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Lung Cancer Stage 4, COPD. Soft Tissue Mass On Chest Plate. General Treatment?

Posted on Fri, 5 Oct 2012

Question: My husband was just DX adenosquamous lung cancer stage 4. He was a smoker and was near 911. Just found out he had COPD in XXXXXXX His health was always good. I know he is in the 1% in cardiology for his age of 52. He went into ER last week. The drained fluid fron is left lung. Removed the plueral lining of his right lung, founf a soft tissue mass about 5x 3 on the chest plate. They have in on O2 and he just came home recuperating from surgery. What would be the general treatment for this. What are his chances of surviving this? He has a meeting with an oncologist on Thursday. Are there any questions we should be asking him to?

Answered by Dr. Ioan Dorian OANA (9 hours later)

Hello,

The adenosquamous carcinoma is a rare combined tumour of non-small cell lung cancer and patients who had been treated only surgically have poor survival prognosis and ask for an adjuvant therapy.

Because unfortunately we speak about an advanced disease, the drug regimen with the highest likelihood of benefit with toxicity deemed acceptable to both the physician and the patient should be given.

Has your husband done molecular diagnostic studies to determine whether certain gene mutations are present? If yes, please let me know the results.

If no, he should and until then Bevacizumab + chemotherapy is indicated in performance status 0-1 patients. Platinum-based chemotherapy is the best one because prolongs survival, improves symptom control and yields superior quality of life compared to best supportive care.

To determine his performance status, please let me know if he is completely ambulatory, so he is able to carry out work of a light or sedentary nature or he is unable to carry out any work activities.

Regarding his chances of surviving this, I am afraid they are very low, statistically the overall 5-year survival rate is less than 10%.

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

Regards
Dr. Dorian Oana MD, PhD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ioan Dorian OANA (3 hours later)

Has your husband done molecular diagnostic studies to determine whether certain gene mutations are present? If yes, please let me know the results.

Not sure. I know they did a biopsy of fluid and lining. Have not recieved the report yet.

He is able to walk around bit with oxygen but has to pace himself. otherwise he gets labored breathing.

Is there anything specific I should be asking the oncologist tomorrow when he see him?

Answered by Dr. Ioan Dorian OANA (7 hours later)

Hello,

Thanks for your reply.

Yes, you should ask him first about the molecular diagnostic.

On the other hand, you should ask him if he considers right to wait until the performance status of the patient improves a little before starting chemotherapy or he thinks he should start it as soon as possible, even if with a less aggressive chemotherapy.

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

Regards
Dr. Dorian Oana MD, PhD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ioan Dorian OANA (14 hours later)

Just got back from Dr. Silberberg. He scheduling him for an MRI of the brain and a Petscan. Wants to start him on chemotherpy Carboplatin + Gemcitabine. The molecular Dx has not come back yet but he does not think XXXXXXX will be a canditate for it. If Chemo is not working well he will bw looking at clinical trails.

Is there any clinical trails that work well with adenosquamous stage 4 lung cancer?

Answered by Dr. Ioan Dorian OANA (12 hours later)

Hello,

Thanks for your reply.

There are clinical trails that work with adenosquamous stage 4 lung cancer. I give you below two examples:

1. Docetaxel, Cisplatin, Pegfilgrastim, and Erlotinib Hydrochloride in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer

2. Gemcitabine Hydrochloride and Carboplatin With or Without MK-0646 as First-Line Therapy in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer

You should discuss with Dr. Silberberg these opportunities before starting any chemotherapy, because these two examples of clinical trials have like inclusion criteria: More than 12 months since prior gemcitabine hydrochloride, cisplatin, or carboplatin or No prior chemotherapy.

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

Regards
Dr. Dorian Oana MD, PhD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ioan Dorian OANA (33 hours later)

Searching the net and came across this site WWW.WWWW.WW please take a look at it and let me know what you think. Is this possible and can it work?

Answered by Dr. Ioan Dorian OANA (1 hour later)

Hello,

Thanks for your reply.

Unfortunately I am 100% this is not possible and it cannot work. Please be very careful because there are a lot offers like that online and you should not buy anything without oncologist's recommendation. This kind of websites just want to make money, with any risk and they are not reliable at all.

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

Regards
Dr. Dorian Oana MD, PhD

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar