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Suffering From Stage 4 Lung Cancer. What Treatment And Diet Is To Be Taken?

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Posted on Thu, 1 Nov 2012
Question: My father is suffering from lung cancer, stage 4 as it is metastasized to brain.
The EGFR report states that mutation L858R was observed in exon 21.
- Can we start with tablets in this case, instead of chemo therapy?
- What are the side effects while tablets are first line therapy?
- While tablets are first line therapy, What should be the diet taken during this therapy?

doctor
Answered by Dr. Ioan Dorian OANA (3 hours later)
Hi XXXXXXX

Thanks for your query.

You did not speak at all about the histopathology of the lung cancer, so I can just assume it is a non-small cell lung cancer, knowing that it has been done an EGFR report. Because the mutation L858R was observed in exon 21, he should start with anti-EGFR therapy, so with tablets, instead of chemotherapy (Erlotinib).

The most common side effects while Erlotinib is first line therapy are: rash, diarrhea, loss of appetite, fatigue, nausea, vomiting, heartburn, gas, constipation, stomach pain, mouth sores, weight loss, headache, bone or muscle pain, depression, anxiety, numbness, burning, or tingling of the hands or feet, swelling of the arms, hands, feet, ankles, or lower legs, darkening of skin, hair loss, changes in the appearance of the hair and nails.

The patient should avoid eating grapefruit and drinking grapefruit juice while taking this medicine. To prevent diarrhea that may be caused by erlotinib, your father should drink small sips of a liquid such as a sugar-free sports drink often throughout the day, eat mild foods such as crackers and toast, and avoid spicy foods.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ioan Dorian OANA

Oncologist

Practicing since :2006

Answered : 101 Questions

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Suffering From Stage 4 Lung Cancer. What Treatment And Diet Is To Be Taken?

Hi XXXXXXX

Thanks for your query.

You did not speak at all about the histopathology of the lung cancer, so I can just assume it is a non-small cell lung cancer, knowing that it has been done an EGFR report. Because the mutation L858R was observed in exon 21, he should start with anti-EGFR therapy, so with tablets, instead of chemotherapy (Erlotinib).

The most common side effects while Erlotinib is first line therapy are: rash, diarrhea, loss of appetite, fatigue, nausea, vomiting, heartburn, gas, constipation, stomach pain, mouth sores, weight loss, headache, bone or muscle pain, depression, anxiety, numbness, burning, or tingling of the hands or feet, swelling of the arms, hands, feet, ankles, or lower legs, darkening of skin, hair loss, changes in the appearance of the hair and nails.

The patient should avoid eating grapefruit and drinking grapefruit juice while taking this medicine. To prevent diarrhea that may be caused by erlotinib, your father should drink small sips of a liquid such as a sugar-free sports drink often throughout the day, eat mild foods such as crackers and toast, and avoid spicy foods.

If you have any more queries, feel free to ask.

Regards
Dr. Dorian Oana MD, PhD