Father with Stage 4 Adenocarcinoma EGFR. Diagnosed 3/2013

Portal Forums Radiation Oncology Brain Metastases / PCI Father with Stage 4 Adenocarcinoma EGFR. Diagnosed 3/2013

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September 5, 2014 at 1:08 pm  #1265767    


Hi, my father has been living with stage 4 nsclc for 18 months (they only gave him 3). He’s been on Tarceva. Unfortunately, it spread to his brain where he has multiple lesions. In literally under a month he went from running errands and doing work to now in a hospital barely able to do any ADLs or make complete sentences. He got through 7 of 10 bouts of Whole Brain Radiation before he fell at home and threw up. Now we are in the hospital. The onc has him off Tarceva and was going to recommend chemo every 3 weeks starting today but we can’t get him out of the hospital. I’m wondering:

A) is this the disease taking it’s toll or the radiation to the brain?
B) what type of facility can we get him in to regain strength? Not sure if we want palliative or hospice yet
C) why his is speech so bad?


September 5, 2014 at 3:56 pm  #1265772    
Dr West
Dr West

I’m sorry about what your father is facing.

I think it’s far more likely that these problems stem from the disease itself rather than the radiation. Yes, the radiation was being done, but it was being done because of significant disease in the brain.

It’s certainly reasonable to try a rehab facility and see if he improves with time off of treatment. That could possibly happen, but if the cancer is truly what is causing his decline, there isn’t a facility that will be able to turn things around. While he and your family may not feel emotionally ready for hospice, it’s important to note that turning down hospice care doesn’t mean that the cancer is deterred. I don’t know what will happen, but he may continue to decline whether he and your family accept the services hospice provides or not.

I am far less able to address why his speech is bad than his own doctors. I would venture to say that one or more of the brain metastases, or the swelling around them, are interfering with his speech patterns.

I do hope things improve for him.

Good luck.

-Dr. West

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