Is it BAC or not? - 1272571


My question is for your doctor who specializes in BAC. I was diagnosed in August 2015 with stage IV
adenocarcinoma NSCLC KRAS positive. I'm stage IV because the cancer was in both the upper and lower lobes of my left lung. reports describe large areas of ground glass nodules seeming to form a tumor like area up to 7CM in my upper lobe. My biopsy was from the lingual of my left lung (wedge resection) and was cancerous.
There are small nodules in my right lung too small for a PEt scan to pick up. There is no evidence of Metastasis to any lymph nodes - lymph nodes were checked in my biopsy/resection, in a mediastinoscopy and ultimately after a left pneumonectomy, Initially my oncologist recommended against a pneumonectomy because the belief was with "this much disease" I had to have mets somewhere. Ultimately, it was decided my cancer is slow growing and confined to my lungs so being KRAS positive, chemo might be ineffective. The hope is I will have healthy years before the small nodule in my right lung becomes a problem. It sounds like BAC, but I did have penetration into the parenchyma - Could it still be BAC/
Thank you,



Hi Jean,

I'm very sorry you have this diagnosis. I've asked a doctor to comment
I hope you do well for years.


Dr West
Posts: 4735

This sounds a lot like BAC, which often has a component of invasive along with a lot of non-invasive disease. The scenario sounds very much like the typical picture of BAC, which is often very diffuse and multifocal within the lungs, but also often quite slow-growing.

There is a lot of information here about it. People can respond to chemotherapy, and the drug Alimta (pemetrexed) in particular has led to some good results. It is typically paired with a platinum drug like cisplatin or carboplatin.

Good luck.

-Dr. West

Posts: 5

Thank you for responding so quickly Dr. West. The fact it sounds to you like BAC is good news to me!
My oncologist has started me on 4 treatments of Carboplatin/Alimta and then, I believe I will be followed with scans. I neglected to mention a brain scan (August), bone Scan (August) and rib biopsy (November) were all negative also.
The oncologist says he's had several patients with this slow growing adenocarcinoma in the past two that he's been following for several years. One had a response to Cisplatin/Alimta but after two years it started growing again. The other had no treatment for two years at which time it began growing and she's starting chemotherapy. Because KRAS does not respond as well, and he said there was less than a 50% chance I'd respond at all - and it might mean being on chemo indefinitely, I opted for the pneumonectomy with the hope that I'd feel healthy until the nodules in my right lung reach a size that requires attention. There's the hope too that in that time something more effective for KRAS adenocarcinoma will be developed!!
I had no symptoms at the time of my pneumonectomy 11/24/15, but he told me if it became any larger, I would begin to cough and possibly cough up blood.
A lung scan showed my poor lung was doing 30% and my healthy lung 70% of my breathing. I'm in good health in general and rebounded from surgery pretty well.
Again thank you for your reply!