Hello,
I live in Scotland. My mother (65) was diagnosed with stage IV NSCLC, (T3 N0 M1a) in December 2013 following admission to hospital with a malignant pericardial effusion. She was found to also have a serious DVT in her right leg, bilateral PEs and had a pleural effusion drained a few weeks later.
Due to her very poor condition, she was told that it was unlikely she'd be fit to have any chemo or radiotherapy. Her EGFR testing then came back positive and she was very fortunate to be prescribed Tarceva. She had her first scan since starting the tablets and we have been told she is responding well to it with some shrinkage of tumours. Her quality of life has changed miraculously - she is fully mobile, eating well almost back to her old self.
We do understand that the Tarceva will not work indefinitely. Is it therefore reasonable to expect that given her positive response and regaining of strength, that the avenues of chemo and/or radiotherapy maybe opened up again if the times comes that the Tarceva stops working? Might the DVT pose a problem?
Many thanks in advance for any advice or information. This is a wonderful resource.
Mo.x
Reply # - February 10, 2014, 03:35 PM
Reply To: Options after Tarceva
Hello,
Welcome to GRACE. Glad to hear that Tarceva has made such a big difference in how your mother is feeling better and that her tumors are shrinking.
Oncologists decide whether or not a patient is fit for treatment by assessing their "performance status." As Dr. West has described this:
"As treating oncologists we recognize that more important that age is one’s “fitness” or performance status: the ability to take care of oneself, participate in physical activity, the amount of time spent resting or the amount of time spent in bed. If you wonder why your oncologist asks you how many hours in a day you sleep, it is for this reason. There are 2 scales that help us assess peroformance status. One is called the Karnofsky scale, and the other is the Zubrod scale (which is also commonly referred to as the ECOG scale):
"Years of cancer care have provided the guidelines that chemotherapy should be administered only when the performance status is good and not poor." - http://cancergrace.org/lung/2009/03/23/sd-chemo-in-elderly/
DVTs are fairly common among lung cancer patients and will not necessarily impact her fitness to receive chemotherapy.
I hope that she has a good, long response to Tarceva.
JimC
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