leahkyle1
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Posts:3
I have squamous to the lung and lymphs, my oncologists says next week they'll put me on chemo- cisplatin and etopicide, wth 35 rad treatments, I have no problems with this ,but since have read that platinum bases chemo, and they mentioned both of the above names ,cisplatin and etopicide, really doesn't work for squamous, I have them doing an egfr mutation but haven't heard anything back yet., my question is why use something that does seem to work well on the cancer ,and if that's the case what seems to respond better to an egfr mutation. Im very confused as they wont operate. could they possibly do stereotactic on my lung, as they have on my brain and it is completely gone
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Reply # - September 29, 2014, 05:43 PM
Hi leahkyle,
Hi leahkyle,
I'm not certain what you're saying about your chemo regimen of cisplatin/etoposide, but that is a standard, effective regimen used for stage III squamous NSCLC, in combination with radiation.
It is unusual for a squamous lung cancer to harbor an activating EGFR mutation, but if that were to be the case then Tarceva (erlotinib) or in many locations outside the U.S.Iressa (gefitinib) would be the treatment of chioice.
Depending on which lymph nodes are cancerous, surgery is sometimes considered. You can read about the management of Stage IIIa squamous NSCLC here: http://cancergrace.org/lung/files/2011/07/grace-cases-stage-iiia-n2-nsc…
Good luck with your treatments.
JimC
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Reply # - September 29, 2014, 09:28 PM
Yes, I would reiterate Jim's
Yes, I would reiterate Jim's statements. Cisplatin and etoposide with concurrent chest irradiation is a very standard, favored regimen for locally advanced NSCLC. Whatever you've read about cisplatin and etoposide not working for squamous NSCLC is just plain wrong. I've read thousands of articles and summary pieces about lung cancer over the past 10-20 years, and I've authored many, but I've never encountered such a statement. I would encourage you to take notice of the source, because reading misinformation is less helpful than not reading anything. You got bad information.
As Jim noted, it's very unlikely that a squamous lung cancer will harbor an EGFR mutation. Not impossible, but with an approximately 1% probability, it's most appropriate to focus on a plan that doesn't presume that an EGFR mutation will be demonstrated.
They won't operate because surgery would have essentially no chance of curing the cancer if there is locally advanced disease in the chest and also a treated brain metastasis. The challenge isn't just treating the disease that is visible at that moment. When there is locally advanced disease in the chest and also a brain metastasis, the chance of there being additional cancer cells that are invisible is so high that it's very likely there would be additional areas of disease identified before you recovered from the very challenging surgery they would have done. I'm sorry that surgery isn't an offered option, but they aren't offering it because it would be so overwhelmingly more likely to harm than to help.
Good luck.
-Dr. West