Multi nodules both lungs

Portal Forums Lung/Thoracic Cancer NSCLC Bronchioloalveolar Carcinoma (BAC) Multi nodules both lungs

This topic contains 2 replies, has 2 voices, and was last updated by  hppycmpr3 1 month, 2 weeks ago.

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August 11, 2017 at 6:57 pm  #1291241    

hppycmpr3

I am a 60 year old woman. In February 2014 I had an open thoracotomy with a wedge resection of my upper and middle right lobe. A sectomectomy of my lower right lobe. The doctor took out as many nodules as he could feel. A couple in the bottom lobe were cancerous adenocarcinoma with BAC features. In the middle lobe a carcinoid tumor and upper lobe all benign. October of 2014 I had an upper left lobe lobectomy same as the right. Adenocarcinoma with BAC features and a wedge resection all benign in the lower left lobe. CT scans every 4 months. In November of 2016 they found a nodule had grown in my lower right lobe. I had stereotactic radiation. CT scans now every 3 months. In July my CT scan showed a nodule in my upper right nodule had grown. Did biopsy and it showed adenocarcinoma with BAC features. All my tumors have been negative for mutations and no PDL-1 as well. The tumor board has decided on more stereotactic radiation. I am wondering if anyone out there has similar scenario? And if so did your doctor’s do something different? I am thinking that the stereotactic radiation is just a bandaid. And how much can be done before my lung function is severely compromised. There had to be something else that we can try. I am willing to travel anywhere to find a solution. So if anyone has any input I would appreciate it tremendously.

August 12, 2017 at 7:28 am  #1291242    
JimC Forum Moderator
JimC Forum Moderator

Hi hppycmpr3,

I’m sorry to hear about all you’ve been through since your last post. I think the most important considerations center on whether your cancer is an indolent form of BAC vs. a more invasive adenocarcinoma. Even if it’s more like BAC new nodules may appear, but if those nodules grow slowly then it may be best not to treat them with local therapy (surgery or radiation), and watch them over time. This is described in Dr. West’s post in which he formulates an algorithm for treating slow-growing cancers, for which he previously provided you a link.

If the nodules grow at a significant rate, then systemic therapy may be preferred over local therapy. In the absence of targetable mutations, the choice would likely be chemotherapy. But it would be helpful to know just how indolent or aggressive your cancer is before making that choice.

At this point, it might be good to seek a second opinion, preferably from a doctor at a teaching hospital. That could either put you on a different treatment path or confirm the recommendations of your current oncologist and tumor board.

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

August 12, 2017 at 9:27 am  #1291243    

hppycmpr3

Thank you Jim! I am seeing my oncologist Monday and I will ask if my newest cancerous nodule is aggressive versus indolent. I will also talk about systemic options as well. I do agree with you about going to another hospital for what would be a third opinion. I did go to Emory which is a teaching hospital about a year ago and they agreed with my doctor’s. But I think it is time to go somewhere else and get that third opinion. Thank you for your thoughts. It is greatly appreciated.

Marian aka hppycmpr3

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