blood clots after first chemo

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May 25, 2015 at 10:26 am  #1269942    

colmor

Hi, haven’t posted a while. My husbans chemo delayed, had surgery, radiation and was awaiting trial biopsy. Etc. Long story short he started actually 6 months! But minimal progression in lungs. But after first cis/pem treatment he got chest pain day 5, After getting him reviewed at local hosp he had multiple blood clots in lungs and vasculitus? (may have that bit wrong). Prior to him starting chemo during the tests for immuno trial radiologist said that most of what had been considered to be metastasis in lungs she thought was cysts and scar tissue. Main mass 3.5 cm adeno, and nodules, considered to be lung mets. He had only had denosumab prior for bone met to hip, for which he had femural pin and radiation.

The radiologist and oncologist at local hospital said his scans are very difficult to interpret. But why so many blood clots so soon after treatment. Remember he had none forn6 months prior treatment. What are the cysts and scar tissue there before? Few other things odd they say they cant explain. What could that be? Could it be another underlying lung disease (yes ive asked they say they don’t know). Should I push it or just let them keep treating and not keep asking. The hospital who told us of blood clots said looking at his scans he should be in intensive care but he’s seemingly ‘ bearing it all amazingly well’. He got blood thinners and home next day. Apparently he had high dose cisplatin with the pemetrexed. Would it be rude to ask for a specialist in interstitial lung diseases to look at his scans. Would oncology already have done that, or maybe it doesnt matter if he has stage iv lung cancer. I dont know. I feel like im talking to myself. Am I being irrational to worry about these seeming anomalies? Maybe this is all perfectly normal? Anyone thoughts, experience to offer?

Kind regards

Cat

May 25, 2015 at 11:58 am  #1269944    
JimC Forum Moderator
JimC Forum Moderator

Hi Cat,

I am sorry to hear of the problems your husband is having, and I don’t think that you are at all out of line to seek answers, including a second opinion from a specialist. In Dr. Weiss’ excellent post on “Blood Clots in Cancer”, he states:

“[T]hrombosis (clotting) is very common in cancer. Second, more advanced cancers cause more clotting than more local cancers. Finally, lung cancer is one of the most prothrombotic cancers. Also of note, the risk of clotting goes up, not down with chemo, even when the chemo works well to control the cancer.”

So the risk was there before he started chemo, and the treatment may have increased that likelihood. Still, I think seeing a pulmonologist would be worthwhile to determine if there are other factors at play.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

May 25, 2015 at 12:56 pm  #1269945    

colmor

Hi jim, thanks.

I will read this and show my husband. I may sound silly, but im not sure what a pulmonologist is specifically, or to be more exact if that is what we call them in England. ? Ive not met one yet as far as im aware. It’s not just the blood clots but the other issues, scarring, cysts etc…im wondering if he had another disease first then got cancer. He’s been tired for years. Ive read many fibrosis or interstitial lung diseases can increase risk of cancer and can present as scarring, cysts and nodules, varying according to type etc. But also wondered if that kind of additional disease could affect treatment choices or not. Maybe im getting ahead of myself which is why id like an expert to explain not just say we don’t know…

But im not a doctor but thanks for the ideas and the link…I appreciate your reply. How do you find the time? Bless you

Kind regards

Cat x

May 25, 2015 at 1:36 pm  #1269946    
JimC Forum Moderator
JimC Forum Moderator

Hi Cat,

I don’t know what they call them in England, but a pulmonologist here is simply a doctor who specializes in diseases of the lung (as opposed to a thoracic oncologist, who specializes in cancer in the lung and chest). I’m sure there’s a similar specialty there.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

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