New nodule - 1266841

renek1957
Posts:9

Dx with BAC in Sept 2010. Starting taking 150mg Tarceva with great results. I still visit oncologist every 3 months and alternate ct scan and chest X-ray. Had ct scan couple days ago and they have found an indeterminate 4mm nodule at lateral left lung base. I currently have a stable 9mm ground glass density in medial left lung but that has been there since the beginning. Everything else on report is benign/negative. This is the first time in 4years anything new has appeared on scan. Oncologist advised to take a lets watch it and do another ct in 3 months. Physically I have felt great other then a stressful life event last month but that has now passed. Could this be the beginning of Tarceva resistance? Not sure what to make of all of this.
Thanks
Rene

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Reply # - October 31, 2014, 07:14 AM

JimC
Posts: 2753

Hi Rene,

That's pretty slow progression, typical of an indolent form of BAC. Dr. West has written about the management of BAC, including an algorithm to help make treatment decisions, here. He stresses that BAC should not be over-treated, since its pace can be so slow as to not require any treatment, or minimal treatment.

Also, usually you do not want to discard an effective, well-tolerated treatment until there is significant progression. Not only is it better to have "bad brakes vs. no brakes" (a subsequent treatment regimen may not be as effective as the current one), but there are a limited number of drugs, so you want to get the maximum benefit from each one that you use.

Your oncologist seems to be thinking along these lines, so waiting and watching seems to be a very reasonable choice at this time.

Good luck on your next scan.

JimC
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Reply # - October 31, 2014, 09:45 AM

renek1957
Posts: 9

Thanks Jim. I have been doing so well it was a shock to see a new module. Just concerned cancer is coming back but I have a very good oncologist and she has gotten me this far.

Reply # - October 31, 2014, 12:26 PM

Dr West
Posts: 4735

Yes, it's certainly possible that it's progression, but that's well within the range of ambiguity, and even if it were progression, that would still be considered such mild progression that I think the vast majority of lung cancer specialists would favor holding off on making any changes.

Glad you've done so well for so long. You're wise to not do anything reflexive, I'd say.

-Dr. West

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