Lung cancer spread to the through the peritoneum cavity

Portal Forums Radiation Oncology General Radiation Oncology Lung cancer spread to the through the peritoneum cavity

This topic contains 5 replies, has 3 voices, and was last updated by  odossani 3 years, 7 months ago.

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April 23, 2014 at 3:01 pm  #1263368    

odossani

My mother was diagnosed with Stage 4 EGFR Exon 19 positive Lung cancer 3 years ago and has been on Tarceva during this time with very good results. Her most recent CT scans showed a small tumor in the liver (8mm) and around the same time she recently became unwell (unable to eat or drink) and so we had a Pet Scan which showed fairly widespread cancer spread to the intestines causing a blockage. We are working on switching to Afatinib but are also considering if radiation can shrink these tumors to where her intestine can allow food and water to pass through. Does anybody know if radiation can help this condition.? Surgeons have said surgery is very risky

April 23, 2014 at 6:15 pm  #1263378    
Dr West
Dr West

I’m sorry she’s facing this situation. Unfortunately, this is a very diffuse process, so I cannot imagine that either radiation or surgery would be helpful for it. It tends to be difficult to treat, but systemic therapy like conventional chemotherapy or possibly a targeted therapy would be the most feasible approach. I wish I could be more optimistic about afatinib, but its track record in the setting of acquired resistance to Tarceva is just not very good except in very unusual cases. Some investigational agents, such as CO1686 (being developed by Clovis) or AZD9291 (from AstraZeneca) have demonstrated more promising activity in patients with acquired resistance to EGFR inhibitors.

Good luck.

-Dr. West

April 23, 2014 at 10:27 pm  #1263389    

odossani

Dear Dr. West,

Thanks for your reply. Your opinion on Afatinib is known to me but the choice is chemo or that and after my review of the different studies and your own consideration that she has done very well with TKIs in the past we choose Afatinib (oncologist offered both options). We have applied for the co 1686 trial but given her condition of not being able to eat it is unlikely they will accept her for the one open slot they have and it is hard to travel in these circumstances.

A different oncologist reading of the Pet Scan resulted in a very different perspective.
He finds no significant progression of the lung disease and is suspicious that this may be ovarian cancer or something else altogether.

So the question for you is “is it common for lung cancer to progress in this manner”. i.e Be stable in the lungs and elsewhere but block off intestines and one of her ureters”

April 24, 2014 at 6:18 am  #1263390    
JimC Forum Moderator
JimC Forum Moderator

The most common sites for lung cancer metastases are the liver, bones, brain and the adrenal glands, but less commonly it can spread elsewhere. And there are times when it is stable in the lungs but progressing elsewhere. With cancer, pretty much anything can happen.

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

April 24, 2014 at 6:49 pm  #1263404    
Dr West
Dr West

It’s not a common form of progression, but it’s definitely a pattern we see — in fact, I saw that pattern of progression in a patient in my own clinic yesterday. It’s possible it’s something entirely different, but more often than being two separate, independent cancers, it’s more likely to be the same process.

-Dr. West

April 25, 2014 at 6:56 am  #1263410    

odossani

Thank you Dr. West and JimC

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