Hi
My dad has nsclc squamous I believe stage 3b tho staging hasn't been brought up in conversation with onc.
My dad has fluid around his lung and the left lung has collapsed. They will not drain the fluid as the said it will keep coming back and the lung will not inflate due to the tumours location preventing this.
The results of my dads ct scan shows the tumour is stable. Last chemo oct 2013 has not shrunk it.
The onc had 3 options for my dad chemo tablet daily, drip chemo every 3 weeks or watch and wait for 3 months. As my dad is doing ok no breathlessness just a cough the onc was happy for watch and wait.
My questions are
How do they know the fluid around the lung is not malignant?
Can my dad live with a deflated lung?
Can my dad live with the fluid as and deflated lung as well as the tumour?
My dad has lost his voice as the tumour paralysed a vocal chord. He is due to have an operation on this tho has been told he will never get his voice back. Do you know the success rate of such operation.
Dad dx nsclc squamous 3b feb 2012
Intense radio chemo April 2012
September 2012 shrinkage of tumour
Jan 2013 tumour stable
April 2013 tumour slight growth watch and wait
October 2013 chemo
January 2014 ct scan shows fluid and collapsed lung
Feb 2014 tumour stable watch and wait
Reply # - February 6, 2014, 07:05 PM
Reply To: Living with a deflated lung
Hi knic,
In answer to your questions:
There is no way to know if the fluid is malignant unless it is drained and tested for cancer cells. As discussed in your previous thread, the main reason to drain an effusion is to alleviate symptoms. The problem is not that cancer cells present in the fluid will spread to other areas of the body; if they are there it is because there are tumor cells already in the bloodstream. So it's not necessary to drain it to prevent spread elsewhere.
It is certainly possible to live with a deflated lung, as many patients have a lung removed and function pretty well afterwards. As far as the fluid and the tumor, it's mainly a question of the fluid not causing any symptoms and keeping the cancer under control.
As far as the success rate for the surgery, that would be a question for your surgeon, given the specifics of that surgery.
Good luck.
JimC
Forum moderator
Reply # - February 6, 2014, 09:46 PM
Reply To: Living with a deflated lung
I believe that based on the treatments being offered, it's presumed if not 100% confirmed that the effusion is a malignant effusion. As Jim said, finding cancer cells in the fluid is the only way to confirm that, but in someone with a lung cancer and no other obvious explanation, it's extremely likely that the cancer is the cause.
Jim is also completely correct that the point of tapping an effusion is to alleviate symptoms, so we don't do it over and over if it isn't going to help the patient feel any better. Even a low risk procedure won't have the benefit exceed the risk if the person doesn't have symptoms to alleviate or an anticipated survival benefit from the procedure.
The success rate of the procedure for his vocal cord depends on the exact type of procedure and other specifics of his case, so I agree that the person doing the procedure is really the right person to offer that estimate.
Good luck.
-Dr. West
Reply # - February 9, 2014, 12:31 AM
Reply To: Living with a deflated lung
Thank you for you valued replies
I wonder if you could help me try to establish the names of the treatment my dad was offered. He cannot remember the name of the drug. I think this is more that he doesn't want to know my dad tends to really put his life and trust in the hands of the oncologist.
I know it would only be speculation but if you could maybe give me the name of the type of drug it could possibly be?
The tablet he was offered he was told he would take daily for the foreseeable future. The side affects would cause quite severe affects to his skin - pimples with pus and volcano type looking spots again pussy. The onc also pointed out that many people loss much confidence with this tablet as they feel embarrassed to go out due to the look of their skin! What could this tablet be?
The chemo line treatment I know less about so I understand that it could be one of too many to name. It would cause hair loss and decrease in bone marrow.
Again I understand you cannot pin point the medication but if you could maybe suggest what it may be especially the tablet form it would be much appreciated.
Reply # - February 9, 2014, 12:46 AM
Reply To: Living with a deflated lung
Thank you for your replies I value them.
I am intrigued as to what the name of the drug was that my dad was offered in tablet form?
I know you can give me a definite name but it your opinion maybe possibilities?
The tablet would be taken daily for the foreseeable future and what put him off was the side effects.
The skin would apparently have severe effects- volcano type pimples with pus and blisters both to the face, the onc highlighted that some people feel it's so bad they lose much confidence and do not leave the house.
My dad cannot remember the name of the drug, and does not feel he needs to know as has chosen the watch and wait option. However I would like to know the possibilities of what it could be?
Reply # - February 9, 2014, 08:58 AM
Reply To: Living with a deflated lung
Hi knic,
It is very likely that the drug offered to him was Tarceva (erlotinib). If you are outside the U.S., it's also possible it could have be Iressa (gefitinib), which is a similar drug no longer prescribed in the U.S. One other possibility is Xalkori (crizotinib).
JimC
Forum moderator
Reply # - February 9, 2014, 09:56 AM
Reply To: Living with a deflated lung
Based on the pattern of the side effects he was told to expect, I would say it's overwhelmingly likely he was recommended an EGFR inhibitor like Tarceva (erlotinib) or Iressa (gefitinib).
-Dr. West