Hello! I am a new member here hoping to get some feedback regarding my mother's treatment and better understand her cancer. I apologize if I am misinformed. I am very new to this and beyond heartbroken. Here is a little background:
My mom is 54 years old. She had smoked for approximately 40 years but no longer smokes. On 9/24/2012, my mom suffered a massive heart attack with 100% blockage and had a stent put in. During her time at the hospital, they did a chest xray and picked up a mass on the right lung. They did further studies and found that the mass on the right lung was 13cm and she had a smaller mass on the lower left lung measuring 4cm. She had a biopsy completed during her hospital stay and was ultimately diagnosed with stage IV NSCLC. There is involvement with the adrenal glands as well as lymph nodes in the chest area.
My mom began chemo on 10/10/2012. She was put on Carboplatin and Pemetrexed which she received every 3 weeks. She has been hospitalized for pneumonia once and received a blood transfusion during that time. After the first two rounds, the ct scan showed no progression. My mom just had her second scan on 01/08/2013 which showed the right mass measuring 21cm and left mass at 6cm. My mom's oncologist stopped the chemo on Wednesday and offered her the potential to participate in a clinical trial for BMS-936558 or she'll receive Docetaxel should she not go for it or if she is not randomly picked for the trial drug. My mom also had to receive another blood transfusion on Wednesday.
The oncologist indicated that since my mom has never received chemo, it isn't a good sign that she isn't responding to the first line chemo drugs. Is that true? Additionally, the first hospital that did the biopsy didn't have enough tissue to do the genetic testing. She has to go in next Wednesday for a secondary biopsy.
I'm certain I have left things out however, I am so all over the place it's hard. Any feedback would be appreciated.
Reply # - January 11, 2013, 08:52 AM
Reply To: Looking for help with my mother
First of all I want to welcome you Grace. It's a great place to get informed about your mom's lung cancer. I'm so very sorry for you, her and the rest of your family. Lung cancer is such a difficult thing to keep at bay. We're here for the sole reason of helping you help her move through the process.
Your mom's cancer sounds pretty aggressive since it grew through the treatment. Are we right in assuming she has adenocarcinoma since she was given pemetrexed?
The doctors must be explaining things really well because you seem to have a good grasp of what's going on and the plans seem very reasonable. The drug in the trial you mention is a quite promising drug. It appears to work on both squamous cell and adeno, so smoking history or mutation findings aren't issues. Like her onc said you would want to have the first line chemo shrink the tumors. First line chemo tends to work better than following lines of chemo. But this is the norm and cancer will do what it wants and another chemo might work but for now she has a great opportunity to possibly get a promising new non chemo drug.
If you haven't, please check out our library and past forum discussions. You can use the tab above for "Focused" or "General" cancer info (there are drop down menus on the right after you choose a page). Our search feature is very helpful (though you may need to log off to access results depending on your browser). We're happy to help find info too if you need it.
Doctors, I wonder since she smoked for 40 years (my husband too was a long time smoker before dx) if it makes her less responsive to the pemetrexed (alimta). I say that because many long term smokers have squamous cell, while never or light term smokers are almost always going to have adenocarcinoma. Pemetrexed doesn't have efficacy on squam cell. Am I making too big a leap here?
Very good luck to your mom, let us know what questions you have moving forward,
Janine
forum moderator
Reply # - January 11, 2013, 09:00 AM
Reply To: Looking for help with my mother
I would only clarify that she has received chemo, but I think that just might be a miscommunication in what you wrote, since you probably know that. The point that she progressed pretty significantly and relatively early on good chemotherapy is suggestive that her cancer is on the more aggressive side, and that would also make me less optimistic about how well she'll do with more chemotherapy. The trial she's enrolling on is one that I'm also offering at my center, and I think it's a very interesting and promising one. I would just underscore that while the novel immunotherapy on that trial is the more appealing component, Taxotere (docetaxel) as the alternative is still a very appropriate second line treatment that has an established role and would be considered by most experts to be the leading option among chemotherapy-based choices if she weren't doing a clinical trial. The leading other alternative would be Tarceva (erlotinib), which would still be considered an appropriate option even if she doesn't have an EGFR mutation, but that can also be done after she gets treated on the clinical trial.
Good luck.
-Dr. West
Reply # - January 11, 2013, 09:01 AM
Reply To: Looking for help with my mother
I truly appreciate your response. You are correct in assuming that she does have adenocarcinoma. I knew I was missing something. I find it difficult to be in this position, to be strong for my mom and to help her as much as possible. I'm quite young myself, 32, and I never imagined dealing with anything like this. Unfortunately, my uncle passed last May of lung cancer so this stings that much more. I will certain check out the resources here on the site.
Thanks again for the welcome. It's nice to find support after being so lost for months.