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Blog Video

Lindi Campbell’s Lung Cancer Survivor Story

In December 2015, I was only 51 when a spot was discovered on the lower lobe of my right lung. I have never used tobacco products, was a very healthy eater and regular exerciser. The nodule was found initially on a routine x-ray by my Primary Care Physician. A CT scan, a PET scan, and numerous follow-up CT scans over a period of 18 months showed some growth, but the reason for the growth was still inconclusive. Lung cancer seemed out of the realm of possibility due to my health history.

When the nodule reached the size of 2.4 cm a biopsy was scheduled to determine if the spot was cancerous. Initially, much to my relief, the results came back showing no signs of cancer. We would later learn that biopsies do not always rule out cancer. After treating the growth in my lung over several months for a possible fungus with no success, I was advised to have it removed without delay and surgery was immediately scheduled within weeks.

The firm advice to proceed with surgery most likely is the key factor in catching it before it had spread. No one could fathom that it would be cancer. A wedge resection surgery was scheduled in December 2017 to remove the unidentified growth. However, during surgery, pathology revealed cancer.

A thoracotomy was performed immediately to remove two lobes of my right lung to ensure all of the cancer was gone. The final pathology report indicated two types of cancer, Adenocarcinoma and Squamous cell carcinoma. This rare form takes on a name of its own, Adenosquamous Carcinoma. According to the American Journal of Clinical Pathology, this type of cancer exists in 0.4% to 4% of cases. My cancer, although very rare, had not spread to the lymph nodes and was stage 1. My survival prognosis was considered to be very good. Unfortunately, only 16% of people will be diagnosed in the earliest stages like me, when the disease is most treatable.

After a year and a half of clean scans post-surgery, a few new spots began to appear in my left lung. We continued to follow the growth of these nodules until one in the lower portion of the lung had grown enough (8 mm) to warrant removal for further testing.  In May 2020 a wedge resection was scheduled to examine the growth. It too was cancer. Molecular testing of the tissue revealed I have a genetic mutation called EGFR exon 19 deletion that is driving the cancer in my lungs. I am now on a targeted therapy drug called Osemertinib to intercept the work of the mutation and help prevent future recurrences. I will be on this medicine until it stops working or until there is a better option. Our hope is the cancer does not ever return or spread outside of my lungs. I am very grateful for my health at this time and for the hope research and medicine provide lung cancer survivors, but there is still so much work to be done to increase survival statistics of this number one cancer killer.

Learn about Lindi’s organization, Breath of Hope KY.

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Industry Updates

HUD MAP Guide – Key Radon Measurement and Mitigation Updates

The HUD Office of Multifamily Housing Programs has released its updated Multifamily Accelerated Processing (MAP) Guide. Released on December 18, 2020, the guidance goes into effect on March 18, 2021. Key updates to radon measurement and mitigation requirements include:

  • Section 9.6.3.2.C – the previous guidance permitted the radon professional to conclude that testing or mitigation isn’t necessarily based on a physical inspection of the property, the characteristics of the buildings, and other valid justifications. The updated guidance requires a valid justification for requesting exemption of testing or mitigation, based on criteria detailed in the applicable ANSI/AARST standard, to be provided by the radon professional in the form of a signed letter.
  • Section 9.6.3.2.C – the previous guidance excluded testing and mitigation for Section 223(f) projects located in Zone 3 of the EPA’s Map of Radon Zones. The updated guidance removes this exclusion, requiring testing and mitigation for all Section 223(f) projects.
  • Section 9.6.3.2.D – the previous guidance permitted random screening of 25% of ground contact units in each building in lieu of the full 100% characterization required by the measurement standard. The updated guidance removes this deviation, requiring radon testing to be conducted in full compliance with the ANSI/AARST measurement standard, which includes 100% testing of ground contact units in each building.
  • Section 9.6.3.2.G – the previous guidance permitted a ‘worst-case’ estimate for mitigation to be conducted as a non-critical repair. The updated guidance requires the lender to include a firm scope of work and all related costs for mitigation in the Firm application. In order to provide the firm scope of work and all related costs for mitigation, the pilot test and building evaluation will need to be treated as a critical repair.
  • Section 9.6.3.2.I – the previous guidance provided general parameters for the ongoing operation, maintenance, and monitoring (OMM) requirements when a mitigation system is installed at a property. The updated guidance requires an OMM program meeting the requirements of the ANSI/AARST mitigation standard to be maintained at a property containing a mitigation system for the duration of the insured mortgage. The OMM plan must be submitted to HUD upon completion of the mitigation project.
  • Section 9.6.3.2.J – the previous guidance did not include a provision for ensuring existing mitigation systems at a property are functioning correctly and meet the minimum requirements of the mitigation standard. The updated guidance requires existing mitigation systems at a property to be evaluated by a radon professional to confirm compliance with the ANSI/AARST mitigation standard and to verify they are functioning correctly. If applicable, corrective action must be taken by a radon professional to address any deficiencies with the mitigation systems.
  • Section 9.6.3.2.K – the previous guidance permitted a ‘worst-case’ cost estimate for mitigation and did not require inclusion of ongoing OMM costs. The updated guidance requires the lender to provide a firm scope of work and all related mitigation costs, to include ongoing OMM costs, in the Firm application.

For loans where the Firm application is submitted prior to the effective date, the lender must choose whether the 2016 or 2020 version of the MAP Guide will be utilized, stating this choice in the application. The lender may not mix underwriting provisions from both guides during the 90-day transition period.

The updated guidance is being implemented as we work to overcome the radon measurement and mitigation challenges created by the COVID-19 pandemic. The COVID-19 measurement and mitigation guidance released by HUD’s Office of Multifamily Housing Programs on April 2, 2020 remains in effect. Check out our April 3, 2020 update on this guidance.

The updated guidance is specific to projects being processed under the MAP Guide. We anticipate similar radon measurement and mitigation guidance for projects being processed under the Office of Residential Care Facilities Section 232 Handbook in the future. The COVID-19 measurement and mitigation guidance released by ORCF on April 10, 2020 remains in effect. Check out our April 10, 2020 update on this guidance.

As always, the trusted professionals at Protect Environmental stand ready to assist you in determining the most efficient and economical approach for managing radon and chemical vapor intrusion. As the largest provider of radon measurement and mitigation services to HUD lenders, you can rely on our knowledge and expertise to provide flexible options to ensure your transactions continue to move forward in a timely and cost-effective manner. Follow our LinkedIn portal for timely updates related to the rollout of HUD’s updated MAP Guide.