mucinous Adenocarcinoma with predominant lepidic (formaly know as bronchioloalveolar carcinoma) Pattern of growth.
Hello I have a 69 mother that was miss diagnosed with pneumonia , after a negative bronchoscopy a biopsy was performed with a diagnosed of mucinous Adenocarcinoma with predominant lepidic (formaly know as bronchioloalveolar carcinoma. I had a radiologist look the film and CT and he concurred and said surgery was not really an option. I know Dr.west and Dr. Pinder have responded to alot of posts here. Issue is my mother is not in the US and I like to do a second opinion if I can .I am a M.D but really need experts that have the correct data on this !.I have access to all the medical information labs and 3 ct starting 4/2013 9/2013 and 10/2013.
what the the protocol for treatment , based on studies if no lobotomy is not an option , what does the cells respond to chemo or radiation and what is the 5 year Survival rate
Thanks, Dr.M
Reply # - October 15, 2013, 03:59 PM
Reply To: mucinous Adenocarcinoma with predominant lepidic
Hello Dr. M, I'm very sorry your mother has been given this diagnosis. Pneumonia is a very common diagnosis given to those with BAC and often isn't appropriately diagnoses until other curative measures have failed.
It isn't unusual either that BAC is best treated with a minimal of treatment closely resembling that of adenocarcinoma but just enough to keep significant progression at bay. Since it's late in our day I won't contact a doctor for comment but will make sure Dr. West provides input. In the meantime this is a blog post by Dr. West that describes his much of the way he looks at this.
http://cancergrace.org/lung/2013/01/20/mf-bac-algorithm/
All best to you and your mother,
Janine
forum moderator
Reply # - October 15, 2013, 07:09 PM
Reply To: mucinous Adenocarcinoma with predominant lepidic
First, I'll say that just about all lepidic predominant adenocarcinoma (LPA)/bronchioloalveolar carcinoma (BAC) is misdiagnosed as pneumonia initially, since they look essentially identical on scans.
The median survival overall is a little longer, stage for stage, than other forms of lung cancer, but in truth the pace of this disease is extremely variable. Because of that, I think it's essentially meaningless to provide a number when, depending on the individual case, survival may be a few months or many years, even without treatment, and the effect of treatment can be meaningless or profound.
As is illustrated in the algorithm I described in the link Jim provided above, the first question is whether the cancer is progressing at a significant rate (as it can be so slow that it doesn't clearly merit treatment), whether progression is in a single area or multiple sites, and then whether there is an identified molecular target in the tumor like an EGFR mutation or ALK rearrangement. If there is, treatment is directed toward that with a targeted oral therapy like Tarceva (erlotinib) or XALKORI (crizotinib). If not, standard chemotherapy is the standard approach. This is essentially the same approach we follow for other forms of lung adenocarcinoma. In other words, there is no special plan that needs to be followed for LPA/BAC -- it's just notable that the pace of the disease can be anything from extremely slow to very rapid, so it's not always clearly helpful to jump into treatment if the disease is so slow-growing that the treatment might be worse than the disease.
Good luck, and I'd encourage you to look at some of the other content about BAC on the website to learn more.
-Dr. West