Hi! I have kind of a generic question about treatment progression of BAC. One of my dear friends, we write a cancer blog together, has advanced BAC. When originally diagnosed was already in lungs and liver. Has been fairly aysymptomatic since diagnosis, about a year and a half ago, while on Tarceva. We were supposed to run in a 5K together in Feb. She was diagnosed with a stress fracture in her spine. Come to find out, only just recently, that it was caused by further metastasis to the bone. She was admitted to the hospital just two weeks ago with pneumonia and 2 small blood clots. They also took samples of lung fluid to biopsy, but no results on that. Doctor has given her maybe 3 months now. Isn't there any other option at this point? Is chemo an option? She is so young, early 40's, and had always been so healthy. She has 2 devastated sons and a wonderful husband. Thank you!
iluvtig/Karen
3 year Stage 3A Non Sectable Squamous Cell Carcinoma Survivor
Reply # - August 13, 2014, 03:42 PM
Reply To: BAC Question
I'm sorry about your friend's recent decline. To answer your question, chemo is an option as long as her performance status/activity level (once she's treated for her bone metastasis) is OK. If she's ambulatory and fairly active, chemotherapy can potentially be somewhat helpful. We often favor a combination of a platinum agent (cisplatin or carboplatin) along with Alimta (pemetrexed) because Alimta tends to be particularly helpful as a chemo agent vs. lung adenocarcinomas (BAC is a subset of lung adenocarcinoma) and may be an especially helpful chemo for BAC.
There's plenty of additional general information on BAC here on this website if you want to do a search for it -- though I'll say that if it has progressed to her bones, it must not be "pure" BAC but can clearly invade other tissues and spread outside of the chest. Classic, pure BAC doesn't spread outside of the chest.
Good luck.
-Dr. West
Reply # - August 13, 2014, 04:00 PM
Reply To: BAC Question
edit to say, one of our specialists, Dr. West, tops in BAC tx has bet me to the punch in which case I'd normally give more moral support. But since I've not written anything too off base I'll leave it.
It sounds as if your friend has only been treated with tarceva. If that's true she absolutely has other options. She should look at options pertaining to non squamous nsclc
Dr. West wrote an article linked to below that stresses the importance of not over treating BAC and other indolent cancers but as important as not over treating is to treat when needed. As the last sentence in the algorithm states and I paraphrase, If an indolent BAC is progressing systemically it should be treated as non squamous nsclc. If that means a person has progressed significantly on tarceva (acquired resistance) then it makes sense to change treatment plan to chemo with or without tarceva. Many if not most specialists have begun to continue tarceva if possible when it has been effective for a long period, the second link provides insight on that.
http://cancergrace.org/lung/2013/01/20/mf-bac-algorithm/
For 2 blog writers, I've changed my mind to add a link to search results to faculty blogs on the subject of acquired resistance with the most recent thoughts first, http://cancergrace.org/lung/tag/acquired-resistance/
http://cancergrace.org/lung/2014/07/04/why-t790m-status-matters-for-rep…
I hope your friend moves forward with tx plan that puts her indolent cancer back under control for a long time,
Janine
Reply # - August 15, 2014, 05:08 PM
Reply To: BAC Question
Thank you so much. It seemed to me that there should be more that can be done
I will keep you posted.
Karen