Two questions...Does it ever occur that a necrotic tumor presents as an active tumor on CT scan?
And if in 4 cycles of pemetrexed a small progression is noted is the normal protocol to re-evaluate that treatment and perhaps start a new regime of treatment.
Wed, 01/14/2015 - 18:25
Since at times the necrosis causes cavitation in a tumor (the center of the tumor contains dying cancer cells) but can leave viable cancer cells on the outside, the tumor can still appear on a CT. There is a good thread on necrosis and cavitation here: http://cancergrace.org/forums/index.php?topic=858.0
Judging from your previous posts, it seems that you are asking about four cycles of second-line treatment with pemetrexed (alimta). In general with any treatment, when signifprogression is seen that treatment is discontinued. But the key is the word "significant". With stage IV lung cancer, the idea is to maximize the benefit from each treatment regimen used, to make the race a marathon rather than a sprint. With a generally well-tolerated drug such as pemetrexed, doctors may recommend staying with it if the progression is slow.