Hello Grace - It appears I just lost my first effort at this post, so I apologize if I end up repeating. In any event, thank you so much for hosting the Boston event! My wife (dx 09/2010 at age 46, non-smoker, with adeno, poorly diff, stage IV, with mets to ovary, bone and brain, egfr+, del 19, 1st line Tarceva and still on it) attended, caught up with several of the docs and learned so much! But today I write about her brother, just diagnosed at age 52, non-smoker, with lung cancer, adeno with papillary features, with several small tumors only in his right lung (one at 22mm and several at 19mm or smaller) and one medium size tumor on his brain (which was removed 2/3 weeks ago and it was this tumor that resulted in his ultimate diagnosis. Presently, he is non-symptomatic. He is being treated at a public hospital in Mexico. Our questions:
(1) In an oligometastatic scenario like this, is it reasonable to treat with the intention to cure, or is this a "manage the disease" situation?'
(2) Regarding treatment, while not asking for a recommendation, what would be a reasonable approach to first line treatment? Is this more of a traditional chemo situation or are TKIs reasonable here (if they are able to pursue mutation testing)?
We understand that they do intend to radiate the site of the brain surgery, but as of yet have not heard an overall treatment recommendation. Lastly, my wife will be undergoing genetic testing to determine if there is a family disposition towards LC. Thank you so very much! Dan