naevesherri
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Posts:4
There has been significant progression of a large left hilar mass. This surrounds the pulmonary artery to the left lower lobe. the total size of this mass is approximately 6 x 4.5 cm. This has mass effect on the artery to the left lower lobe. The most prominent finding is marked enlargement of a left hilar mass, likely reflecting confluent lymphadenopathy. This is resulting in narrowing of the artery to the left lower lobe.
My question is how will this effect my husband and what can be done?
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Reply # - October 8, 2012, 06:31 PM
Reply To: ct scan
Hi naevesherri,
Any time a scan shows significant progression, that indicates that the current treatment is not effective and a change would be in order. Since your husband has already had a platinum agent, Gemzar and Alimta, one would normally look first to the drugs that are best tested in the second and later-line setting. In the U.S., the three drugs which are FDA-approved in that context are Alimta, Tarceva and Taxotere (Docetaxel). In your husband's case, he has already had Alimta and does not have an activating EGFR mutation, so the choices would be Tarceva and Taxotere, with no preference based on mutation status. As you read in your previous thread, Tarceva can provide a modest benefit even to patients who do not have a mutation and for many patients it can be easier to tolerate. But if your husband has not had a taxane before, Taxotere might be a good choice. His doctor may be able to guide that decision based on all the details of your husband's situation.
As far as the mass effect on the artery, your husband's oncologist should be able to express an opinion as to whether any specific treatment is necessary or advisable. If the mass effect is causing symptoms or is likely to cause them, his doctor may suggest a procedure (such as radiation) to alleviate that problem.
I hope that your husband's doctor will create a good, effective treatment plan.
JimC
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Reply # - October 8, 2012, 07:49 PM
Reply To: ct scan
In truth, what can be done depends on what has been done so far. As Jim noted, we certainly want to make a change when clinically significant progression has been detected. It sounds as if there's some issues with the bulk of the tumor alongside the artery to the left lower lobe, and that may be a reason to consider radiation to shrink that area with some reliability and likely rather minimal to modest problems with side effects. That's often the way we try to shrink an area of cancer causing or threatening to cause compressive problems against key structures.
Good luck.
-Dr. West