Chemo/radiation or Opdivo or Keytruda - 1271461

loveumami
Posts:1

My mother (63 and healthy) was diagnosed with 3a adenocarcinoma lung cancer 2/15. She received monthly chemo infusions (cisplatin and vinorelbine) in April and May 2015 due to lymph node involvement found during a mediastenoscopy. The oncologist said chemo was not very effective as her tumor shrank from 2.9cm to 2.6cm. She had a lobectomy July 2015 of her right lower lobe. Additional lymph nodes taken out during her lobectomy were positive for cancer and the surgeon also said that there were additional small tumors found. She has now been scheduled for concurrent radiation and chemotherapy ( trying a different combination- cisplatin and alimta) Her oncologist told her he would rather leave Tarceva as an option if it's needed later. I am not very knowledgeable in the difference between medications, but a friend who also has lung cancer told me she thinks that Opdivo or Keytruda might be a better option for my mom than radiation or more chemo. She has an appointment with her oncologist in a couple of weeks, but I'm wondering what another doctor might think. Thanks for your time.

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catdander
Posts:

Hi

I'm sorry your mom is going through all this, cancer is a horrible thing. The difference in treatment sounds like there may be a difference in what the staging is considered. A combo of chemo and radiation is used to cure/get rid of all cancer cells while systemic therapies like tarceva, the immunotherapies and chemo alone are used to control growth; this treatment is used when lung cancer grows outside (right or left) the lung of the primary.

It is worth having a discussion with the oncologist about the reasoning behind the plan. It's also a good idea to read up on some lung cancer basics here on Grace so you have a better understanding beforehand. I'm not able to paste links at the moment but you can use our search engine until I can get to my computer. You may have other questions for us as you learn more.

Good luck,
Janine

catdander
Posts:

I'm back at my computer and wanted to add these blog post links that I think will help you understand the decision making process. While cancer and lung cancer specifically is "the emperor of all maladies" our faculty here at Grace are not only among the best at treating those with cancer but the best at explaining the whats and hows of treatments. They are passionate enough about cancer education and patient advocacy to share their expertise with everyone with access to the internet. (I'm not only a moderator but also a user)
...My point, an understanding of what's best for your mom is within grasp if your willing to do some reading and questioning. :)

A good start is here, http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/

One of my favorite quotes is pasted here. While the topic is chemotherapy this passage can also include other systemic therapies such as tarceva and immunotherapies. It refers to non curable cancer and I'm not sure that this fits your mom's case, but if it does, Dr. Weiss puts it succinctly, "Every cancer therapy has two purposes: to improve duration of life, and to improve quality of life. Every other measure of chemotherapy success, such as response rate or progression-free-survival, is a surrogate to these two true goals." http://cancergrace.org/lung/2010/04/16/introduction-to-first-line-thera…

If there is confusion in the decision making process a 2nd opinion is always a good idea. Dr. Weiss has written an excellent blog post on the many reasons why 2nd opinions are appropriate. http://cancergrace.org/cancer-101/2011/11/13/an-insiders-guide-to-the-s…

I hope this helps and I hope your mom does very well,
Janine