Additional treatment - 1265941

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Additional treatment - 1265941

I have stage IV nsclc dx December 2, 2011. Started Tarceva June 2012. Last scan(and several before) show no activity in previous bone mets and only faint FDG uptake within the speculated lesion in posterior right upper lobe abutting fissure. SUV 2.1,1.5, x 1.1 cm . However, my CEA level was 13.3 on the blood test. My oncologist feels thee might be something brewing that we cannot see yet. The CEA level has been increasing slowly over the last year, yet my scans remain stable. Is there any possibility that targeted radiation to the lesion in my lung would make sense at this time? Knock out all the 'active' cancer since the cancer has not yet spread beyond my bones. I do not have any mets in any organs and my brain MRI is clean. Thank you for your time.


Dr West
No. There is no reason to

No. There is no reason to favor local therapy for a known stage IV cancer, treating a lesion that isn't seen to be growing.

Just about all lung cancer experts strongly disfavor using CEA levels to guide therapy. While there may possibly be a role for CEA and/or other serum tumor markers to shape timing of imaging that might alter treatment recommendations, I and most other lung cancer specialists tend to see CEA levels misused all the time, where people use them to override all of the better established measures of the status of a lung cancer.

I would consider this to be such a situation, where all indicators that are actually worth following (imaging and how you feel) are stable and favorable. My impression is that it isn't necessary to go out of your way to FIND trouble when there isn't any compelling evidence of it.

Good luck.
-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

Thank you Dr. West. I have

Thank you Dr. West. I have confidence in my lc oncologist at NYU, but it is good to hear his thoughts and advice seconded by another top specialist. Thank you again.