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Diagnosed with small cell lung cancer. Not responding to chemo and radiation therapy. Swelling persists. Alternate treatment options?

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Practicing since : 2002
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My sister has been diagnosed with non small cell lung cancer, stage 3B, she has received chemo and radiation therapy and is now resting/recovering from the treatment. Her scan does not show improvement after the therapy; however, the extremity swelling she was experiencing has improved, but is starting to return. It has been one month since she stopped treatment. She has an appointment in early Feb for another scan and evaluation with the oncologist. Is there an alternative treatment to radiation and Chemotherapy that has shown promise? The doctor said he may recommend more chemotherapy.... maybe once a month, but no more radiation... depending on what the next scan shows. How does this sound to you?
Posted Sat, 21 Apr 2012 in Lung Cancer
Answered by Dr. Robert Galamaga 5 hours later
Hello and thank you for submitting a question.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding what are going on with your sister.

Regarding chemotherapy and radiation inpatients would've been diagnosed with stage IIIB lung cancer long-term and very large clinical trials have shown a wheel benefit to chemotherapy and radiation in helping to eliminate any residual disease as much as possible.

Advanced stage lung cancer is very difficult to treat and if your sister is otherwise healthy I would recommend a really aggressive approach in treating this. I am sure your sister has completed several cycles of chemotherapy which do have significant side effects. As you know significant degrees of nausea and vomiting as well as weight loss can occur. Large fluid shifts can also cause swelling of the lower extremities.
Generally this will improve over time in addition to good nutrition. It is important that she maintains good protein calorie intake in order to help the fluid in her legs slowly resolve.

In some patients maintenance chemotherapy has also been recommended to help maintain a remission of the cancer. I'm sure this is what your sister’s oncologist was when he mentioned the idea of monthly therapy. Additional radiation does not provide any benefit and can cause major toxicities.

Additional scans of the chest are certainly standard of care for this type of diagnosis and I would certainly recommend that your sister have her scan performed in furry as scheduled. It looks like she is receiving optimal care for her cancer. This is a very difficult diagnosis and as a patient is a very long and difficult process as well. I am glad you're serving as a good support mechanism for her as she certainly needs this as she continues to battle the cancer. I would also make sure her tumor specimen was tested for EGFR and ALL mutations if her tumor was described as an adenocarcinoma. If these mutations are positive it may give her oncologist another target to treat if she happens to have relapse of her disease in the future pure

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr. Robert
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