage 1 lung cancer—caught early not because of the system, but because she pushed beyond it.

This conversation challenges everything we think we know about risk, prevention, and what it really means to be “healthy.”

In this episode, we cover:

• Why lung cancer is rising in healthy, non-smoking women
• The dangerous gap in current screening guidelines
• What happens when you’re told “you’re fine”… and you’re not
• The tension between trusting your doctor and trusting your instinct
• How access, resources, and advocacy can change outcomes
• The emotional reality of facing cancer as a mother of four
• Why early detection isn’t just about science—it’s about access

About Shira Boehler:

Shira Boehler is an investor, healthcare policy advocate, and founder of the Cancer Doesn’t Care Foundation. After her unexpected diagnosis, she has dedicated her work to expanding access to early detection and pushing for changes in national lung cancer screening guidelines.

LISTEN, FOLLOW & SHARE

If this episode made you think differently, share it with a friend who’s been told “you’re fine” but knows something isn’t right.

Follow the show so you don’t miss future episodes.

Join the Inner Circle: https://the-iconic-midlife-with-roxy-manning.kit.com/3433416614

Want bold guests, unfiltered stories, and iconic midlife insight in your inbox?

Listen & Follow

The Iconic Midlife is where smart, stylish women over 40 come to rebrand midlife on their terms.

New episodes every Tuesday. Bonus game episode drops on Thursdays.

Tap “Follow” so you never miss a moment.

Listen on:

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-iconic-midlife-with-roxy-manning/id1817484587

Spotify: https://open.spotify.com/show/4FRDzq3AalXaqfpfWq7dlm?si=7e91db12ba1f4bfa

Amazon Music: https://music.amazon.com/podcasts/ff905ad8-332f-430e-a040-ce1ba5047483/the-iconic-midlife-with-roxy-manning

Let’s Connect

Social media: @theiconicmidlife (show) | @redcarpetroxy (host)

• YouTube: https://youtube.com/@theiconicmidlife

Free Download: 5 Power Moves Every Midlife Woman Should Be Making​

This high-impact worksheet is your shortcut to owning your next chapter—on your terms.

Grab your free worksheet here​

Need more energy, fewer symptoms, and a better night’s sleep?​

I'm obsessed with Hop Box, a women-founded supplement brand designed for our midlife needs.

Use code ROXY for 10% off sitewide.

​Shop Hop Box now​

If you’ve ever wanted real data on what’s actually happening inside your body, I can’t recommend Function Health enough. It’s one of the most comprehensive ways to track your biomarkers, hormone health, metabolic markers, and long-term wellness—without guesswork or overwhelm. This is about informed choices, not fear.

If you’re curious, you can join here: Function Health

You were so healthy.

So like, how does your brain even process that information when you literally ran six miles and then you're in the same day, like within the same 24 hours, you're getting this diagnosis. Like, what was going through your head?

Walked into a lung doctor from there who looked me in the eye and said I had lung cancer. And I've never been so surprised in my life.

So many people don't know about lung cancer and about, like, how prevalent it is for women.

If you have lungs, you can get lung cancer. And we're not catching lung cancer until it's so spread that it's too late.

The system seems so broken in that way.

Right? I still to this day sometimes have moments where I'm like, huh, I have lung cancer.

How do we further the cause? Like, how do we, you know, change, help to make change?

Essentially one skin at a time, one woman at a time.

Version of this story that shouldn't exist. A healthy, active woman, a mother of four, a non smoker, someone who did everything right. And still she had lung cancer.

Not because it couldn't be found earlier, but because by today's standards, she never should have been looking for it in the first place. That's the part that should stop you. Because what if the biggest risk of isn't what we're doing wrong, but what we're not being told to check?

Today's guest, Shira Bowler, wasn't supposed to be the patient. She was the outlier, the exception, the person the system wasn't designed to catch. And yet one decision, one scan changed everything.

This isn't just a story about cancer. It's about access, it's about assumptions, and it's about the uncomfortable reality that early detection isn't always about science.

Sometimes it's about who gets the chance.

If you've ever been told you're fine, if you've ever felt like something was off, or if you've assumed that doing everything right guarantees anything, this episode might change how you think about your health. This is the iconic midlife, unfiltered, unapologetic, and built for a midlife that doesn't ask for permission. Let's get into it.

Welcome to the iconic midlife. Shira, how are you today?

I'm great and I'm excited to be here.

I am so excited to have you here. I had such a good time with you in Washington, D.C. when we were both at the National Conference on Women's Health.

I mean, talk about moments that are meant to be in Besharet that I Found you. We latched and we became best friends, fast friends.

And then shared the car back to the hotel and then realized that I was moderating the panel right before you were moderating the panel. And we got to share our story and became fast best friends after that. It was like the perfect moment.

It made me calm down before I got on stage, just knowing I had someone out there that I knew that would be looking out for me.

To be honest, we were laughing so much, and you were so real, and that's what I really appreciated about you. Very authentic.

Like, I think the second year purse emptied out on the floor and we picked it up together. I was like, we get each other. I got it. We're gonna figure it out together.

Totally. Oh, my God, I totally remember. It, like, flew everywhere.

If you're not your purse isn't falling out at a cocktail party, then, like, what are you doing?

Yeah. Obviously not having enough fun.

Totally. Totally.

Well, I so appreciated meeting you, and you were so open and honest with me about your story, which I thought was like, just the second you were telling me, it just, you know, like, I was so captivated because I think that so many people don't know about lung cancer and about, like, how prevalent it is for women and just all of these things. So let's talk about that, because I know you're so open and honest with your story.

So, you know, you were telling me you were kind of setting up the story for me.

Like, you know, you're this healthy, you know, like, running six miles a day, like, take care of yourself, all of these things, and you opted to do one of these sort of like, full body MRIs, and you got some crazy news after that, like, devastating. So just take me back to that time.

Like, what was that exact moment when, you know, you're hearing this news and it was like life before and then life after.

So, to be honest, what was crazy about it was that I did the full body MRI actually, over the summer, and I'm really claustrophobic. So remember, I don't like to do things like that. I fought my husband a lot. I canceled a lot of appointments.

Ultimately did do it, thinking I would get this great baseline, because you were right.

I ran six miles that morning, went to the full body mri, and actually my results came back that there was just a minor finding and that I should correlate with symptoms and consider a follow up, which to me, I had no symptoms, I was running. So I kind of dismissed it, rolled my eyes, told my husband that I was perfect. On the inside and outside now, you know? So he knew and moved on.

What's interesting about all this is you're right. I run. I try to eat out of the fridge, not the pantry. I have four little kids. My parents are both doctors, My brothers are both doctors.

My father, I mean, my grandfather, you know, my aunt. My father's actually a lung doctor.

So I showed him my findings on the mri, and he kind of rolled his eyes a little bit and said that we look at lungs in a CT machine, not an MRI machine, because there's a lot of air. And he thought, if you want, you can follow up. My husband and I are in healthcare too.

And so we kind of like, do all the things, like, we do all the blood tests, like Galleri and Grail. We did 23andMe when it came out, we had our full genome sequence.

We kind of have bought into it all and been very proactive and made sure that our health was in line the best we could. And so when my dad walked me through CT versus an mri, I ultimately did follow up with that.

And so I ran six miles, I went sweaty into the CT machine, which is like less than a minute, the easiest machine of all time. Don't even have to take off your clothes. And walked into a lung doctor from there who looked me in the eye and said I had lung cancer.

And I've never been so surprised in my life. I mean, being the daughter of a lung doctor means that you've never puffed a single cigarette. Like, means that you avoid secondhand smoke.

Like we were taught, my brothers and I, at all costs, get away from smoke. And I've done that, and I've run and I've tried to do all the right things. And so I was shocked.

I just kept saying to the doctor, wrong person, wrong scan, you're. You've got it incorrect. Like, I don't smoke, I don't this, I don't that.

And so basically that, like, journey for the next week that I went on, which ultimately, you know, confirmed my lung cancer. And then I had surgery to remove it.

I realized that I was so lucky that I caught it so early, before symptoms, super random scan, but that I wasn't unique.

Like you said, Roxy, that people don't realize that lung cancer is killing more young, healthy women than breast cancer and ovarian cancer and colon cancer combined. And it's like, crazy.

So I was like, this luckiest girl in the world with lung cancer, which is, like, not the cancer to get, but not a unique diagnosis. It wasn't like this rare disease that I was lucky to catch. It was one of the. It is the biggest cancer killer, and no one talks about it.

I think the whole idea behind it being a deserved disease and a lifestyle choice, like, if you smoke, then maybe you deserve to have lung cancer. Like, we have to change that narrative.

Like, if you smoke, you should stop smoking, because your chances of getting lung cancer are greater than if you don't smoke. And if you smoke, you should get your lungs checked because you have that greater chance.

But what I realize is that there's all these other factors that we don't know about, and that if you have a thyroid, you can get thyroid cancer. If you have lungs, you can get lung cancer. And we're not catching lung cancer until it's so spread that it's too late.

And then it's the number one cancer killer. Women disproportionately.

Absolutely. And, you know, going back to that day, you know, you mentioned running six miles, right? You did all the things. You were so healthy.

So, like, how does your brain even process that information when you literally ran six miles? And then you're in the same day, like, within the same 24 hours, you're getting this diagnosis. Like, what was going through your head?

I love that you're asking me this, because I think still to this day, I haven't processed it. So part of my journey and processing is I wrote a book. It's called One Scan. Saved My Life.

And I just want to educate people so they can get scanned and they can catch their cancer early if, God forbid, they have it. But to be honest, I was just having a conversation with a girlfriend of mine. Her husband's an oncologist, not my oncologist.

She lives in a different state. And I was telling her that I was having this moment. And I actually don't think it was me. Like, literally, like, how is that me?

I mean, I. I know it's me. Like, I have numbing and I have scars, but I sometimes feel like that wasn't me. And I'm.

And I can tell she's on speakerphone because she's, like, cooking. You know, the kids are home. And I hear her husband. He has a thick Australian accent, and he yells in the background, I saw you had lung cancer.

Confirming it's correct. You know, And I was like, thanks. But I still have these moments where I just can't believe it. I mean, because I tried to do all the right things.

And I sometimes think writing the book, talking a lot about it, has helped Me. But I don't know, I still to this day sometimes have moments where I'm like, huh, I have lung cancer. I ran this morning.

I did my six mile loop this morning and I felt fine doing it.

And then I realized, like, wow, when I get back in the minivan to drive out of the park that I do the loop, I'm like, wow, I had lung cancer five months ago. It's crazy.

Yeah.

And it's amazing that you're back, you know, doing all the things you did before with, like, running and, you know, being able to enjoy life, which is definitely what you want. Was there ever a moment that you had, like, anger, like, where you like, God, like, I've done everything right.

I've done, you know, all the healthy things. And then this happens. Like, were you mad at all? Was there anger there?

Yes, just like moments of not believing that I have lung cancer. I have moments of anger.

Like I'm not proud of them, but I remember just last month I totally lost it and I was lying down on the floor in the hall, like, screaming that it just wasn't fair that, you know, I tried to eat out of the fridge, not the pantry. I try to run, I try to do the right things.

Like my friends joke that I should have smoked with them because then maybe I wouldn't have lung cancer or I should have smoked because it doesn't matter. I was going to get it. Like, I really worked hard at that. I didn't go out outside of the bar.

You know, when you're 22 and your friends have like a social cigarette, I didn't do those things. And there I was with lung cancer. And I definitely have angry moments.

I think some of my anger, not proud, but is around the fact that lung cancer research and all the information we know is 15 to 20 years behind others. So because it was considered a lifestyle choice and maybe it deserved disease, it just doesn't get as much money or research or time spent on it.

Even though what we're realizing now is it's kind of a female health crisis in it all as well. And so I do, I get a little bit angry.

Like I say, there are other diseases out there that are deserved diseases or lifestyle choices that are getting all this funding. Why? Why none for lung cancer. So for me, for example, I'm on nothing.

They took out half my right, low, half my right lung, my middle lobe and the lower part of my upper lobe, and they sent me home. And now I'm just like on what they call is like an aggressive Surveillance. So I have blood work and I have lung CTs done every few months.

And they're just watching me to see if it comes back. And their thought is, if it comes back, we can operate and take it out again. And if it doesn't come back, you have no evidence of disease.

Now, there's no reason to give you chemo drugs or radiation prophylactically because there is no disease in you. So you think, okay, that's okay. I can deal with that.

Well, there's these other drugs, like targeted therapies and immunotherapies that a lot of people have for their cancer treatments, which are awesome and amazing, and they don't cause a lot of the bad side effects that a chemo drug does. But for my kind of cancer, my biomarkers, there is no drug for me. It hasn't been found. So there isn't even that option.

And so the doctors are like, look, if it comes back, we'll operate again, and then we might put you on a full dose of chemo to make sure we get rid of every cell. But they didn't feel it was necessary at this point. They kind of want to keep it in the arsenal.

Their hope is, as time goes, they find more drugs, and the opportunity for me to take something becomes available because there really isn't an option for me right now.

Mm. Okay. Was there ever a sense of, like, betrayal of your body?

Yeah. It's interesting. My mom is a breast cancer survivor, so I always thought I would get breast cancer.

So every six months, when I have my mammogram or my MRI or the ultrasound, I literally put on the scrubs, because you have to change, obviously. And I take a picture, and I'm like. And I text it to my mom, and I say, is today the day? Right? And I just always felt like, that's okay.

Like, if I get breast cancer, there's great drugs. Like, I'm going to beat it. Like, my mom's been able to beat it, and then I get a new set, right?

So when it was my lungs, I was really angry and felt betrayed because I felt like, hey, I run, I exercise, I do all the things I'm supposed to do for you. And, like, rude. You turned your back on me. I feel like that's the whole, like, deserved disease. Like, people want to give me.

Want a reason why I have lung cancer? No one asks somebody who has breast cancer or ovarian cancer, what did you do wrong? Or how did you get it?

They're just like, oh, my God, that's terrible. But with lung cancer, people are like, well, do you smoke? Do you use too much hairspray? Do you not exercise? Do you not?

And you're just like, no, wait, what? I do all the right things. So, yeah, I get really. I get mad at my body sometimes for sure, Right?

And it seems like, you know, your past. Like, thank God you got the second scan. Right? Like, do you ever.

Does your mind ever go back and think, God, what if I hadn't gotten that second scan all the time?

I. I was never, like, that much of a spiritual person before, but this whole process has made me very spiritual. So when I first found out I had lung cancer, my aunt just passed away from stomach cancer. And she and I were so close. She'd get me.

I would FaceTime her every morning to pick out my outfits. Like, we were just so close. She had three boys, and so I kind of adopt. Was adopted as her daughter a little bit from the young age.

I was born on her 30th birthday. We're just so close. And she passed away a month before my diagnosis. And at first I was, like, kind of angry with her, too. Like, why aren't you here?

Like, you left me during my battle, and, like, I was there during yours. And then I kind of started. I would, like, look up at the sky and yell a little bit at her, like, what the hell? Come back. I need you right now. And.

And then, like, this spiritual side of me was like, wait a minute. Maybe she's the one who told me to get that scan. Like, what? Nudged me to do it. You're right. Why did I do it? I don't have an answer.

No doctor, no friend, no husband, nothing. No one said, you should go follow up with the ct.

It was like, I was actually at my endocrinologist's office showing him how cool the full body scan app was. Oh, look at all the features.

And I was doing that, and I said, oh, actually, you know, it showed I had nodules on my thyroid, which makes sense because I have Hashimoto's. And he was like, yeah, we know about those. So I was showing him, like, literally how you could zoom in and out on my thyroid nodule. And then I.

And then he. I said, oh. And it also found something on my lungs. And he said, oh, do you want to follow up? It says, only if you have symptoms.

And I said, I know I don't have symptoms. And then I was, like, leaving his office, and I turned to him and I said, actually, just sign me up for a Low dose ct. I've never had one.

Maybe it'll be interesting, but like, why did I do that? And I sometimes think that maybe it was this spiritual thing where someone from up above was like, girl, you have lung cancer. Like, go check.

Yeah, that's, that's. I mean, you have to almost chalk it up to something like that because, like, why would you have, you know, like. And thank God you did.

And, you know, I think another interesting point, when we were talking at the conference, you know, you were saying that, like, screening is not popular amongst, you know, especially women to go get lung cancer screenings and oftentimes not even covered by insurance. The system seems so broken in that way.

It does, right? I mean, I think I feel like in the mammogram world, right, you have like guilt if you don't go.

Sometimes, like, I'm like, oh my God, I'm at 13 months, not at 12. Like, oh my God, I gotta go. Like, there's a lot of guilt around that.

And I think that that's from decades of, you know, Nancy Brinker through Susan G. Komen and things like that, pushing people to understand, change the narrative to explain, explain to people breast cancer is not your fault. Like, just check for it and we can catch it early enough now and we can, you know, cure so many people.

Like, it's so wonderful how much science has helped breast cancer patients. And I think that the current guidelines for lung cancer screening need to be changed. And there's a few reasons.

So currently, in order to get Medicare or Medicaid or your insurance to cover your lung cancer screening, you have to be over the age of 50 and smoke a pack a day for 15 years. So there's a few issues with that.

One that doesn't account for people that have parents who are lung cancer survivors or passed away from lung cancer. So there's no family history brought up in that like we do with breast cancer.

That doesn't account for veterans who are in burn pits or, or people that work in industries in like, you know, I don't know, maybe like nail salons or maybe like an engineering plant or, you know, things like that doesn't account for that. And it doesn't account for just young, healthy women which are on the rise. And so in addition to that, who.

In my peer group, there are not many people that are smoking a pack a day. That isn't a thing. People vape or they do this or they do that. It's almost like it's antiquated. It's not a thing anymore.

There's not like smoke a pack a day people as much.

And so I think that's one of the things I talk about in my book and things that I'm talking about with the government is we need Medicare and Medicaid and the guidelines to change so that it trickles down into the insurance companies and that the rest of us can get it. The reality with a lung low dose chest CT today is it's less than $200, which is not that expensive, but it is not affordable for everyone. Right.

So I started a foundation called Cancer Doesn't Care. And that's my whole mission, is to pay for people's lung screenings until we can get insurance to cover it.

So that's like a pretty big number.

That's big.

And it's also crazy number because that means all of those patients found it, incidentally. So maybe my friend's mom fell down the stairs and she cracked a rib. So she went to the emergency room and they found lung cancer.

Oh, wow. So for things that don't even necessarily have to do with the lung at all.

Right. That's how they're catching it. Because by the time you really have symptoms from lung cancer, it's too late, it's spread.

So a lot of people find lung cancer like their hip hurts and it's in their bones or they have a seizure and it's in their brain. So you don't like feel your lungs. Your lungs kind of compensate and just take in more air in the healthy parts in order to keep you going.

So you don't like, know sometimes that there is an infection and that it's growing if it's small enough to start.

Okay.

So for a woman like listening at home that maybe, maybe she has symptoms, maybe she doesn't, maybe she just wants to, you know, pre preventative about this.

What is she saying to her doctor, like, what are the tests she should be requesting or the blood work or what, what should she be saying to the doctor?

That is the million dollar question. And the problem right now is when you ask your doctor about it, they'll probably give pushback because you don't meet guidelines.

So what I recommend is talking to your doctor and asking for a low dose CT scan.

And it is the same scan that they actually do for your heart when you look at calcium scores, but it just widens the view and looks at your lungs also. So you can do both at once if you want. It's less than a minute. It should be less than a couple hundred dollars.

But your insurance isn't going to cover it. I've actually found it's better to tell them you have no insurance when you show up than to have them bill your insurance.

It get denied and then you pay more for whatever backwards reason.

So I would ask your doctor for a low dose ct. A lot of doctors that my peers have come across because they've reached out to me after they've asked, have given major pushback and said no. So I tell them to blame me, blame Shira. Say you have a friend. I can be everyone's friend that this happened to.

And you want to pay for a low dose ct. You want a good baseline. You want to just make sure everything looks good there. Your lungs are have nodules all over them just like your skin freckles.

So it is not bad to have nodules. What's bad is like these ground glass nodules or if they're really big and then they grow a lot.

A lot of us have scarring from past pneumonias or infections. Not a problem.

But sometimes if you get this baseline scan today and then maybe you follow up in a year or a couple years, if any of those have grown, you can tell and you'll have an answer more quickly. But the low dose chest CT today is our only option. A lot of research, hopefully dollars will go into the lung cancer side too.

But to find a blood test that'll catch it. So I had done that gallery grail blood test, catches some cancers. Mine was negative. It was done a couple of weeks before my. I definitely had cancer.

Okay. But it didn't it. So it's not great for lung cancer yet. Okay.

There's a lot of companies out there that are trying to figure it out because a blood test would be amazing to be able to catch some of that circulating tumor DNA. But right now the only thing we have is is a low dose chest.

Okay, so in other words, like the full body MRI is not necessarily going to catch it, right?

Yeah. I mean an MRI is not great for your lungs. The full body MRI I found really interesting. I think people you hear mixed reviews.

Some people say they go down rabbit holes. They didn't need to go down. The full body MRI is not as affordable. It's like $2,500.

But I find it interesting if you can mentally prepare that, it's going to find stuff that maybe isn't something you need to really check.

But if you're just interested in getting your lungs checked, like you get your mammogram and your Pap smear then, or your colonoscopy, you can just do a.

Low dose chest ct. And how often is it recommended? Is it like kind of a once a year thing like a mammogram or more frequently or less?

Right. That's fair. They haven't done that much research on it.

There are a few AI companies out there that'll read your scan and they have this like AI wrapper around it that can better predict if you need to come back in a year or six years. They have not been FDA approved, They're not really readily available. I'm working with some of them to, to help push them over the line.

But I would go, and then if you have nothing really and everything looks okay, go in five years. You know, it could be more like a colonoscopy.

Okay.

But they don't have the data yet, so I can't really tell you 100%,.

Which is so crazy because I feel like, you know, I mean, I had a great uncle that passed from like lung cancer. You know, like lung cancer is not a new disease. You know, it's been around.

So why do you think it's just taken so long to kind of bring it into the, you know, into the consciousness of people?

I mean, I think a lot is because it was considered a lifestyle choice. I mean, I had a call with a CEO of a major national insurance company and he said, why should I scan people for lung cancer? It's a lifestyle choice.

And I was like, whoa, we've got to change the narrative. It's not, it's not a lifestyle choice. The other side of it is, as we know, as, you know, 40 something year old women were kind of on the back burner.

And it is a female health crisis. So men can also get lung cancer, obviously. But they've done recent studies.

They did a study in Taiwan, they repeated it in New York and it found that the Taiwanese, Asian, never smoking women were getting lung cancer at a twofold increase than their Asian male counterparts that smoked.

Why is that?

They have no idea. At first they did it in Taiwan and they thought it was cooking oils, which is why they repeated it in New York where no one cooks.

And they found the same. And so it's a female health crisis. Like no one's talking about it.

It's just starting to, as I, as I talk about it today, you'll start noticing it a little bit more. You'll see an article or this or that.

It's just at this inflection point where people are, I think, are starting to pay attention and realize that it's not good to smoke. You can get lung cancer, but it is not an only smoker's disease. Right. There are people out there.

The other thing I found reading studies was they did some work on breast cancer survivors. And I feel like I have so many peers that are breast cancer survivors right now, and I've spoken to a lot of them about this.

The study found that breast cancer survivors had a twofold increase of getting lung cancer as a primary cancer. So. So it was not a metastasis of the breast cancer. It had nothing.

They held constant for radiation and chemo, but they found that a breast cancer survivor should be getting a lung screen because their chance of getting lung cancer was two times the average person. So again, they're not covered in the lung screen for guidelines or for insurance.

So if you're a breast cancer survivor, you should talk to your doctor, find the study. You can read about it in my book and tell your doctor, I want a lung scan, I'll pay out of pocket.

Because they're finding that breast cancer survivors have a two times increase. And that is not fair. You do not need to be the person who survives breast cancer to then get lung cancer. It's not fair. One is enough.

We don't need to.

Right?

Well, and when you're getting these low dose CT scans, does that also, because it's, you know, the lungs, like, does that also include breast tissue that you could see on that scan?

I know. You know what's crazy, Roxy? None of these things really overlap.

So even like when I did my full body MRI over the summer, I thought, oh, will that count? Because I do a breast mri and they were like, no, the breast MRI is like more focused on the breast.

The full body MRI is like high level of everything. Then I had to go get brain MRI once I was diagnosed with lung cancer and I said, oh, I have my brain MRI from like three months ago.

And they were like, no, redo the brain MRI because it's like more focused.

And so I think in a similar way, like a mammogram machine versus a low dose chest ct, even though it is in the same area, it's just like the way they do the pictures, it doesn't show the same Thing.

Yeah. It doesn't translate for like every body part.

And I know, I wish, because a low dose chest CT is so chill, less than a minute. You don't get undressed, you lay on your back, your hands over your head, you go in, out, in, out, and that's it. And it's like a small donut machine.

Oh, and like a mammogram. I just had one. Again, that is not joke. It's like painful. They're like, don't breathe. Suck in round your back. Hold here. Don't move.

And you're like naked. And the machine, you're like the lady's hands. You're. It's not fair. You're like, what is this? Why can't we just land the thing?

I like to take a nap in the machine. But no.

So it's that quick? It's like a two minute process.

Yeah, it's actually, I think you're laying down less than a minute. Oh, my gosh. It's crazy how fast and easy and like a colonoscopy is two days, right? You, like spend a day at home on the toilet, right.

And then the next day you go in and they put you under and then you miss work for two days, easy.

Right? Right, Absolutely, absolutely.

Whereas like a low dose chest CTs, it's a minute you can go at a coffee break if you live close enough to, to an imaging service.

Right. So how do we, you know, for those people listening, like, how do we further the cause?

Like, how do we, you know, change, Help to make change, essentially?

I mean, I think we have to think about changing the narrative. We have to talk to our doctors and ask for the scans. We have to tell our girlfriends, like, take your mom to go get a scan.

Take a girlfriend to get a scan.

I've been doing that, taking my friends, meeting them at the, at the imaging place and saying, okay, and they go in for a minute, come out and they're like, that's it. I'm like, yep, bye. You know, we make it like a thing. Go get a coffee and get a scan and ask your doctors and educate your friends and read your.

Read my book called One Scan Saved My Life. And, you know, talk to people in the medical community and in the government community so that they understand that we're paying attention.

We're changing the narrative. We're out there advocating for ourselves to say, we got to fix this. You know, I just.

It's like one skin at a time, one woman at a time, just, you know, like, mammograms have become very constant in our lives. But it wasn't like that before. It's taken a lot of work.

What do you think is the biggest roadblock right now? What is the biggest, you know, the thing that's like stopping the progress.

I've had some interesting conversations recently. That's fair to ask. I think that one, we need to change the guidelines.

And so if we get the guidelines changed at the health and human services level, which I'm working on, that will cover the insurance that will force Medicare and Medicaid and insurance to likely cover it. So I think that's a big roadblock. I think doctors are a big roadblock because that's not what they were taught. And they're looking for a smoker.

They're looking for the black coal lung. They're looking for that in a lung cancer patient when it could be a young, healthy runner with four kids who's super active.

So I think it's all that narrative changing in addition to getting the guidelines changed.

In order to get the guidelines changed, though, I think we need a groundswell of young, smart, healthy women to start yelling from the rooftops, this is a female health crisis. We've got to get our lungs checked. This isn't fair. If you're a breast cancer survivor, you need your lung checked.

If your family history of lung cancer, you need it checked. You know, there's all these reasons, and we're just saying it's a lifestyle disease and brushing it under the rug. Yeah.

You know, it's interesting. It kind of parallels like, like what we were talking about at the conference with the menopause care too.

It's like you really have to push to get anything done.

When you feel like when you're a woman, you know, it's like our health is just not in the past, has not been seen as valuable as much as, you know, men's. It's like we're constantly having to fight to get the change to happen.

Right. And now we're doing it with the menopause. So all of the hormone replacement therapy.

I feel like this administration has recently come out and been like, what are we doing? Let women have hrt. Like, let's support them and Give them what they need, and they deserve to be stronger, healthier women.

And so that's been happening and I think helping. And that is still going on. And now we need to add lungs, too, and be like, this is a female health crisis.

Why aren't we taking care of ourselves and our moms and the women in our lives to make sure that they're healthy and strong?

Are there any women that should specifically sort of be on the lookout for possible dise?

Yeah, I, you know, there isn't that much research, but if, from my research, I would say if you have a family history, you should definitely look. If you, you know, the guidelines state if you were a smoker, you can be tested, but not if you're a secondhand smoke.

So if your parents are big smokers, you should probably be looked at.

If you quit smoking, it's great because every time, every year you've not smoked, your chances go down and down and down, but you should still be checked because you are at higher risk than if you've never smoked. I think if you have a breast cancer survivor, you should be looked at.

And then I think you should think about your workplace, where you work, how that environment is, because I think that there are a lot of factories or plants where people work that maybe have toxins in the air. The other thing that they've realized recently is though, smoking is the number one issue. Second issue is radon.

And they're finding that a lot of homes have radon issues. So, like a smoke detector, you can buy this little machine to detect radar in your home.

It's very reasonably priced, and you just put it in your house and it'll tell you where your radon is in your house. If your radon's high, all they do is they put, like an extra pipe underneath your house.

It's not that expensive, and it pushes the radon out and you're fine again. So there are certain neighborhoods and cities and states that have higher radon than others and certain homes.

And that's just with the radon detector to figure out if you're at a higher risk or not. Again, if you find you've been living in a house for 25 years and it has really bad radon, you should get your lungs checked.

But again, it's not going to be covered by your insurance because it's not in the guidelines. Even though research has continued to show that radon is the number two reason people are getting lung cancer.

Wow.

And what about, like, just being outside, like pollution in the air, you know, I mean, is that, you know, you and I both live in big cities, so it's like, you know, who knows what we're breathing most of the time,.

You know, I mean, I mean, sometimes, yeah, you don't know. And sometimes you think like, I think maybe it's because I'm a runner. I mean, that seems crazy, but, you know, I have these moments, right?

Attack myself, it's my fault. Even though it's not my fault. I didn't do anything wrong that I intentionally or anything like that.

Just like if you have breast cancer, it's not your fault that you have breast cancer. Or if you're going through menopause, it's not your fault you're going through menopause.

You should just do the best thing you can to take care of yourself. So it's not my fault. But I do think about that sometimes. I think, oh, it's because I run and I'm like breathing the air.

But I grew up in Santa Barbara, so, like on the beaches. So that's like salty air. Is salty air bad? You know, I, I live in Nashville now. I don't even know if this air is that bad here. Right. But it is.

I, I lived in. People have talked to me a lot about radon and I, my, I moved my eldest to seven different states before they turned 10.

So in that 10 year period, we lived in seven states.

So even if I had a high radon house or a bad pollution neighborhood, I don't know if that would be enough to affect me personally because I never was anywhere very long. But now I've been in Nashville over four years. Yeah, exactly.

You're like, I, hopefully I'm in a safe area. So what about general cancer, family history?

Like, not even necessarily lung cancer, but let's say, you know, there's like a family history of breast cancer or stomach cancer. Like you're saying, like, how does that all play into lung cancer percentages?

Yeah, they don't have that many, that much research on it still.

I did my full genome sequencing about five years ago, and I paid extra for an extra cancer panel on my genes because my mom was a breast cancer survivor. And I turned out I didn't have any of the genes that they know of for breast cancer.

I had a slightly elevated colon cancer gene that no one in my family's ever had colon cancer. So I started getting colonoscopies, but it really showed nothing.

And I think that I probably do have some cancer gene in my system, but they don't know what it is. Yet they haven't found it, actually. Interesting. When I found out I had lung cancer, I had done my genome sequencing at Harvard.

So I called and I said, hi, this is Shira. I wanted to call and let you know I have lung cancer. And the geneticist was like, what? I was like, well, I.

You didn't tell me at any elevated risk for any of the cancers, including lung cancer.

So I want you to know, because maybe there's a gene you'll discover one day, based on my data, that is a lung cancer gene or cancer in general, elevates a little bit. But, yeah, my aunt that I talked about who has stomach cancer, she's actually not a blood relative. Oh, my dad's brother's wife.

But I feel like she's my blood relative. But that was interesting because when I look at my family history, like, there's heart disease and things like that.

My mom had breast cancer, but her mom is still Alive. She turns 100 on May 5, and she doesn't have breast cancer. And my mom's sister is still alive and never had breast cancer.

So, you know, we don't know. It's not a gene like BRCA1 or BRCA2 that they were able to pinpoint for our family, but my mom's really the only one.

My dad's family, his parents both passed away at 97. You know, we have heart disease, but we don't have a lot of cancer. Until me, that.

I think that that is a really good point, though, for people listening to realize is that family. It doesn't always mean there's some sort of family history or what have you.

And that kind of goes along with, you know, a lot of cancers, is that you don't necessarily have to have a family history to have cancer, you know, And I think that that's the. That's also important for people to be aware of. You know, it's. It's. There's no way to tell, really. You know, a lot of the time,.

I mean, that's the reason my foundation is called Cancer Doesn't Care, and my website is Cancer Doesn't Care dot com. Because Cancer doesn't care. It doesn't matter how rich you are or how poor you are or what your family like. It. Sometimes it just doesn't care.

And it's, like, out to get you. And, like, what?

So sometimes when I get really upset, like you were saying before, and feel like my body betrayed me, and I have, like, anger issues about what I'm going through, I realize, like, I probably didn't do anything wrong. It's just like cancer doesn't care. It doesn't care.

I'm just lucky that I got that scan that I paid out of pocket, that I had this, like, moment of like, eh, I'll just go get it and see how it goes.

Yeah, no, absolutely. Thank goodness you did.

You know, you're a mom of four, so was there ever a moment when you, you know, we're kind of going through the thick of it that, you know, the fe crept in and you kind of, like, took off, like, the patient hat and you had the mom hat on? You know, like, was there ever that kind of a moment?

I mean, that moment still goes on. So I have a few anecdotes for you. So when we were.

When my husband and I were sitting in the doctor and they told me that I had lung cancer, I told him that we needed to, like, pick up the kids from school. He was going to pick them up.

I was going to meet him at home, and we were going to tell the kids that I had a medical procedure the next day because I was going to be put under general anesthesia to have a biopsy done, but that we weren't going to use the C word. That was my plan.

So I went home, he drove, picked up the kids, drove home, and the kids walked in the door, and I said, hey, I want to talk to you guys. And the kids looked at us, and one of my kids said, are you guys getting divorced? And the other one said, or does mom have cancer?

And my husband and I froze. And we were like, why would you say that? And they were like, dad's never picked us up from school before.

Wow. Wow.

So that opened it, right? So then the C word was on the table.

And so we explained to them that I'd had a scan that morning after my run and that they thought maybe it was cancer, but maybe it wasn't. And I was having a bronchoscopy the next day to have a biopsy done of the tumor. And so my son said, well, what are the chances that it is cancer?

And I think he was hoping I'd say 1 or 2%. And we said, the doctor told us it was 90% chance it was cancer. And then my kids all laughed.

They laughed, and I think they thought it was gonna be one or two. And it was like this moment where we're all on the couch telling them that their mom has cancer. And they giggled.

And I was like, but I think it kind of broke the ice. And you're like, okay. And then, you know, it was a tough couple of weeks with surgery and recovery and all of this. And now I wrote my book.

I'm on book tour. As I go on the news, I'm trying to, you know, teach people and raise awareness about lung cancer.

And my son came home the other day and said his friend. He overheard a friend of his speaking to the friend's father about how their mom. His mom has cancer.

So I said to my son, well, why don't you talk to him? Why don't you say, you know, you're here if he wants to talk to anyone that you understand, because your mom has cancer.

And he said, mom, that is so embarrassing. You do not have real cancer. I was like, oh, I don't. And my husband kind of looked. And he was like, no, you look fine. You do not have real cancer.

You kind of walked away like, I'm the most.

Fake cancer.

Yeah.

And what I think I realized talking to my kids a little bit more and understanding why they think I have fake cancer, is that today we think of a cancer patient as, like, bald, sick, and nauseous and not getting out of bed and not doing anything. And so, again, like, I'm really lucky I caught it early enough that I'm not currently sick and bald and not getting out of bed.

I'm fine and healthy and running and driving them to and from school every day in the minivan and going to all the sports games and acting like I'm fine.

And so I think that just goes to show, again, like, how these drugs and all this, like, make people think cancer patients are, like, sick and dying when some of us are thriving and we're doing okay.

And I think that was another thing I talked to some of the people in government about is, like, the cold capping that a lot of my friends have successfully worn during their breast cancer treatments. And. And then it keeps their hair.

And even though, you know, hair is, like, this vanity thing and doesn't really matter, I think as a woman in their 40s and 50s, like, it's so much of our identity and our children's identity of us that I think my children were spared a lot of that because they didn't see me as, like, a sick cancer patient victim. They saw me still as, like, the strong mom who can. Can do anything and everything for them.

Absolutely. How do you look at life now after this? Like, on the other side of it? Like, does it change your perspective?

Yes, I. It's funny because I'm on this book, you know, Journey Right now.

And so I feel like I've been traveling and gone a lot more from the kids, which is hard for me, so my guilt is up on that. But I do. I feel like you only live once. Like, fear of missing out. I want to say yes to everything. I run around. I.

When I go for my runs, I feel, like, really good and, like, proud. When I'm running, I try to exercise. You know, I still exercise every day. I feel really good. I feel like I'm out there.

I saved my life, and I just want to save other people's lives. It's given me a new lease on life. I have, like, this new passion and drive and focus that I never had had before.

And I want my kids to see me doing it and being. And be proud of me for working hard on it also. And, you know, I was in a dark place when they first told me. I mean, I remember some funny stories.

Like, I turned to my husband, and I said, I want you to remarry when I die, but you can't have more kids. He was like, what are you talking about?

I was like, if you have another kid, then the new wife will not pay attention to our four kids, so you can get married, but you can't have more kids. And he was like, you're crazy. You're not going anywhere. Right? You, like, get in all these things. Right?

Like, it makes me want to, like, be with the kids all the time and travel and see my friends and just say yes to everything, which also makes me have guilt because I'm, like, running around like a lunatic. So hopefully it'll calm me down a little bit. But I do.

I mean, I've always kind of had, like, a big, high energy level in life, but now I feel like it's even more so.

And I just try to smile all the time and tell people how great they are and tell people how much I appreciate them and tell them how beautiful they are. Because sometimes you don't realize it, but you take it for granted.

Absolutely. What kind of change would you like to see happen in the next five years when it comes to lung cancer?

I would love the guidelines to be changed, and with the guidelines, I would love it to trickle down for Medicare, Medicaid, and insurance so people can get their lungs scanned and it can be caught early and they can be a lung cancer survivor like me. That would warm my heart. Because right now, Roxy, to be honest, it's hard for me to find lung cancer survivor peers. Really? Yeah.

Is it just.

There aren't many of us. Yeah, I'm joining the breast cancer survivor crew. I'm always like, we're cancer survivors. I'm in your crew. I'm in your crew.

I think because by the time lung cancer is found, it's too late. And so it's really hard to find other young, healthy women that are beating it because it's caught too late. Gosh.

Is it more aggressive, like the younger you find it, or is there no, like, real correlation with that?

Okay, yeah, that's not. If you find it before it's spread to your lymph nodes, you're in better shape than if you find it after. Right.

Which is a lot of cancers, but this one specifically. And because we don't have that many drugs for it yet.

Okay. So that's got to be part of the changes, like the drugs and the research and.

Yeah, the narrative.

Right, Changing the narrative. I mean, is there active research being done right now in the way that you would like to see?

She was the mother of five. She was very active and ate out of the fridge and did all the right things.

And her hip hurt, like I'd said earlier when she was on a run, and she kind of ignored it for a little bit and then ultimately went in and it was lung cancer that had spread all over her body.

Oh, my God.

And watching that family, because I've known them since my early 20s, just spiral as any family would, was so hard. You know, her five kids, her widowed husband, her two sisters, her mom and dad. All of YouTube. Right.

Where would YouTube be if we still had Susan at the helm? And so the Wojcicki other sisters are starting a foundation in her honor.

They're really focused on, like, blood tests for lung cancer and more drugs because there was. That wasn't available to their sister who, you know, passed from lung cancer. And so, yes, I think in five years, we'll be in a much better place.

And I think a lot of that is because narrative is changing, but I think we need to change it more. I think we need to fix the guidelines, and I hope a lot of money gets in there so that we get the blood tests and all that.

Absolutely. Turning the tables a little bit, what advice would you give your 25 year old self? And what were you like at 25?

I want to know what the Shira was like.

I mean, I was probably still crazy. I probably went out more, danced a lot on tables and had a really good time all the time.

But now kids and all the things, I have my moments of that still, but I keep them under wraps just a few times a year. They pop out.

I would probably tell my 25 year old self to enjoy every moment and to get the scans and pay attention and not by my husband on getting that one, I guess, and to continue to do the right things because I also believe in, maybe it's the higher spirit, but my lung cancer, interestingly enough, had like they said, like a thin layer of cancerous cells that were less invasive than the main tumor itself that circled them. And I've spoken to oncologists and they sometimes say that they find that in healthy, active individuals.

So it was almost like maybe my body was fighting the tumor.

And so it made these cancer cells that surrounded my tumor, they were still cancer cells, but they were less aggressive, invasive cancer cells than the mass of the tumor. So the mass of the tumor was growing and it would have broken through that protective barrier.

But I think my body or somebody somewhere pushed to have it kind of protected. And so I think it's important to still take care of yourself. So even though I eat right and I exercise, I think that did help.

I think it did protect me a little bit from it spreading to my lymph nodes sooner. And I think I've probably had the cancer for a few years when I finally found it.

And I think I'm really lucky because if I had not gotten the scan and waited a few more months, it would have spread around my body and it would have been too late.

Wow, so you think you had it for some years? Like it was just kind of laying dormant and then growing and growing and growing?

Yeah, it was growing, but it was like, you know, because of that layer around it was growing, but it was kind of growing from the inside out versus like this way. And that layer was getting thinner and thinner, I think. And it was about to break through it, which would have made too late in a few months.

My God. Thank goodness you went in. That is just. That's crazy. So what lesson have you learned in midlife? What is like the most important lesson?

I mean, to be honest, that the minutes are long and the days and years are short. I sometimes find myself like trying to get to bedtime, but the reality is like then the week goes by and I'm like, wait a minute. Did I do this?

Did I do that? I'm trying to see that. My oldest are freshmen in high school, and I know that soon they'll be driving and definitely leaving me.

And so with this whole process, I've realized I just want to hold on to them, and I'm trying to focus on them more, and I'm embracing it. I'm okay in my 40s. I feel good. You know, I think there's so much pressure when you're younger.

And I've, like, come into my own, and I have my own career, and I have my family and my babies that I love on all the time, and I feel good about it. And I've learned a lot to stand up for myself and say, this is what I need right now. And a lot of that I didn't do before I had cancer.

And I think cancer has helped me with that to, you know, be honest with myself and with my family and friends around me.

Absolutely. And how are you living iconically right now?

I mean, look at me. All the things. Of course I know. I have never had a social media. I've never been on television. I've never done podcasts.

I've just, you know, hunkered behind and along the road. I think I've always introduced myself as Adam's wife. I've always played.

I always say I play wife really well, or I'm roots mom, or I'm, you know, Rachel's mom. And I just always am behind the throne. I'm always, you know, the wife or the mom or the friend or this.

And I am living iconically because now I have a big social media. I started. It's called Shira Bowler, my name. I'm trying to raise awareness about lung cancer. I've been on FOX and cnn.

I'm going to be on the Today show. I'm just doing all these things now that I never thought I would do, and I'm putting myself out there.

And it's something that changed when I hit 44, and I kind of love it.

Yeah, there's something really nice about, like, feeling good about where you are and not really giving so many fucks about, like, what everyone else thinks and being able to put yourself out there, you know, why not?

I mean, and I just. I think I. I guess I have Diary of the mouth, right? I just share my story. I keep telling everyone because I want people to get help.

So many people have come to me, and they're like, I just wouldn't have told anyone. I can't believe you're doing that. I can't believe you're telling the world about all the stuff you went through.

But that's something that changed for me because I was like, if I don't, who will? And who's going to stand up and say, lung cancer is a thing? It's a female health crisis.

It's happening to women in their 40s and 50s, just like menopause, just like breast cancer. We need to talk about it. We need to, like, get the word out. And so I never thought I'd be an author. I never thought I'd be on a podcast.

I never thought I'd go on television and, like, doing it all. And I started it all at 44 and like, here I am, you know,.

See, it's never too late. It's never too late.

So what do you say to a woman at home that feels stuck, that she doesn't really know what to do in midlife, especially, you know, like, what advice would you give her?

It's funny.

Like, I feel like I'm my husband's wife, I'm the mother of my four children. You know, I have my mba. I worked really hard as a student.

Like, but I'm just kind of like, eh, I don't really know, like, what's mine, who am I except a wife and a mother and all those things. And I said that. And I said, I'd love to, like, find my passion or drive or something that excites me to get up every morning.

And I didn't think it would be lung cancer, but I mean, I'm the luckiest girl in the world. I have no evidence of disease. I'm a lung cancer survivor. And like, I'm going to help change the guidelines and save lives and move the needle.

And I just never thought that would be me. And so when I look back at me when I was a little bit stuck, I would say stand up and like, do something.

Like, just, I don't know, whatever it is, if you want to get super active in the kids, school or more active in your husband's job or more active in your own job or start your own career, I think that this whole, whole thing in your 40s, I see so many Friends restarting. And I used to think, like, I love connecting people and talking to people. Maybe I should be a recruiter.

And I started working a little bit with my husband's company and the recruiting team to see if I could help and introduce them to people and things like that. And, like, put on clothes and went to the office every single day, you know, and just figure out what made me tick. But I think.

I think our 40s and 50s are, like, it's it for us. I think it's like, the go time it is, right? You don't have to be pregnant. We don't have to be, like, nursing anymore.

We're just, like, crushing it at this stage. Yeah.

It's like our time. It's like, this is it. Like, this is it, you know? I totally agree.

I think it's never too late, and I think anybody can start anything at any time, you know, why not? Knowledge is power. And what is next for you, my friend?

I'm getting on a plane. I am heading to Texas for a couple of days.

I have a book party in Dallas and Austin and some meetings and a conference, and I'm going to go talk about my book and spread the word to get people's lungs checked and take care of their bodies.

Amazing. And where can everybody find you and if they want to reach out to you as well?

Yeah, I have my social media. My name is Shira Bowler. S H I R A B O E H L E R On Instagram. I just joined LinkedIn. I'm doing all the things. Roxy. I have a website.

It's called Cancer Doesn't Care Dot Com. And you can find my book there. You can find my book on Amazon. It comes out later in April. And you can write me on any of those places, too.

And I'm answering and really active on it all, because I just. I want people to get their lungs checked.

Yeah, this is. This is what's happening. You're making it happen. You are making it.

Got it?

Yeah. Absolutely. Well, thank you so much for coming on the show, everybody. Please check out all of Shira's amazing work that she's doing. Go get your scans.

Go get your scans. Right? And be absolutely.

Be sure to come back on Thursday for Shira's game episode, because we're going to be diving into all the things you're not going to want to miss it. It's amazing. And be sure you, like, subscribe and rate wherever you get podcasts so we can bring you more amazing conversations like this.

Shira, you're a rock star. Thank you, thank you, thank you. Yay. Loved, loved, loved, loved. What makes this conversation so powerful is not just what happened to Shira.

It's what almost didn't happen. Because her story only exists the way it does because she had access, she had information, and she pushed when most people are told not to.

And that's the question this leaves us with. How many women are doing everything right and still being missed?

If this episode made you think differently about your health, your instincts, or the questions you're asking, don't keep it to yourself. Share it with a woman in your life who needs to hear it.

Text it to a friend, Send it to your sister, your mom, or your group chat, because this is the kind of of conversation that can actually change outcomes. And if you haven't already, follow the show so you don't miss what's coming next.

We're having these conversations every week with bold, smart, interesting guests. Some you know, and some you'll be very glad you met here first.

Whether you're questioning the system, trusting your gut, or just training to figure it all out, you're not crazy. You're evolving, and that's iconic.