Hi Dr. West and team,
I need your guidance on next steps for my mom (aged 73).
She was diagnosed with Stage 4 Adenocarcinoma with malignant pleural effusion in March 2014.
Since underwent VATS, Biopsy, Pleurodesis and 4 rounds of chemo (Carbo & Alimta) & she tolerated the treatment well. Brain MRI was clear.
Her CT scan following these 4 rounds reads as follows:
Opinion:
CE CT Chest demonstrates pleural based nodule shows regression in size compared with previous CT scan..." (before chemo started)
Details:
"Pleural based soft tissue density is seen measuring 1 x 1 cm along with fibrotic stranding and collapse of posterior segment of LLL. An irregular opacity is seen measuring 1.5 x 1 cm in inferior lingular segment based on oblique fissure. Loss of lung volume on left side.
Bilateral apical pleural thickening is noted
Multiple enlarged pretracheal and subcarinal lymph nodes are seen, largest measuring 8.7 mm.
Moderate pleural effusion is seen on left side.
Is this an average or a good result? And what would you suggest she do next - get additional rounds of chemo, etc?
Thank you so much,
Semone
Reply # - July 9, 2014, 09:24 PM
Reply To: CT Scan result after 4 rounds with Carbo + Alimta
Semone,
Tumor shrinkage is always a good result. After 4 rounds of chemo, it is reasonable to consider a couple of additional rounds of the two drug combination, dropping the carboplatin and continuing with Alimta (pemetrexed) alone, perhaps switching to a new drug like Tarceva (erlotinib), or taking a break from treatment for a fixed period of time or until disease progression. The recommendation of which of these to pursue is not something that can be done by someone who doesn't know the patient or have the relevant details, as each of these is a reasonable option, and patient preference and individual circumstances are very relevant.
You can learn more about the options in these links:
http://cancergrace.org/lung/2014/04/13/what-is-the-value-of-maintenance…
http://bit.ly/MaintRx
Good luck.
-Dr. West
Reply # - July 9, 2014, 09:25 PM
Reply To: CT Scan result after 4 rounds with Carbo + Alimta
Semone,
Tumor shrinkage is always a good result. After 4 rounds of chemo, it is reasonable to consider a couple of additional rounds of the two drug combination, dropping the carboplatin and continuing with Alimta (pemetrexed) alone, perhaps switching to a new drug like Tarceva (erlotinib), or taking a break from treatment for a fixed period of time or until disease progression. The recommendation of which of these to pursue is not something that can be done by someone who doesn't know the patient or have the relevant details, as each of these is a reasonable option, and patient preference and individual circumstances are very relevant.
You can learn more about the options in these links:
http://cancergrace.org/lung/2014/04/13/what-is-the-value-of-maintenance…
http://bit.ly/MaintRx
Good luck.
-Dr. West