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Found non- small cell adenocarcinoma of the lung. Treated with SRS. What is the life expectancy?

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Practicing since : 1979
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BACKGROUND: Mother is 86. Mother is maybe 4'11", and weighs 93 pounds. Has ALWAYS lived with excellent health with no problems. March 2012, a spot was found in the lung, biopsied and found to be non- small cell adenocarcinoma of the lung. It was treated successfully with SRS and today is not considered to be a problem. In July 2012 she was feeling "fuzzy" and an MRI identified spots on the brain. She decided to go with SRS again and scheduled it for early September 2012. In August 2012 the did another MRI to prepare for the SRS and it showed even MORE spots than they had seen in July (one month prior). All the spots were treated with SRS in September 2012. Very hard on her. She was hospitalized with Dilantin overdose, steriods were hard on her. It has taken until now for her to feel somewhat good (but still very tired) again. January 2013 MRI shows more spots and doctors say all they can do for her is WBRT. WBRT is not a cure. Either way she will die. We have chosen NOT to do WBRT. Today, she is doing well, feeling well, driving and independent. Hence, my question. Without WBRT, WHAT CAN WE EXPECT GOING FORWARD? HOW LONG DO WE HAVE? HOW WILL IT HAPPEN? WILL SHE MOST LIKELY HAVE A STROKE? DIE IN HER SLEEP? OR WHAT? PLEASE -- NO FLUFF -- I WANT TO KNOW THE HARSH REALITY. Based on your knowledge and experience -- I realize you can't tell the future -- BUT, you know the reality of the situation and I NEED TO KNOW THE REALITY WE ARE FACING. THANK YOU FOR YOUR INPUT -- I AM GRATEFUL!
Posted Sat, 2 Feb 2013 in Blood Cancer(Leukemia)
Answered by Dr. Jawahar Ticku 13 hours later

Thanks for sharing your worries here. I understand your concerns and appreciate the efforts you are taking for the benefit of your mother.

She has received SRS for a metastatic lesion. It is a localized form of treatment used for single lesion. Since primary site is not treated, many more metastatic deposits are likely to come. She required treatment with WBRT initially itself.

What is needed is to consult a clinical Oncologist who will give drugs which will take care of primary as well as the secondary deposit. Presently the lesions in the brain might be small so your mother is fine. Problems will start when the tumors grow and press on the vital parts of the brain. When the problem grows, she may slip into confusion or coma depending on the area of brain involved. She might have recurrent seizures. Speech or movements may be affected. It all depends on the part of brain involved.

Complications can come from the brain lesion or the problems from the primary i.e lung. In the best set up, prognosis should be good for two years if treated. In exceptional circumstances, survival can prolong or reduce depending upon the patient’s general condition.

Hope I have answered your queries. Let me know if I can assist you further.

Dr. J. Ticku
Above answer was peer-reviewed by
Follow-up: Found non- small cell adenocarcinoma of the lung. Treated with SRS. What is the life expectancy? 5 hours later
Dr. Ticku,

Thank you for your answer -- I am grateful.

When you say "prognosis should be good for two years, if treated".

The one spot in the lung has long since been treated with SRS and they monitor it regularly. At this time the lung cancer is in complete remission. I.E., the primary spot has been treated SUCCESSFULLY.

The four spots the saw in the brain in September WERE treated with SRS. Then more spots show in January and they tell us they cannot do anymore SRS -- it is time for WBRT.

So...when you say, "if treated", do you mean treatment with WBRT? WE HAVE CHOSEN NOT TO DO WBRT.

When you say , "if treated", do you mean drugs to keep her comfortable?

I'm confused. Thank you again Dr. Ticku for your input.
Answered by Dr. Jawahar Ticku 24 hours later

I am happy you could understand what I said. If the primary in the lung is under control, there must be some focus or the wandering cells in the blood which come to brain and grow. To stop this happening, she needs some form of chemotherapy. So that the new metastasis do not occur in the brain. The tumors already present in the brain and the cells, which are at present in the primitive stage, can be taken care of with WBRT.

So if WBRT and appropriate CT are given, useful prolonged survival will be there.

If you have chosen not to have WBRT, use of chemotherapy will also be of great help.

When the metastasis does not grow, comfort will automatically be there.

I hope I am clear to you.

Dr. J. Ticku
Above answer was peer-reviewed by
Follow-up: Found non- small cell adenocarcinoma of the lung. Treated with SRS. What is the life expectancy? 4 hours later
Dear Dr. Ticku:

Thank you for your patience and putting it so a layman like me can understand what you are saying.

It is clear now. My doctor has never addressed Chemo. I'm wondering why. I agree -- it is in the blood -- traveling not only to the brain, but all over her body. I'm even wondering if it is elsewhere in her body that we don't know about. Maybe we don't even want to know. But it is so good to hear that chemo may help and I am grateful Dr. Ticku -- THANK YOU. We were told WBRT was really all that was left!?!

Two more years -- even one more year of quality life -- I will be grateful. If not, I understand it now: CANCER KILLS.

Thanks you again for your insight!
Most Sincerely, XXXXXXX
Answered by Dr. Jawahar Ticku 13 hours later

I feel happy that i could make things clear to you. Immediate concern is the brain. To stop recurrence of the growing metastasis WBRT is the answer. You can observe her for some time and later you might consider for having it.

Best wishes for you and your mother.

Hope I have answered all your questions. Please use any answer clarification before closing and rating this answer. I will be happy to explain or expand on any issue you may have.

Dr. J. Ticku
Above answer was peer-reviewed by
Follow-up: Found non- small cell adenocarcinoma of the lung. Treated with SRS. What is the life expectancy? 5 hours later
Dr. Ticku,

Thank you kindly for your insight and your patience with me. You have so answered my initial questions.

And so, because her doctors want WBRT and you mention WBRT as something that can help, please let me ask some questions ABOUT WBRT.

Is it true that 85% of WBRT patients are dead one year later?

Is it true that WBRT extends life, BUT ONLY ON AVERAGE 3 to 5 more months?

What is the risk of some impact to her mental capacities? HIGH? LOW? WHAT IS LIKELY?

What is the risk of some impact to her ability to walk? HIGH RISK SHE WILL NEED HELP WALKING? LOW RISK OF IMPACT ON HER ABILITY TO WALK?

Today she is doing so well -- living independently with minimal effect from the brain metastasis. After WBRT, what are the odds she will return to feeling good and living independently? ARE THE ODDS GOOD? IS THE REALITY BAD?

I just do not want ANY surprises if we go ahead with WBRT at some point. I need the knowledge and understanding BEFORE we jump in.

Thank you for understanding Dr. Ticku. Again, I am grateful for your expertise, your time and your patience.
Most sincerely, XXXXXXX
Answered by Dr. Jawahar Ticku 25 hours later
WBRT is an established treatment for multiple brain metastasis. The doses of radiation are given within tolerance limits.There is no danger of any side effect or any untoward effect. Radiation complications do arise but very late for which a person might not live that long. Mild nausea or vomiting might occur which is called radiation sickness which is a transitory phenomenon and can be taken care of with anti vomiting and anti-nauseating drugs. Your mother will continue to live as she is living presently. The complications likely to come shortly due to growing brain metastasis will be long delayed by WBRT.
Hope that helps
Dr. J. Ticku
Above answer was peer-reviewed by
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