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Is it possible to have stage 4 lung cancer neuroendocrine low level and high level? My husband was being treated for high level after first biopsy. Second biopsy (second opinion) indicated low level. Is it possible that 3 round of cisplatin/etoposide "killed off" high level and now just low level is left? Or...could original diagnosis have been incorrect?
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Reply # - July 1, 2014, 06:33 PM
Reply To: hybrid lung cancer
It's very possible. This isn't extremely well studied or described, to my knowledge, but I think many lung cancer specialists have seen some similar cases. It's not that rare to have part of the same neuroendocrine carcinoma progress appear more or less high grade, along different parts of the neuroendocrine spectrum. The high grade portion is more chemosensitive, and I have seen exactly what you describe -- chemotherapy leading to eradication of the high grade portion of the cancer, leaving just the lower grade typical or atypical carcinoid. There's no standard approach to how best to deal with the findings -- it is ultimately a matter of your best judgment.
Good luck.
-Dr. West