adenosquamous lung cancer - 1262197

carrieanne2
Posts:6

Hello I have adenosquamous lung cancer 3b mets in chest and neck.
I was diagnosed May 2013 June I had collapsed lung and had stint put in
successfully. Had radiation just after to make sure cancer did not grow over stint.
then I had 4 lots cisolatin/alimta every 3 weeks.
I was told radiation shrunk it significantly also chemotherapy shrunk it significately too.
I was given 3 months to get over chemo and went back to oncologist last week and
had a xray
He told me the site what was radiated where tumor was or is has got bigger than
when I had a body scan last september therefore he wants me to have a body
Scan to find out if it is the cancer or scar tissue.
I would love to hear fr8m people with knowledge of this type of cancer also
knowledge on scar tissue lung.

thank you very much Carole uk treated at Christies Manchester

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Reply # - February 10, 2014, 06:21 AM

JimC
Posts: 2753

Hi Carole,

Welcome to GRACE.

There can be some ambiguity on scans following radiation, but as Dr. Hensing said:

"Differentiating between therapy-related changes and recurrent cancer can be a challenge. Most patients will be followed with periodic CT scans. Fortunately, both surgery and radiation cause fairly typical and expected radiographic changes in the chest, so most of the time the CT scan is all that is needed. PET scans can be helpful in evaluating an area that may be more concerning for recurrence and help guide the decision about whether or not a biopsy is necessary. Fortunately, the need for a biopsy is uncommon. As long as the same imaging modality is used (usually CT scan – compare “apples to apples”), the change in radiographic appearance over time is usually enough to differentiate between expected post-treatment change/scarring versus recurrent cancer." - http://cancergrace.org/forums/index.php?topic=11506.msg95128#msg95128

In that same thread, Dr. Pennell agreed, saying:

"As Dr. Hensing pointed out, differentiating scar from tumor can be challenging but is certainly doable most of the time. After the radiation there will be changes, and those changes tend to undergo a predictable evolution over time. Any change from this pattern, or changes after the radiation scar has stabilized, will prompt another step to determine what is happening. Examples would be PET scans and/or biopsies. But most of the time we are able to tell from CTs alone."

Hopefully what you're seeing is only scarring, but if not it may be advisable to try a different chemo regimen, as alimta is not effective against the squamous component of your cancer. You can read about that here: http://cancergrace.org/lung/2008/09/30/cispem-fda-approval/

Good luck with your follow-up scan.

JimC
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Reply # - February 10, 2014, 06:43 AM

carrieanne2
Posts: 6

Thank you JimC moderator for the information and very quick response.
I now wonder why my oncologist used alimta as a course of treatment.
however in October he said he was very pleased with the shrinkage and
then I had my 4th Infusion.
Any more information on this cancer type would be appreciated.
Thank you Carole

Reply # - February 10, 2014, 08:58 AM

JimC
Posts: 2753

Hi Carole,

One possible reason he used it is that the squamous component may be small in comparison to the non-squamous part. And it's hard to argue with good shrinkage. But if there is progression it may be the squamous component that's growing, so it probably would make sense to talk to your oncologist about other chemo options.

JimC
Forum moderator

Reply # - February 10, 2014, 09:47 AM

carrieanne2
Posts: 6

Thank you for the advice. I am having ct scan next week then seeing my oncologist week after to see if it has grown or it is scar tissue. My fingers are crossed.
thank you for information. If necessary I know more of
what to ask now. Carole

Reply # - February 10, 2014, 09:06 PM

Dr West
Posts: 4735

Yes, it's very common to not be able to interpret whether the residual findings after chemo and radiation. If we see it growing, we need to check further, and our suspicion is much higher.

As Jim noted, the concern about adenosquamous NSCLC and Alimta (pemetrexed) is that it doesn't seem to be active against squamous NSCLC. That is less of a concern if there's very little squamous component.

If progression is confirmed, the most common next treatment is usually going to be chemotherapy, unless the viable cancer is still very localized and a radiation oncologist feels that there is potential room for additional radiation.

Good luck.

-Dr. West

Reply # - February 11, 2014, 12:59 AM

carrieanne2
Posts: 6

Thank you Dr West for answering me with your valued advice.
I will let you know my outcome after I next see my oncologist
As he should have my CT results by then.
Thank you again tor taking your time to reply to me.

Carole

Reply # - March 2, 2014, 06:50 AM

carrieanne2
Posts: 6

Hello Dr West and Jim C I would like to give you a update.
I met with my oncologist after having my scan and we are
both happy as it was scar tissue on my lung so now I am having
another 3 months free of meds.
Thanks for advice it was well appreciated.

carole

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