Hypothetical Question???

Portal Forums Cancer Basics General Cancer Basics Hypothetical Question???

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November 30, 2016 at 6:44 am  #1289296    

cards7up

This is as I titled, a hypothetical question. What is the likelihood of having an “aggressive” undiagnosed cancer of any kind for more than 12 years? Then diagnosed and treated after all that time but supposedly seen on a scan more than 12 years before. Also, on the BAC post, is it unusual to have a pleural effusion?
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

November 30, 2016 at 11:01 am  #1289297    
JimC Forum Moderator
JimC Forum Moderator

Hi Judy,

Although as it’s often said that “cancer can do anything”, I think it’s pretty hard to imagine an “aggressive” cancer lying dormant for that many years. It would be much more likely that what was seen on the scan 12 years prior was a benign nodule and the eventual cancer showed up coincidentally in the same spot. It’s extremely likely that something changed over the course of those 12 years, such that even if it was a very indolent cancer originally. later more aggressive cancer cells developed, probably not related to what was already there.

As far as your second question, if we’re talking about pure (non-invasive) BAC, you’re correct in that it would be unusual for it to enter the bloodstream and cause a malignant pleural effusion. On the other hand, there is a continuum of BAC types ranging from the least aggressive, non-invasive types to those which are much more aggressive. So if the BAC results in a pleural effusion, it’s almost certainly not the indolent form of BAC that is typically over-treated.

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

November 30, 2016 at 11:04 am  #1289298    
JimC Forum Moderator
JimC Forum Moderator

Just to add, Dr. West discusses that continuum of BAC cases in his Basics of Bronchioloalveolar Carcinoma post.

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

December 4, 2016 at 2:54 pm  #1289341    

cards7up

But if it was indolent for years and then a pleural effusion, could it be adeno and not BAC?
Take care, Judy


Stage IIIA adeno, dx 7/2010. SRS then chemo carbo/alimta 4x. NED as of 10/2011.
Local recurrence, surgery to remove LRL 8/29/13. 5.2cm involved pleura. Chemo carbo/alimta x3. NED

December 4, 2016 at 4:34 pm  #1289344    
JimC Forum Moderator
JimC Forum Moderator

Hi Judy,

Yes, it could be, although since testing of the effusion cancer cells showed BAC, it might be what has historically been referred to as “adenocarcinoma with BAC features.” Dr. West discusses this subtype in his “Basics of BAC” post.

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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