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    • The intent from his doctor may well be to eradicate the cancer, but I don't think that's possible in this situation, receiving chemotherapy alone. The cancer may well shrink, some of it may be killed by the chemo, but chemotherapy would not realistically be able to eradicate all of the viable cancer (More)
    • So sorry to hear that. Then the intent is for just maintenance? He can't be on this chemo forever. So what you are saying that it's just a matter of time before it starts spreading after all treatment is over? He is so hoping for a complete recovery. (More)
    • While there are circumstances in which chemotherapy is given with curative intent after surgery or chemo/radiation, I'm afraid I don't think it's realistic to expect that chemotherapy can eradicate all evidence of cancer if there is biopsy-proven residual viable cancer after chemo and radiation. (More)
    • Hi Dr West, My husband was diagnosed with NSLC Stage IIB back in May, 2014. They tried doing VATS surgery in July but the tumor was too big and inoperable. He has no metastasis and no lymph node involvement anywhere. He was treated with 7 rounds of carbo/taxol chemo very aggressive then had 3 mor (More)
    • I'm sorry it's not possible to answer that question -- we just don't have the data to provide an answer. I would favor taking the drug as directed, though I certainly recognize that cost is a factor. Good luck. -Dr. West (More)
    • If I had EGFR + stage 4 lung cancer and for financial reasons wanted to take Tab Iressa 250mg every other day, what is the likelihood of benefit? Any literature to support this? (More)
    • Thank you Dr West, aside from some fatigue and moderate diarrhea I am doing well with tarceva for last 7 months My oncologist mentioned acrometatasis and aggressive raadiotherapy treatment at this stage. Is it better to wait and enjoy this hiatus thank you (More)
    • At this point we have some third generation EGFR TKIs such as rociletinib (CO-1686) or merelitinib (AZD9291) that clearly have significant activity in the majority of patients with T790M mutation-positive acquired resistance to a n initial EGFR TKI. I would say that the evidence we have now is that (More)
    • Dr. West if tarceva was still working on the original turmors but the patient had progression in other areas - would you consider adding opdivo to the tarceva or would you switch? (More)
    • :( i agree that cancer is the emperor of all maladies (More)
    • I would only add that the PET uptake may also be instructive, as it tends to be associated with the growth rate of a lesion.. A "maximum SUV" of under 2-3 is suggestive of a very indolent process, but if it's over 4 or 5, it suggests that it may be transitioning to a less indolent process that may m (More)
    • Radiation is usually very well tolerated and is an obvious compromise between observation and intervening with something as potentially risky as surgery. It satisfies the compulsion to DO SOMETHING when you get a diagnosis of something that is technically called cancer under the microscope but your (More)
    • Dr West, I am so grateful to have found you. So much of what you share resonates. My mother had a CT scan 5 years ago and they found a nodule that was 1.1cm - they did another CT scan 2 years later and it hadn't changed. They dismissed it as being nothing. Then, 2 weeks ago she was in the hospit (More)
    • My wife Lucy is on pemetrexed now, still too early to say how it's working. Assuming one of these is available soon, I expect it will be next up, at least I'll be pushing for it, since it's demonstrated to be better than docetaxel, and unless I read things wrong, Tarceva (in our case). One thi (More)
    • My leading goal when considering trials is to try to maximize the options available. CO-1686 (rociletinib) isn't likely to be commercially available to patients who are T790M negative, but the agent may have some meaningful activity, even if less than in T790M-positive patients. On the other hand, O (More)
    • Dr West What factors would you consider when deciding between Opdivo and Clovis 1686 (tiger 3 trial) for NSCLC stage 4 positive EGRF and negative T790M patient who responded well but is progressing on Tarceva, attempted CHEMO with no results after two cycles, and is now back on Tarceva? (More)
    • Thank you, Dr. West, for your response. (More)
    • It is very reasonable to stop chemo after a couple of cycles if someone is having trouble tolerating it. The benefit is "top-heavy", in that there is more value in the first couple of cycles, and you reach a point of diminishing returns by 3-4 cycles. Moreover, patients with stage IB lung cancer ha (More)
    • Just checked current NCCN says every 6 - 12 months! So I will ask my oncologist....that sounds better than every 3 months! :) (Saw this site referred to on another link: What follow up should patients have after surgery for early lung cancer? | GRACE :: Lung Cancer, so checked (More)

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