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    • Yes, it is common to have residual imaging abnormalities after chemo and radiation, but if it hasn't progressed over many years, it's overwhelmingly likely that there is NO viable cancer and that the treatment has been curative. I suppose it would be remotely possible that a stage 3 cancer could re (More)
    • If you have stage 3 non operable lung cancer and have had a stabel disease for 5 years, can you then be called "cancer-free" I have heard that when you have stage 3 you have a chronic disease...but I dont quit understand that its chronical if its stable for 5 years.. (More)
    • It's common to repeat scans every 2-3 cycles (about every 6-9 weeks) to assess response to treatment. I'm sorry, but the other questions really depend on details someone on the internet cannot address -- it is most appropriate to review the specifics of your case with someone who has all of that (More)
    • Thank you Dr West. Is it common to not do scans while still getting treatment. So yes I am terrified as to what's next ? And my chances again of beating this horrible disease. Due to them removing the main tumor and one positive lymph...Will that help me in the long run ? What do they normally rec (More)
    • I'm sorry that because the issue here is primarily centered around whether he has a recurrence of esophageal cancer, we can't provide any kind of guidance about the advisability of any treatment now -- we have many doctors here with expertise in lung cancer but at this time haven't extended our expe (More)
    • My dad had esophageal ca diagnosed t3n1m0, with Chemo and rad followed by esophagectomy w gastric pull up. Feb 2013. Has been NED. This January 2016, CT showed pulmonary effusion. Thorecentisis ensued 1.5l removed (.5 liter left) clear yellow no sediment that I noted. Fluid came back negative - as m (More)
    • I'm sorry to learn of your recurrence. You're right that the post-operative (adjuvant) chemotherapy was given to try to eliminate any micrometastases that may be in the bloodstream and therefore not amenable to surgery, but unfortunately this eradicates the disease only a minority of the time. W (More)
    • I was expecting adenocarcinoma stage 2A due to one of the seven lymph nodes.positive. had wedge surgery that removed tumor and lymph node, I had the chemo x4 after surgery, now 6 months later found it returned in lymph nodes.I am confused now as to why ? I was told the chemo us given to get any cell (More)
    • I am not involved in his care, so I could not possibly say whether his diagnosis is correct. Nor could I say whether the firm area you are feeling is cancer or just scar tissue. Mesothelioma is a different cancer. It is typically limited to the lining around the lung, and it can be difficult to d (More)
    • Thank you. My dad was dx with adenocarcinoma. Did they misdiagnose him since you're mentioning mesothelioma? Or is pleural mesothelioma a symptom of lung cancer? I'm really concerned that maybe the tarceva hasn't worked then since my dad did not have the lumps on his chest before and now they're (More)
    • My concern would be that it may well be the cancer itself, growing in the chest wall. That is actually fairly common in patients with a pleural mesothelioma, less common but certainly possible in lung cancer. It may be scar tissue, but I understand and share your concern that it may represent the (More)
    • Thanks. I really appreciate your response. We are staying hopeful for now. My dad recently complained of this really hard spot that formed near the incision in his chest where they had a VAT procedure done in order to diagnose him in November 2015. He complained the site was itchy for a few weeks (More)
    • I am not in a position to say what she should do. However, as I said above, changes in the amount of pleural fluid are a very soft indicator and are generally not considered sufficient to make clinical decisions that a treatment is clearly working or not working. -Dr. West (More)
    • Dr. West I have two opposite opinion about the situation of my wife- One Onc says that since her PETCT shows no sign of the illnes then the Tarceva works. The other one claims that a continious accumulation of Pleural fluid indicate that the Tarceva is not fully effective and that additional chemo (More)
    • The changes in the pleural fluid are a rather soft, imperfect measure of the efficacy of a treatment, but it's generally favorable if there is a lower volume of fluid and it's becoming less bloody. It's certainly possible for the lung to re-expand, but the longer it has been collapsed, the less (More)
    • Dr. West, My father was recently dx with malignant pleural effusion (adenocarcinoma). He was put on tarceva as first and only line of treatment. He's been take the tarceva for a month. A month ago when he was diagnosed we were draining him daily and we noticed his fluid was this deep red color/bl (More)
    • Thanks very much for those kind words. Much appreciated! -Dr. West (More)
    • Thanks Dr. West! Excellent discussion of the issues. As a cell biologist I tend to agree with the general approach of finding out as much molecular information about the tumor as is easily obtainable. As more treatments get developed to be directed at particular genetic or cellular markers, the m (More)
    • Dan, I'm sorry that your wife's situation sounds very case-specific and complex. If she has clearly progressing disease, then I think that trying subsequent treatment beyond Tarceva (erlotinib), whether chemotherapy or the newly FDA-approved oral agent Tagrisso (osimertinib) if she has progres (More)
    • Dr. West My wife has NSCLC stage 4, treated with Tarceva. Recently she had a PET CT scan and the results were good-NED. 5 months ago she had a pleurodesis and the Docs said that it would give her better quality of life. After the operation she was told that it was successful. However the adhesion (More)

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