Dx: May 2013 at age 74 with NSCLC-Stage 4-adenocarcinoma in right lower lung with3 active lymph nodes and numerous nodules in both lungs. There was and to this day no mets to brain, organs or any other part of the body. I started Tarceva (erlotinib) a daily oral targeted drug on July 17 with very good results. Primary tumor decreased about 35%. lymph nodes decreased by 50% and all lung nodules have resolved and disappeared as of Sept. 11 CT scan. Treatment continues. Side effects minimal to none. Health is very good otherwise.Have had no weight loss, nausea, etc.
My dilemma is that I am so in need of a total hip replacement due to a bone on bone condition and constant pain and walking issues of the right hip. My oncologist is concerned about whether I could tolerate surgery because of possible pulmonary function problems. She refuses to give medical clearance but she suggests that my primary care doctor or the in house Internal Medicine doctor at this hospital do another physical exam with a lung function test. I was taken off the surgical schedule last May when a CT scan showed a mass in the right lung. That medical facility conducts their own pre op physicals but, so far, has not offered me another one. They only want a medical clearance from the oncologist.
I am joyous about my response to treatment but the possibility of having such a lower quality of life wheelchair) troubles me. Case is under review by the surgeon and I will have some kind of an answer by Oct. 4. I need advice.
Hip Surgery Possibleith NSCLC-Stage 4 - 1259589
jck5
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Reply # - October 1, 2013, 09:40 PM
Reply To: Hip Surgery Possibleith NSCLC-Stage 4
A pulmonologist is the key person to help provide the best prognosis for whether your lung function is sufficient to tolerate the surgery well. Pulmonary function tests are the key to doing that. A second opinion from another pulmonologist may be helpful if you don't get a clear answer from your current doctors or just want another opinion for confirmation.
-Dr. West
Reply # - October 2, 2013, 06:52 AM
Reply To: Hip Surgery Possibleith NSCLC-Stage 4
Dear JCK5
I wish you good luck with the surgical review. My wife also had stage 4 adinocarcinoma at age 64 and she had mets to right hip that required total hip replacement. She tolerated the surgery very well, but every case and individual is different. I will be pulling for you on Oct 4. Bob
Reply # - October 4, 2013, 03:45 PM
Reply To: Hip Surgery Possibleith NSCLC-Stage 4
Unfortunately this poster didn't ask about continuing on with Tarceva and having the surgery. I recommended that they post here and as that questions. I said that I believe you have to stop Tarceva before surgery. I'll contact them on the other site if there's an answer here. Take care, Judy
Reply # - October 4, 2013, 05:24 PM
Reply To: Hip Surgery Possibleith NSCLC-Stage 4
jck5,
Dr. West has addressed Judy's question previously, saying "Tarceva (erlotinib) and most other EGFR inhibitors have no significant anti-angiogenic activity (vandetanib, or Zactima, would be an exception, since it actually has anti-EGFR and anti-VEGF activity, but it's not commercially available). There are no real guidelines, but I personally might suggest stopping just days before, and even then, saying days instead of hours is just being conservative. You wouldn't expect any significant problems with wound healing from Tarceva." - http://cancergrace.org/forums/index.php?topic=10579.msg85160#msg85160
Earlier in that thread, GRACE member Laya related that her Mom had stopped Tarceva the day before surgery and resumed it ten days later.
JimC
Forum moderator
Reply # - October 4, 2013, 07:01 PM
Reply To: Hip Surgery Possibleith NSCLC-Stage 4
That's still what I'd say. No real evidence, and little to no reason to think there would be a problem.
-Dr. West