Update On Wife’s Condition - 1252494

sawcmw
Posts:41

My wife had been taking a break from chemo (Alimta/pemetrexed) for the past three months due to her 10/2/2012 CT scan showing significant response in the primary left lung tumor as well as “dramatic” decrease in the size of the nodules throughout both lungs. In addition, there was extensive regression in both osseous metastasis and lymph glands. While she tolerated the 14 sessions of pemetrexed quite well, she did experience hair thinning, skin discoloration and a good deal of fatigue. Her last chemo session was 10/17/2012 and since then hair, skin and energy levels are almost back to normal. Having said all that, she had another CT scan last Monday 1/7/2013 that showed continued regression of lung nodules/lesions with “no mediastinal or hilar adenopathy, no pericardial effusion and no osteolytic lesions visualized”. However, the loculated pleural fluid in both the upper left lung and the lower right lung remain unchanged (5-6mm) from the 10/2/2012 CT scan. We were thinking that taking a break from pemetrexed might help these dissipate and hopefully over time they will. She has an appointment with her Oncologist next Wednesday and I guess we will make the decision to continue the pemetrexed break or start back on the chemo at that time. She will probably be lobbying to go another three months without chemo but it is hard to know the right thing to do with this sinister disease. It is worth noting that her first line (and only line) of treatment was with pemetrexed and not a doublet including a platinum based drug. Good news overall I think.

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Reply # - January 11, 2013, 01:16 PM

sawcmw
Posts: 41

Here is history - I thought I had fixed it so that the history would be included

Wife 64/65 never smoker 12/11-DX NSCLC Aden, small left pleural eff
12/9/2011-CT scans-3cm mass left lung,”innumerable nodules in both lungs under 5mm”
12/20/2011-PET scan 3cm lower left lung mass, mets both lungs, extensive osseous mets
12/14/2011-biopsy-neg for EFGR,ALK,KRAS,BRAF mutations
12/2021-Begin Alimta(pemetrexed) 3 wk intervals
2/2012-MRI brain,2 lessions 2.5mm&2.0mm,not appear to be brain mets
3/2012-7/2012- 4 chest x-rays,left lung mass sig reduced,”tiny nodules both lungs”,no pl eff
9/2012 – Brain MRI - Clear
12/2011-20/2012-blood serum markers CEA 403.7 to 7.1,CA-19 5,210 to 27
12/2011-10/2012-14 sessions of pemetrexed in 3 wk intervals (with three 4 wk & one 5 wk interval)
10/17/2012 – Present – Break from chemo
1/7/2012 – CT Scan - Stable/Continued Regression

Reply # - January 11, 2013, 05:56 PM

Dr West
Posts: 4735

That is very good news, indeed. Congratulations!

I am very happy to have my patients continue on a break from treatment if they show little or no progression off of treatment. I don't see a clear reason to restart in someone whose cancer isn't showing clinically significant progression, especially if they're feeling clearly better off vs. on treatment. I'm particularly confident that it's very unlikely that there will be any significant loss of treatment opportunities if patients are aware of a need to contact me in the event of any new or worsening symptoms, which would lead me to re-evaluate for progression earlier than otherwise planned.

Good luck.

-Dr. West

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