PrimarySquamous lung cancer, IIIb spreadinng rapidly, possible pericardium mets

Portal Forums Lung/Thoracic Cancer NSCLC General NSCLC PrimarySquamous lung cancer, IIIb spreadinng rapidly, possible pericardium mets

This topic contains 4 replies, has 3 voices, and was last updated by  catdander forum moderator 9 months, 2 weeks ago.

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January 9, 2014 at 3:04 pm  #1261440    

maya

I am not looking for a miracle, but a way to give my aunt (72) a chance to have more time and a better quality of her remaining days.
After almost a month in a hospital she was diagnozed yesterday – Carcinoma squamocellulare non-keratodes, IIIb and she received the first part of her chemo (unfortunately we were not told what they actually gave her). Today she received the second part but had a bad reaction and was rushed to see a cardiologist. Later, a CT scan (I hope I got it right) showed “spots on her pericardium” and the doctors were reluctant to confirm the mets, but were extremly worried. They pumped water out of her lungs. It was bad. We knew that the tumor had infiltarted the chest bone and ribs as well as lymph nodes, but is it possible that it started attacking th epericardium in less than two weeks? Aren’t the squamous tumors supposed to be slower? Or, maybe, this is slow compared to other types?
She survived breast cancer twice (1960 and 2004), the last one ended with double mastectomy. If the diagnosis is correct (histoopathology report arrived yesterday) thi stulor has nothing to do with the older ones.
We changed her diet a few weeks ago – no dairy, eggs, poultry, red meet, gluten, high processed foods. She stopped smoking 16 years ago. We are looking into some complementary therapies/supplements to boost her immunity (thymus injections, Cuban vaccine…).

Please help us better understand the ilness, prognosis, possible options… we have no one to turn to. Doctors are (probably) doing what they can in the circumstances, but they’re not telling us anything.

January 9, 2014 at 7:43 pm  #1261441    

catdander forum moderator

Hello maya, I’m sorry your aunt is going through this difficult situation. It sounds as though she is being treated for palliative care instead of curative? If so the goal is to lengthen life and raise the quality of life. It’s possible they will want to try something other than the chemo that caused such a bad reaction.

If you want to understand this illness better I’ll paste links to some of our blogs that will help you get started.
I wonder what the idea behind the restrictive diet is? Two of the common symptoms of cancer are loss of weight and appetite so taking away so many choices may be more harmful than good. I don’t know of data to show a mostly vegetable diet will lengthen or heighten her quality of life of someone with as invasive a cancer as her’s.

Cancer will do what it does with no reference to averages and statistics so it’s impossible to say how fast it might move.

I hope I’ve not overstep my bounds but I know you’re reaching for straws and I know you aunt is having an extremely difficult time.
All best,
Janine

http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/

http://cancergrace.org/lung/2011/10/03/lilenbaum-on-lc-in-elderly/http://cancergrace.org/cancer-101/2010/09/02/does-sugar-feed-cancer/


My husband, 53 @ dx of stage 3 squam nsclc R. pancoast tumor 8/09 caused destruction of 3 ribs, touching brachial plexus. 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable). Chemorads, 9/09. MRI by pancoast specialty surgeon 11/09 spine met found, stage IV, Rad to spine, Chemo changed from cis/etop to navelbine/carbo. 6 cycles total. Tarceva 2/10-11/10. 3cm tumor L lung, biopsy undx w/collapsed lung. Gemzar, 12/10 through 7/12. NED 3/12, stop tx 7/12. Remains NED as of 8/14.

January 9, 2014 at 9:04 pm  #1261444    

Dr West

I’m afraid it sounds to me like her cancer is advanced and most likely stage IV if it is involving bones and possibly/likely the pericardium. I can’t say whether it has spread there in 2 weeks or was more extensive from the start — sometimes it takes a few weeks to get a better sense of the full extent of the cancer. It would be unusual, but certainly very possible, for a cancer to progress at a pace of spread over a few weeks.

The general guidelines about one type of cancer being slower or faster growing, more or less responsive, etc., are overstated and are truly not helpful compared with direct evidence of an individual patient’s case. There is so much variability in how cancer behaves within these categories that it is far, far more valuable to interpret what you see in an individual patient’s case than to try to predict what will happen based on an assigned histology.

Unfortunately, there really isn’t nearly as much impact of diet on patient outcomes with most cancers, and lung cancer specifically, as people would like to believe. It would be nice if you could survive significantly longer by eating fresh fruits and vegetables and eliminating gluten and sugar, but in truth, there is no evidence at all that those kind of dietary manipulation exert a significant influence on patient outcomes in this setting.

Prognosis is also something that is individual enough that it is most important to get that information from someone directly involved in a patient’s care. It is typically difficult to predict even in a patient you know personally and have all of the details for, which means that it’s essentially pointless for someone who doesn’t have a direct knowledge of a patient to speculate wildly. I understand that her doctors may not be very generous with information about what to expect, but people who don’t know her or the details of her case are not a useful substitute.

Good luck.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

January 10, 2014 at 2:08 am  #1261445    

maya

Dear catdander, dear Dr West
thank you so much for your support and the insights.
It seems to us as well that the doctors are just trying to make her comfortable and that chemo’s purpose is to lessen the symptoms.
She really wants to live for as long as she can. I’m not saying that she’s delusional and that she doesn’t understand that the illness she has is terminal. She just wants to enjoy life for as long as she can. That’s why we opted for diet changes. Something she should have done a long, long time ago. I don’t know if vegetables, brown rice, fish and fruit can fight the tumor, but I do know that highly processed foods are really bad.
This morning she felt better. Good enough to get out of bed and move around check her emails and read a bit.
Unfortunately the doctors in the country we live in are not forthcoming. We can’t get anything out of them. We still don’t know what are the “spots” on pericardium, hopefully someone will get to the bottom of that.

As soon as the doctors give us her dossier (results, scans…) we’ll try to get a second oppinion. Again, not because we’re looking for a better diagnosis. It is what it is. But to make sure that she’s getting all that she needs.
Thank you again!

January 10, 2014 at 3:10 pm  #1261463    

catdander forum moderator

I completely understand your need to make sure your aunt gets the best care for the best quality of life she can have for as long as she can have it. This is an awful disease but hopefully she’ll move through it with as few complications as possible. A healthy diet certainly can be helpful, I didn’t mean to sound flippant about that, I only question whether restricting too much of what she likes may take away some of the quality she can control. It’s a balancing act where everyone is different.
All best to her, you, and the rest of the family,
Janine


My husband, 53 @ dx of stage 3 squam nsclc R. pancoast tumor 8/09 caused destruction of 3 ribs, touching brachial plexus. 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable). Chemorads, 9/09. MRI by pancoast specialty surgeon 11/09 spine met found, stage IV, Rad to spine, Chemo changed from cis/etop to navelbine/carbo. 6 cycles total. Tarceva 2/10-11/10. 3cm tumor L lung, biopsy undx w/collapsed lung. Gemzar, 12/10 through 7/12. NED 3/12, stop tx 7/12. Remains NED as of 8/14.

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