2 Primary Cancers Neck and Lung - 1273384

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2 Primary Cancers Neck and Lung - 1273384

Hi, my dad was diagnosed with stage 3 head & neck squamous cell carcinoma & nsclc andocarcinoma cancers no mutations. He first received 35 weeks of rad to neck & 4 out of 7 weeks of cistplatin. His blood levels dropped a couple times delaying chemo. His follow up CT & PET revealed no tumor & lymph node resolved in neck. The lung showed reduction from 5.4 x 3 to 4.1 to 2. SUV decrease by 5 to 10. However the lymph nodes increased in size and SUV. Hilar, pre tracheal, mediastal, precarnel and subcarnil nodes affected. No stage provided for lung. I can only assume the lung is stage 3b as no other organs have been affected. So for the lung they did 30 weeks of radiation and change chemo to carboplatin and pemetrex every 3 weeks. He was only able to get two infusions as his blood levels drop landing him in the hosp. His last week of rad was delayed by a week. Originally they said after rad was done they would give him a 5 week break and cont with chemo. After break he had a CT scan. His blood showed his platelet count at 101, hemoglobin at 10 and rbc at 3.5. Tumor reduced. Spiculated tumor is 2.7 x 1.4, tracheobrionchial node 1x1.3 stable, satellite node and all other nodes stable. This the first time the tumor was identified as spiculated. What does that mean? Is that good or bad or was it likely always spiculated? Is the tracheobrionchial the same as the pretracheal node? What does it mean all of these nodes are stable. Does it mean they shrunk or that they did not get bigger? Dr decided not to give him more chemo due to his levels and decided to wait and give him a PET in June. I am concerned about him waiting that long? Currently nothing has showed up elsewhere. I asked if it would continue to shrink and the dr maybe a little but not likely. If the tumor is still there won't it grow while we are waiting for June? I asked about maintenance chemo while we were waiting to do the PET, and they said they are not taking that path righ

Hi Kars,

Hi Kars,

Welcome to Grace. I'm sorry it's taken so long to post. When a tumor is stable after some time that means it's not bigger or smaller. That's usually considered a good thing. Stable, progressive and diminished descriptions can all be in relation to all cancer in the body or just one tumor. Unless the tumor that remains stable is causing immediate problems then stable is a good thing.

Spiculated describes the shape of a mass with irregular edges as opposed to smooth edges. When cancer is spiculated it's usually a primary tumor and when cancer has smooth edges it's usually a metastasis.

All doctors on this site agree that anticancer treatment for incurable cancer has 2 goals. Dr. Weiss puts it like this, "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. I am using the broken record as my pseudo-apology for repeating this mantra repeatedly on GRACE, to my colleagues, and in my mind every time I make a treatment decision."

Taking a break from treatment after such an aggressive front/first line treatment isn't unusual. Timing differs anywhere between 3 and 6 weeks to 3 months. It's important to note how one is feeling. As long as they are feeling better it's a good thing. If symptoms worsen or new ones appear it's important to let the onc know.
2nd opinions are never a bad idea, http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide-...

Dr. West wrote this blog post on options when treating someone with health issues,
There are new drugs like immunotherapies that may be a choice for your dad that have a less toxic profile.

All best,