treatment options for residual disease after surgery - 1264623

falstaff
Posts:12

Hi! My father has a history of adenocarcinoma nsclc and cll (chronic lymphocytic leukemia). The adeno has remained off the radar for 4 years and the CLL is currently being treated. He was diagnosed in January with a second primary, squamous nsclc and had surgery to resect a 1.8cm nodule that had invaded the pleura. Now, 6 months after surgery he had a PET/CT that shows high SUV (13) only on the pleura we knew the nodule had invaded and wasn't thoroughly resected. He shows no other involvement (mediastinal or lymph), nor distant metastasis. I'm thinking that because of the location, radiation might not be an option as he was already irradiated 4 years ago in the same area and it is close to his windpipe, trachea, etc. Although he seems strong, maybe further surgery wouldn't be helpful as there could be micrometastasis. Is chemotherapy the recommended treatment in this situation?

Thank you in advance!

Forums
Full Archive

Reply # - June 27, 2014, 05:19 PM

JimC
Posts: 2753

Hi falstaff,

I'm sorry to say that your father's situation is probably too complex for anyone online to do anything more than guess. For example, the question of whether re-irradiating the pleural nodule is one which would require careful consideration of the risk to nearby, vital structures. And whether chemotherapy would be appropriate would involve consideration of possible interaction with the current CLL treatment and your father's overall health. Only those closely involved in his care would be able to intelligently assess all the relevant factors.

JimC
Forum moderator

Reply # - June 27, 2014, 08:13 PM

Dr West
Posts: 4735

Exactly right. I'm sorry to hear about his new findings, but his situation is completely unique -- there is no standard recommendation for his very specific case, and it will require the careful consideration of his doctors using all of the details available from his scans, pathology, and past history.

-Dr. West

Previous PostNext Post