My mother has two primary stage 4 cancers. Stage 4 BAC lung cancer and Stage 4 Pancreatic. Last January were told no further treatment as her pancreatic cancer which had been successful removed with clear margins had returned and spots in the liver were also seen,additionally the lung cancer had become more dense. This was also after 6 months of chemo to ensure all cancer was gone from the pancreas Gemzar and Carboplatin for the lungs. Fast forward today. My mother is still alive. She has been on hospice ever since. We were given4-6 months with probable pancreatic pain in 4 weeks or so. While she has declined she is still active and not bed bound. she is on a morphine pain regimen but otherwise doing well. she is on oxygen but only for comfort and not needed 24hrs. She has never really had the pancreatic pain that doctors described that she would have. Her hospice nurses call her a walking miracle and they only come to see here every two weeks or so. So my question is has anyone every seen this before? All research I have found is that her prognoss was grave. Can cancer go into remission itself? Could the doctors have gotten it wrong? We have been so grateful for this time. But I wonder is there something in my mom that might be worth studying, potentially to help others. We have asked her if she wanted to go back to an oncologist and she says she was in more pain before when she was on chemo and we are all afraid to go back and hear more bad news. Sometimes ignorance is bliss.
Fri, 12/27/2013 - 09:53
Hi alira, I'm very sorry about your mom but I know too how lucky you must feel that she is doing alright in the face of such a dire prognosis. Doctors are notoriously bad at predicting how long someone will live with cancer, very few fit into the parameters of average, most fall to one side or the other. My husband fits into the outlier group that's doing well with stage 4 disease. While no one can explain why or what I too enjoy each day of ignorance.
When a person has the fortune of living longer and feeling better than expected the course of treatment or lack there of is often left to the person with cancer. In other words doctors often let the feelings of the patient dictate how to proceed.
I'd wager money that genetics and mutations have something to do with the wide range of how people do with stage 4 disease. At this time I don't know of any research going on in the clinical setting.
I'll ask a doctor to comment on your questions.
All best for a long long time with your mom,
Fri, 12/27/2013 - 17:57
The truth is that there is just a huge amount of variability in how different cancers behave (really, cancer can do just about anything). We know that bronchioloalveolar carcinoma (BAC) can be pretty indolent as far as lung cancers go. In truth, pancreatic cancers and colon cancers and breast cancers and many other cancers vary from indolent to extremely aggressive, all within the range of what cancer regularly does.
Oncologists can give a great idea of how 100 or 1000 people will do as a group, but not how one individual person will do with the same type of cancer, since they could have the most or the least favorable cancer in the bunch.
Overall, then, I'd say it's great that she's on the much more favorable side of the spectrum, but we're not at a point in our understanding of the biology of the cancer that we can take an individual person's cancer and understand enough of why it falls in the most indolent vs. aggressive, or the most responsive vs. resistant part of the spectrum.
Sat, 12/28/2013 - 08:16
Agree with Dr West. Cancer behavior can be very variable and while we give average figures, they don't apply to an individual patient necessarily but just provides a range that they can work with. In this case, your mother has two cancers and its a little unclear which of them is spreading to the liver for instance.
But, the more important issue is that she is well and happy being cared for by hospice and we don't need to change that. All the best!