apat33
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Was reviewing documents my 3 NCCLC's, each is separated by 6 years. My 2nd onset in 1994 I went to the Mayo Clc. for an opinion on adjuvant chemo. here's a quote from that report, "His recent right lower lobe is difficult to categorize. This could represent a new primary versus a late-onset metastatic focus" The last two, 1994 & 2010 were declared new onset, my understanding this was due to the time between onsets. What's your opinion on the odds I could have a slow growing squamous NSCLC.
Thanks Andy
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Reply # - February 18, 2013, 08:02 PM
Reply To: Late onset metastaic vs. new primary ?
There aren't that many squamous NSCLCs that grow that slowly, but I think the hint would be from whether they have shown evidence of growing very slowly or quickly in the interval before diagnosis. If there were occasions when interval scans were done 3-6 weeks apart (perhaps a chest CT followed 3 weeks later by a PET/CT (in 2010, at least) and there was a change in that time, obviously it's not that slowly growing.
Squamous cancers are thought to often arise from a "field defect" in which the area is prone to developing a cancer. Therefore, you can see a few different cancers develop independently because of a predisposition to developing them, and I'd say that's a likely scenario if the interval is more than 4-5 years between cancers. However, as of 2013, we don't have a way to reliably classify one squamous cancer vs. another. In a few years, we may be able to create a detailed molecular profile of various cancers more readily to identify a signature for one in 2013 and then identify whether a cancer in 2016 has mostly the same profile and represents a recurrence or appears different enough to presume it's actually a separate cancer.
-Dr. West
Reply # - February 20, 2013, 02:44 PM
Reply To: Late onset metastaic vs. new primary ?
As Dr. West notes, squamous cancers all pretty much look the same under a microscope. There are detailed molecular profiles that can be done to answer the question that you ask. But, since insurance doesn't typically pay for these, and because it wouldn't really arm you/your doctor to treat you better, I don't recommend them.
As for timing, it proves nothing absolutely. While SqCC lung tends to grow quickly, there are definitely some that grow very, very slowly. Your'e asking great questions that I'd want to know if I were in your situation, but it may be very hard to get an absolute answer.