Squamous Cell Carcinoma (unknown primary) - 1258162

harmeet
Posts:4

My father,59 and healthy individual, was diagnosed with poorly differentiated squamous cell carcinoma last week. He has a tumor in his upper sternum, t4 vertebrate (no lesion to bone), and his liver. They did a biopsy from the tumor in his sternum. The oncologists can not figure out the primary origin of cancer. They are starting radiation on his sternum and back today to relieve some of the pain due to his tumor. They suspect that the cancer originated in the lungs but lungs came back clean on PET and CT scans along with all of his other organs. He will receive 13 treatment sessions of radiation before starting his chemotherapy. His oncologist suggested to wait 10 days after his radiation before starting Chemo. He will be Chemo regiment will be GemCar (Gemzar and Carboplatin). His drugs will be administered on 1, 8, and 15 day of the month with day 21 being a rest week. We do not have any experience of anyone in family dealing with cancer.

So I am hopeful that I will get some tips or helpful comments. I will appreciate it.

Thank you,

Harmeet

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Reply # - July 23, 2013, 02:37 PM

catdander
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Hi Harmeet, I'm very sorry that your father has been diagnosed with cancer. I know it must be quite a shock for the whole family. As you understand more and can know that he's being treated appropriately the stress does lighten a bit. So welcome to Grace, I'm sure you will find answers you need and most likely some support along the way.

It's not common but not rare either to have lung cancer without having evidence of a primary lung tumor. Gemzar and carboplatin have been shown to have good efficacy on squamous and IV infusions need to be separated to give the body time to manage toxicities. A separation period also needs to be given between radiation and gemzar as gemzer creates a hypersensitivity to radiation. Radiation is very appropriate/helpful in managing pain.
From what you've written his plan sounds good. On your end or those who will be caring for him from home it's important to understand the ins and outs of managing toxicities from treatment.
http://cancergrace.org/cancer-treatments/2012/08/03/dr-stephanie-harman…

Below I've pasted several links that will help you get a good start on understanding. Please feel free to ask specific questions as he moves forward in treatment.
I hope your dad, you and the rest of the family will continue your rally to help you dad feel as good as possible for as long as possible.

All Best,
Janine
forum moderator

http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/
http://cancergrace.org/lung/2010/09/18/lung-faq-ive-just-been-diagnosed…

Reply # - July 23, 2013, 02:42 PM

catdander
Posts:

continues....
As well as other issues, this is a link to a list of links concerning managing a host of difficult issues that arise with advanced lung cancer. FYI, the first link just happens to be on the subject of hospice, while very important it sounds like you may not need to worry about that for awhile hopefully a long long while so skip it for now and return when you have the well or need to do so.
http://cancergrace.org/cancer-treatments/

Reply # - July 23, 2013, 07:56 PM

Dr West
Posts: 4735

Janine provided a great summary of the key issues here. Yes, radiation makes good sense to treat painful bone metastases, and the regimen of carbo/gemcitabine is a commonly used and very appropriate one for squamous cell lung cancer that probably works well for other squamous cancers. The only issue is that it's possible to have inflammation in the region of radiation if chemo with gemcitabine follows very closely after radiation, so we often wait a week or two between the end of radiation and the beginning of chemo, but that's not based on any actual evidence or firm rules...it's just a common thing that oncologists are concerned about. but the general plan makes good sense, I'd say.

Good luck.

-Dr. West

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