Dear Dr. West:
I just got my PETCT report last night. The main tumor on my upper right lung, which was 1.1x1.2x1.0 cm with SUV max 1.2 cm in the April 2013 report (it had been remained so since August 2012), suddenly increased to 1.4x2.9x2.2 cm, with SUV max=4.5 cm. I have been taking Iressa since 7th July 2012 and I have expected the occurrence of acquired resistance, but this significant increase still shocks me.
I was told that it usually takes 120 days (4 months) for adenocarcinoma to double its size; but my main tumor has increased by more than 150% in about 100 days. Does it indicate that the nature of the tumor has changed - i.e. it has become another type of cancer, or is it caused by T790M or something else? In order to know better, shall I request another biopsy when I am going to see my oncologist on Tuesday?
My oncologist talked about radiotherapy last time I saw her; but I was told that NSCLC does not response well to radiotherapy. Shall I try Tarceva first if there is no T790M mutation?
I am not sure if it is fair to ask you all these questions, but I am very worrying, and any advice would be deeply appreciated.
Many thanks and best wishes,
56 Y never-smoker Asian female stage IV adenocarcinoma with exon 19 deletion