Watch & Wait? - 1263299

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Watch & Wait? - 1263299

Easter Greetings!
As you may gather from my attached BAC Summary, I'm in relatively good physical shape,
with some shortness of breath, but mentally uncertain and perplexed as to what treatment steps,
if any, make sense. Therefore, I earnestly seek other opinions! I tend towards "Watch & Wait" to
the END since it is my understanding that Chemo- or Targeted therapies are probably ineffective,
even possibly counter-productive, in my case. Although I have reached a point where it is becoming
more and more difficult to think about my condition like "diabetes, high cholesterol, or obesity",
I continue to be optimistic that survival extension treatment may yet become available, e.g.,
compatible with positive KRAS mutation.
PS - I'M a US citizen currently residing in N. Germany.

Attachment: Bronchioloaveolar Carcinoma Summary - "Superball".

Reply To: Watch & Wait?

Hi Superball,

Welcome to GRACE. I read through your history, and it's good to see how well you've done since diagnosis. BAC is something that can often be over-treated, so it's important to discuss with your oncologist whether there is any benefit to be gained from treatment, and whether that benefit outweighs the risks and side effects of that therapy. Dr. West has written a post on that subject here:

As he stated:

"People with a very slow growth rate are likely to do very, very well no matter what treatments they get, as much despite as because of those treatments. In many cases, interventions are pursued on patients who are destined to do very well, and then when their short term survival is good, the people who did that intervention write a paper saying how their approach is feasible and attractive because the patients did well — not recognizing, or at least glossing over the idea, that they were going to do very well anyway."

Wishing you continued success,

Forum moderator

<p>I began visiting GRACE in July, 2008 when my wife Liz was diagnosed with lung cancer, and became a forum moderator in January, 2010. My beloved wife of 30 years passed away Nov. 4, 2011 after battling stage IV lung cancer for 3 years and 4 months</p>

Dr West
Reply To: Watch & Wait?


I'm afraid it's not feasible for me to say what to do. First, we're not permitted to give medical advice to people who aren't our patients. Second, because the judgment of if/when to favor systemic therapy is a very subjective one that I think needs to be based on seeing the images of how quickly things are changing and estimating the probability that this will become a threat in the next few years or not.

As Jim noted, I do often favor holding out on treatment for a long while, and I see a lot of patients clearly over-treated when they likely don't need to be.

-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education