In '96 my father had a frontal lobe tumor (met from squamous cell lung ca). 1cm tumor in his lung. Brain tumor removal followed by whole brain radiation and carboplatin/radiation. A yr later the lung tumor begin growing so it was removed w/ neg nodes. 5 yrs ago, ureter tumor (transitional cell) treated w/ ureter/kidney removal on one side with no chemo necessary. In addition to frontal lobectomy he has progressive vascular dementia and has been in an assisted living facility since January. 10 mos. ago he was found on his kitchen floor with increased confusion.It was determined that he had a seizure and his CT was unchanged from previous head CTs. The doctor wanted to perform a lumbar puncture to rule out cancer cells in the CSF.They were unable to obtain fluid due to his spinal stenosis and scheduled a tap w/ radiology. The puncture caused my father great pain and he was literally in bed in the fetal position for days after. I asked him if he wanted to do the 2nd tap and he stated "yes, do what you need to" but after talking with him further I realized that he did not remember the first tap. After talking with his internist we decided to not go through with the tap. I also had a suspicion that the seizure was part of the course of his vascular dementia and perhaps brought on by the stress of my mother's passing the month before.He was discharged with anti seizure meds. One wk ago my father started losing interest in eating and said he felt "funny".Today, he had increased confusion and a few "staring into space" episodes.He is in the hospital now for testing.My guess is another seizure. Neg bloodwork/CT/chest xray. They are pushing for a tap saying that cells can hang out in the CSF and he has had back pain for 2 yrs. Mets16 yrs later? Is this possible? Ever hear of this? Sounds far fetched since his CT is the same as in Jan. Don't want to miss something life threatening or painful but in all honesty he can't tolerate tx. Plus the experience from the last tap
Stage 4 Lung Cancer- CSF spread after 16 yrs of NED? - 1249084
andygavanna
![]()
Posts:1
Forums
Reply # - October 15, 2012, 09:55 PM
Reply To: Stage 4 Lung Cancer- CSF spread after 16 yrs of NED?
I'm sorry to hear about you father's recent problems.
As you probably suspect, his situation is unique -- I would say it's unprecedented. But to me, the key question is what you'd do with that information if you found he had cancer cells in the CSF. There really isn't any treatment that is particularly effective in the setting of meningeal carcinomatosis from lung cancer, except for the possible exception of patients who have an EGFR mutation, which would be very unlikely in someone with a squamous NSCLC. I come back to the question of what you'd do with the result in someone as debilitated as your father is nowadays.
-Dr. West