Decision on treatment for NSCLC - 1247932

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Decision on treatment for NSCLC - 1247932

My dad,65 year old and has advanced NSCLC with bone metastasis ,diagnosed in Feb 2012. The EGRF mutation test is positive and he has been taking Iressa since March 2012.He has been admitted last week with complaint of breathlessness. His cxr showed interstitial lung changes. The Iressa was discontinued as the possibility of its complication of interstitial lung disease and furthermore there are signs of progression. The oncologist has suggested alimta as single therapy for my dad.My dad is still breathless on exertion. We are in dilemma now, whether to agree or to with-hold any chemotherapy at the moment.Advice is much appreciated.thanks.

Reply To: Decision on treatment for NSCLC

Hello qiqing, welcome to Grace and thank you for your question. I'm so sorry your dad is going through this very difficult situation. I know how very difficult too it is for you and the rest of your family.
I will contact a doctor to respond to your post. It may take up to 12 hours. Until then you may want to read some of what we have available on the site. If the decision is not to go further with anti cancer treatment there is good info on hospice care also. If you haven't yet, please check our FAQs, and the General and Focused cancer info links. Too the search feature is actually very useful (if you are using explorer browser you may need to log off first before using the search).
I found this with a search of "interstitial". It does sound like an awful complication.

The best to you and your dad,
forum moderator

Dr West
Reply To: Decision on treatment for NSCLC

Whether to start chemo or not really depends on being able to actually examine the person and assess what the cause(s) of the shortness of breath might be and whether the patient is too fragile to tolerate chemotherapy safely. If the breathlessness is potentially from progressing cancer, then chemo may help, so we'd likely be inclined to try to give chemo if it would be safe to do so. If the shortness of breath is from infection, then chemo may add risk, so we would likely favor treating the problem and holding chemo until things are better. And regardless, if we far that chemo is just not safe because the patient is too fragile, then we would not pursue chemo unless/until the patient's "performance status" (activity level) might improve enough to give room to safely administer chemo.

But I'm afraid this kind of decision needs to be made by someone directly evaluating the patient, not just reading a bit about them online.

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