Stage 3 lung cancer and cerebellar atrophy re-immunotherapy

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February 10, 2017 at 10:32 am  #1290039    


Hi I was diagnosed with Stage 3 advanced adenocarcinoma of the lung spread to lymph nodes in August 2016.I have had 4 rounds of cisplatin/pemetrexed and 4 rounds of pemetrexed maintenance. CT shows all has shrunk and is stable. I also have cerebellar atrophe which causes balance problems. I have tested positive for immunotherapy but my oncologist is very cautious as this could affect the cerebellar problems.He thinks it could be paraneoplastic syndrome. My question is would I be able to have immunotherapy?

February 11, 2017 at 7:53 am  #1290041    
JimC Forum Moderator
JimC Forum Moderator

Hi willis3,

Welcome to GRACE. I’m sorry to hear of your diagnosis, but it’s good that your cancer has responded well to treatment. As Dr. West wrote in his post on paraneoplastic syndromes, these are most often (but not exclusively) associated with small cell lung cancer. If your cerebellar atrophe was caused by your cancer, then from what I’ve read immunotherapy will not help, although I haven’t found anything that indicates it would be worsened.

On the other hand, there are many conditions which can cause cerebellar atrophy. Since paraneoplastic syndromes are usually found in connection with small cell lung cancer, your medical team may want to perform further workup to try to rule out other causes for the atrophe, especially since there is evidence that immunotherapy may actually help the atrophe when not caused by cancer. That may require consultations with experts from fields other than oncology.

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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:

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