Dear Grace doctors and consultants,
I was dx'd in 08/10 with Stage IV Adenocarcinoma. I was given Alimta and Cisplatin as first line treatment which worked well. In 05/12 I noticed a small lump in between my neck and collarbone. This was needle biopsied and live cancer cells were found within the node. I was offered chemotherapy at the time but I am fully aware that treatment options diminish as you use them. Over the almost two years there has been very slow increase in the size of some lymph nodes. Apparently my chest is clear and self tests prior to the scan told me this (I do not know any lung cancer patients who can comfortably hold their breath in excess of two minutes with no training. I do this to see how well gas exchange is happening in "damaged lungs" ).
My CT on 02/18/14 showed some growth in the mediastinal nodes but I have no physical effects as such. My oncologist (who Dr West knows) has suggested Taxotere "again." I have declined Taxotere as I am all to aware of the side effects which I can, in my circumstances ill afford, living on my own and after the effects of the previous chemo which included massive weight gain (around 22 kgs). My stepmother and mother both had Taxotere and did not survive.
I would like to know what potential treatment options are possible. Online the picture is a bit confused. I would prefer to leave Taxotere until it is the only potential way of surviving. To have Taxotere now could damage my health in other ways, my mobility and my current general wellness and destroy my life quality.
In the UK we're appointed an oncologist and most "seem" blinkered to alternatives and have little insight into how it changes our lives, physically and psychologically. I think there are more options than cytotoxic drugs, so any advice would be most welcome on tactics for prolonging life and its quality, whether it be radiotherapy, less toxic drugs, or some other treatment combination.
Hope to hear soon
Thanks
Jon
Reply # - February 20, 2014, 08:29 AM
Reply To: Alternatives to second line treatment with Taxotere
Hi Jon,
It's good that your progression has been so slow. Although the three agents best-studied for second line treatment are Alimta, taxotere and Tarceva (which could be an option for you depending on your health care system's policies), there are other drugs such as Gemcitabine and Navelbine which have activity against NSCLC and tend to be somewhat less toxic than taxotere.
Since you had such a long response to Alimta, some oncologists would consider returning to it as a single agent.
JimC
Forum moderator
Reply # - February 20, 2014, 10:39 AM
Reply To: Alternatives to second line treatment with Taxotere
One other option might be to enter a trial for a PD L1 drug. They are still looking promising for prolonging life while maintaining QOL. This is a link to clinical trials in the UK for PD L1 drugs, perhaps one near you. http://clinicaltrials.gov/ct2/results?term=PD++L1&recr=Open&rslt=&type=…
As for oncologist choices, perhaps a move to a new doctor in a research hospital would find you a more open minded onc. Unfortunately you find good and bad, open and closed minded doctors all over the world, you're likely to find open mindedness at a research center. certain spring, a past member who was from the UK made a change to a more open minded doc who worked with her to make treatment decisions. I don't know the mechanisms of how that works in the UK but evidently it's possible.
The best of luck,
Janine
Reply # - February 20, 2014, 05:47 PM
Reply To: Alternatives to second line treatment with Taxotere
Sometimes patients are only progressing in one particular spot, and simply aren't ready for another chemotherapy. In this setting, one could request a tumor biopsy of the active area (to confirm it is progression) and send the tissue for multiplex biomarker testing.
In parallel with this, for this select setting, it is sometimes reasonable to just to do external beam radiation to that spot, and hope it will keep the disease quiet for another several months. That can give some time for the biomarker testing results to come back.