AIS/BAC Treatment - 1289960

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fran65
AIS/BAC Treatment - 1289960

A CT in May 2016 revealed that I had 9 spots in my lungs. I have been told that I am Stage 1 and that each tumor will be treated individually. No chemo of any sort at this time. Just wondering if anyone has similar circumstances,I was told to wait 3 months and have another CT performed by my surgeon, I saw a Radiation Onc on January 20th who wants to perform 5 SBRT treatments immediately to tumors in right lung.
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Primary tumor was actually 4 CM when removed on July 26th. I had a wedge resection of the LLL. No lymph node involvement tumor had an SUV of 7.3 the remaining lesions had a SUV of 1.9 brain scan was clear at that time. Pulmonary breathing test was done before surgery.

2) I have Adenocarcinoma in Situ with a KRAS mutation. On Nov 21 exactly 6 months from my first CT in May and 3 months after surgery on LLL revealed the following;

In the medial aspect of the left lower lobe, there is a 6.5 mm nodule showing increase in size from 4.9 mm

The lesion in the right lower lobe shows increase in size from 1.9 cm to 2.4 cm .

The lesion in the right upper lobe demonstrates more dense components and is also slightly
larger measuring up to 2.5 cm versus 2.3 cm.

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JimC
Hi fran65,

Hi fran65,

Welcome to GRACE. Dr. West has frequently commented that there is a tendency to over-treat adenocarcinoma in situ (also known as BAC). In a previous discussion in which he was asked whether the appearance of BAC in both lungs represented metastatic spread from one lung to the other or resulted from independent processes, he stated:

"It's entire unclear whether multifocal BAC lesions arise from multiple sites more or less independently, based on some predisposing risk in the lung tissue (the "field defect" Dr. Pennell speaks of). Functionally, I don't think it really matters, because I don't think that multifocal BAC is well treated with aggressive local therapies: new lesions just seem to appear later, so it tends to be futile and sometimes detrimental to resect or radiate additional lung tissue just to battle a multifocal process later." - http://cancergrace.org/forums/index.php?topic=9651.msg76478#msg76478

In your case, if additional nodules continue to appear (whether due to metastases or "field defects"), radiating them would probably be as futile as trying to radiate distant metastases - that local therapy isn't addressing the central problem of cancer cells circulating through the bloodstream, creating new metastases over time.

If the rate of growth is judged to be significantly rapid, systemic therapy such as chemotherapy, immunotherapy or a targeted therapy would likely be more beneficial. Dr. West has created an algorithm to aid in treatment decisions, which you can find here: http://cancergrace.org/lung/2013/01/20/mf-bac-algorithm/

JimC
Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>