wjjlyj
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Posts:12
My husband was diagnosed with lung cancer stage 4 this past april. Non-smoking otherwise healthy 67 year old. He was, at first, treated for sclc, although original biopsy was inconclusive Pancoast tumor had been mentioned as tumor presented itself initially as enlargement on right side of neck.. When he responded to chemo (but not as rapidly as oncologist thought he would) we got a second opinion. Second biopsy indicated low-grade neuroendochrine lung tumor. Is this considered sclc or nsclc? He is now receiving a different type of chem in addition to radiation to his neck for the next 33 days. How long before one can expect to see results? Thank you!!!
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Reply # - July 10, 2014, 09:55 AM
Reply To: changing diagnosis; lung cancer stage 4
Hi wjjlyj,
A low-grade (well-differentiated) neuroendocrine lung tumor is a form of NSCLC that has similarities to SCLC. As Dr. Sanborn has described it:
"Well differentiated neuroendocrine carcinoma is a subtype of non-small cell lung cancer that has some elements of the neuroendocrine features that the spectrum of small cell lung cancers and carcinoids have. The more poorly-differentiated in that spectrum, generally the more aggressive the tumor is. The better differentiated, generally the slower-moving the tumor is, but also tends to be a bit less responsive to chemotherapy than the more poorly differentiated tumors.
It is difficult to judge the difference in prognosis with a mixed-type tumor. Most of these will behave like other adenocarcinomas, if the neuroendocrine component is indeed well differentiated. It is a very individual issue, though, and one needs to see how chemotherapy goes to really know." - http://cancergrace.org/forums/index.php?topic=11327.msg93337#msg93337
Usually your doctor will order a scan after 2-3 cycles of chemo, and often some results can be seen. With radiation it can be more difficult to judge response in the short term, because radiation takes longer to kill cancer cells and creates scarring which can obscure the actual response.
JimC
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Reply # - July 10, 2014, 01:54 PM
Reply To: changing diagnosis; lung cancer stage 4
Thank you...
Reply # - July 10, 2014, 06:46 PM
Reply To: changing diagnosis; lung cancer stage 4
As a general rule (not an inviolable law), lower grade cancers tend to be less responsive and respond less quickly than higher grade ones. Practically, what this means is that the highest grade cancers like small cell lung cancer can be associated with responses within days to weeks, lower grade lung cancers will take 6 to 9 weeks to show most of the response they ever will. Cancers almost always show their most significant response up front (I describe the response as "front-loaded", diminishing with subsequent cycles of treatment and less impressive changes with subsequent scans after the first), so you typically don't see a response suddenly appear after the first 2-3 cycles have been administered. Immunotherapy is a potential exception and can have a more delayed response, but immunotherapy for lung cancer remains an investigational approach we're still learning about.
Good luck.
-Dr. West