My mum has been diagnosed with stage IV sarcomatoid kidney cancer with bone methastasis in her ribs, and some smaller focal points in her lung and liver. The cancer is 95% sarcomatoid, so very aggressive. She had her kidney resected on March 3rd, then in April started to feel back pain which ended up being the bone methastasis. At the end of April she had 5 radiation sessions performed, which have improved the back pain significantly, and now she is back to her normal life. She is 76.
We now have to decide between 3 treatments, and the doctors we´ve visited have different opinions each:
1. Traditional chemotherapy with Adriamicin + Gemcitabin, which our doctors say works better with sarcomatoid cells.
2. VEGF therapy, with Sunitinib, Everolimus or Pazopanib. However, I read reports that this may not be effective with such a high percentage of sarcomatoid cells.
3. Wait 3 weeks to join a clinical trial by Roche of AntiPD-L1 + Bevacizumab, which opens on June 6th and is first line only (so no possibility of starting with one of the other two treatments and then join this trial).
She has had two scans done within a month of difference. The 2nd scan was two days ago, and it shows some cancer advancement, but not a huge difference vs the one performed a month ago.
My preference is option 3 based on articles like this one: http://www.oncologynurseadvisor.com/targeted-therapies-have-potential-f…
However, not totally sure we can afford to wait 3 weeks to start a treatment. So if you had to choose between treatments 1 and 2, what would you do?
Thanks a lot for your help,
María
Reply # - May 16, 2014, 12:36 PM
Reply To: Sarcomatoid kidney cancer
Hello Maria, Welcome to Grace. It's never a good thing to need us but I'm glad you're here and I'm sure we can help give understanding to your mum's choices. I've asked a faculty member to respond to your post but please understand no one who isn't closely involved with your mom's case can make recommendations. What we do is help you understand as well as possible the options on the table.
A sentiment our doctors often make is 3 treatment options from 3 different doctors only proves there's more than one way to proceed. I understand the feeling of urgency to proceed as soon as possible but often the doctor feels the cancer is moving at a slow enough rate that 3 weeks isn't going to make the person too sick for treatment. It's not unusual for people to wait for trial placement. Again only someone with all the info can make those types of observations.
Again welcome and all the best for your mum. Anyone here will tell you the waiting is so tough, once the decisions are made a lot of stress is relieved.
Janine
Reply # - May 16, 2014, 07:28 PM
Reply To: Sarcomatoid kidney cancer
We can ask Dr. Monty Pal, an expert in kidney cancer, to offer his thoughts in general terms, but he won't be able to make a specific recommendation for someone who isn't his patient. He also may very we'll say that these are all very valid options and that there simply isn't any evidence to choose among them, leaving the docs and you only able to make the best judgment possible with limited actual data to guide a decision.
Good luck.
-Dr. West