Stage IV NSCLC adenocarcenoma / keeps coming back help pls - 1257838

Hello Alistair, Welcome to Grace. I feel confident we will be able to help you come to an understanding of your wife's treatment.
I'm very sorry to meet you in such dire circumstances and sorry you and especially your wife are going through all this. It exacts a great toll on the whole house.

Surgery isn't normally an option for metastatic cancer because it doesn't extend life or improve quality of life which are the 2 reasons for treatment metastatic cancer. Further it's quite likely to leave the body in more debilitated state than before. For instance much of my husband's pain comes from the aftereffects of a thoracotomy. Here is a FAQ discussion on the subject, http://cancergrace.org/cancer-101/2011/01/01/cancer-101-faq-i-have-meta…

From Dr. Weiss, "Every cancer therapy has two purposes: to improve duration of life, and to improve quality of life. Every other measure of chemotherapy success, such as response rate or progression-free-survival, is a surrogate to these two true goals. I am using the broken record as my pseudo-apology for repeating this mantra repeatedly on GRACE, to my colleagues, and in my mind every time I make a treatment decision.
Chemotherapy is the most important treatment for achieving these two goals in stage IV disease. Stage IV means that the cancer has spread and is no longer curable. Incurable is not the same as untreatable. Cure means eliminating every last cancer cell. Treatment means providing real benefit, in the form of achieving these two goals." http://cancergrace.org/lung/2010/04/16/introduction-to-first-line-thera…

This discussion describes next best steps after initial treatment, http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…

Please let us know of further questions you have,
Janine
forum moderator

Alistair,

I'm sorry about your wife's diagnosis and recent progression. I think Janine covered the key points in most of your questions, but with regard to cannibis, it's potentially useful as an anti-nausea agent, but there's no meaningful evidence that it fights cancer in any way. Even for nausea, we generally favor other agents, as many people find cannibis to be unsettling to take, with other more commonly used and readily available non-chemo options often favored for this purpose.

-Dr. West

Has her tissue been tested for mutations since she has adeno? Take care, Judy

Dear Alistair,

My apologies for my delay in reply. I am in agreement with Dr. Weiss and Dr. West with regards to surgical management of stage IV metastatic adenocarcinoma. Outside of unusual circumstances surgery is unlikely to improve quality or longevity. However additional treatment if her disease is responsive may help her with improvement in symptoms and may allow her to live longer.

With regards to cannabis there are many avenues to obtain it- in pill form, to be smoked, or compounded into products such as a cannabis cookie. In certain states it is legal for medicinal purposes. The pill format is called marinol and sometimes is used as an appetite stimulant or for nausea. In a few cases I have also seen it help with pain. I do not think there is any data for cannabis to be a cancer fighting agent, mainly a symptom control agent.

Dr. Ramchandran