Guests/Speakers
James Hiter
Endurance Athlete | LCFA Speakers Bureau Member | Survivor
James brings curiosity, determination, and hard-won wisdom to conversations about living with lung cancer. Diagnosed in 2017 with a rare multicystic presentation, he’s undergone three lung surgeries and now operates on roughly 55% of his original lung capacity—yet he still runs every single day. His journey through multidisciplinary tumor boards, second opinions, and ongoing surveillance gives him an intimate understanding of what patients and caregivers face. James asks the questions patients actually want answered because he’s wondered them himself.
Maida Mangiameli
Voices of Hope Speakers Bureau Member | SCLC Survivor & Advocate
Maida is a 74-year-old survivor of extensive-stage small cell lung cancer (SCLC) who has been in remission for six years. Her journey—marked by an “unflappable energy” and a vital sense of humor—began with an urgent diagnosis that forced the immediate cancellation of a dream cruise to Bali. Since then, she has navigated chemotherapy and precision radiation for spinal tumors while refusing to be defined by grim statistics. A dedicated advocate for research and early detection, Maida focuses on her “indomitable spirit” to support other patients and prioritize quality time with her 7-year-old granddaughter. She brings a powerful perspective to the “time toxicity” conversation, having learned to balance intensive medical monitoring with a commitment to living a vibrant, active life.
Lung cancer treatment is often described in terms of side effects, outcomes, and survival. But there’s another cost that rarely gets talked about — time.
Time spent in infusion chairs. Time driving to appointments. Time waiting, recovering, adjusting, and simply getting through the day.
That’s what this episode of Living With Lung Cancer: Ask Me Anything explores.
Host James Hiter sits down with lung cancer survivor Maida Mangiameli for a candid conversation about “time toxicity” — the cumulative impact treatment has on how patients live their daily lives. From long days in infusion centers to weeks structured around appointments, they unpack what treatment really demands beyond the physical toll.
When Treatment Becomes a Full-Time Commitment
For many patients, treatment isn’t just something that happens occasionally. It becomes a central part of life.
Maida describes spending multiple consecutive days each week receiving chemotherapy, followed by additional visits for supportive care — a schedule that repeats over months. What seems like “a few appointments” quickly becomes a routine that reshapes your entire week.
Even outside the clinic, recovery time matters. Fatigue, appetite loss, and emotional strain often mean that the hours at home aren’t fully your own either.
As James puts it, treatment can feel like a full-time job — one that patients never applied for but must learn to manage.
The Time No One Prepares You For
What surprises many patients isn’t just treatment time — it’s everything leading up to it.
Before a diagnosis is confirmed, there are scans, tests, biopsies, and consultations. Days turn into weeks of waiting, uncertainty, and constant appointments. It’s a phase that many people don’t anticipate but quickly realize is just as demanding.
Maida reflects on how unprepared she felt for this part of the journey — not knowing how much time it would take simply to get answers and begin treatment.
“When the treatments get started, that’s when your time just moves like a snail or at times you feel like you’re rushing through your life.” — Maida Mangiameli
The Ripple Effect on Work and Daily Life
Time toxicity doesn’t just affect patients — it impacts every part of life around them.
For those who are working, balancing treatment with job responsibilities can be overwhelming. James shares how he tried to maintain his work schedule, even traveling between treatments, while navigating fatigue and side effects.
At the same time, caregivers take on additional responsibilities — driving to appointments, managing schedules, and supporting recovery — often without fully recognizing the time burden they’re carrying.
Time becomes something to constantly negotiate, prioritize, and sometimes surrender.
Clinical Trials and the Time Tradeoff
Clinical trials offer hope — access to new treatments, closer monitoring, and potentially better outcomes.
But they also come with added time commitments.
Patients may need to travel long distances, attend more frequent appointments, or even relocate temporarily to participate. For some, that means hours on the road or extended stays away from home.
Despite these challenges, Maida emphasizes that for many patients, the benefits can outweigh the time investment — especially as clinical trials continue to shape the future of lung cancer treatment.
Learning to Adjust, Not Just Endure
Living with lung cancer often requires a shift in mindset.
For people who are used to being constantly active, slowing down can be one of the hardest adjustments. Time that was once filled with work, movement, and routine becomes time spent resting, recovering, and waiting.
“I wasn’t a sit-on-the-couch kind of guy. And all of a sudden I had to become a sit-on-the-couch guy… it takes a mental shift, especially if you’re a go-go-go person.” — James Hiter
But within that shift, many patients find new ways to measure time — through moments, milestones, and connections that matter most.
Maida shares how focusing on family, especially her granddaughter, became a powerful source of motivation and perspective.
What Patients Want Others to Understand
If there’s one takeaway from this conversation, it’s this:
Time is one of the most significant — and least understood — parts of the lung cancer experience.
Patients aren’t just navigating a disease. They’re navigating a complete reorganization of their time, energy, and priorities.
Understanding that reality can change how we support patients, how we communicate about treatment, and how we think about care.
If You’re Navigating Lung Cancer
You may not be able to control how much time treatment takes. But understanding it — and preparing for it — can make a meaningful difference.
“The milestones are all what make it worthwhile to keep fighting and to keep trying. Time toxicity, financial toxicity, all the physical toxicity—you endure all of that to get to those milestones.” — James Hiter
