Is BAC lung CA, KRAS mutation, slow growing? - 1262737

Wed, 03/12/2014 - 23:41

Is BAC lung CA, KRAS mutation, slow growing? By the time my dr. did a CT scan, all five lobes had been affected. I believe I read this type of non small cell ca is slower growing than most. I am to be evaluated for a lung transplant and I don't even know how long I've had this. A dozen years? More? Any info or references you can offer me about its rate of growth would be greatly appreciated. Thank you.

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Dr West

Honestly, there's an incredible range even among people with the same tymor type under the microscope. Everything written about "___ type of lung cancer is typically fast growing" or "___ is typically slow growing" is over-simplified and pretty much worthless for an individual patient. The things that really count are how fast YOUR particular lung cancer grows, and how well it responds to treatment. The best way to get a sense of the underlying pace of your cancer's progression is to compare scans over time, not on treatment, and see how much or little has changed. Many people with lung cancer have had serial imaging over at least a couple of months before the diagnosis was established (and this is especially true for BAC because it looks so much like pneumonia and is almost always treated as that for a while before a biopsy is done). If the imaging shows no changes over the course of follow-up, that's a clear signal that the cancer is relatively indolent. On the other hand, if it has obviously progressed over a few months, it indicates that the cancer is more rapidly growing.

In truth, unless there's imaging of the same process going way, way back, nobody can tell you how long you've had your cancer. If they do, they're making a wild guess or completely making it up.

Good luck.

-Dr. West

JimC

Hi sherilyn,

You might also find useful Dr. West's previous comments on lung transplant in the BAC setting:

"Transplants have been tried in small series of patients here and there, with short-term follow-up looking good in the year or two after surgery, but then no long term follow-up reported. My understanding is that there are typically recurrences long term, and it’s not really clear that this is actually curative for people in very high risk (otherwise incurable) situations. Because BAC can often progress slowly, and this surgery is most likely to be offered to unusually fit patients, it’s not clear at all that lung transplants as a treatment for BAC really add beyond what would happen with these people anyway (they are more likely to be the ones to do well for a few years). It’s certainly not a common intervention and not one that is routinely recommended by lung cancer experts." - http://cancergrace.org/lung/2010/07/09/basics-of-bac/ (This quote appears a bit past halfway down that page, which is quite lengthy).

JimC
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