what are the option s for suspected stage IV metacised lung cancer - 1256297

Tue, 05/07/2013 - 19:32

What are the treatment options for suspected stage IV NSLC multiple spots discovered on other lung at 1year scan anniversary and 2 months later not much change in size. Treatment plan is to have another CT scan in June. Current DR no treatment options available except for a clinical trial that could increase survivability by 15%. previous treatment was remover lower left lobe followed by 4 rounds of cisplatin and Altima with a 3 weeks break between treatments.

What's the progression of the disease?

Thank you,


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Posts: 2753

Hi Hal,

It seems that when you say "suspected" Stage IV NSCLC that perhaps the new spots in the other lung are small, and that although nodules which appear in your lung after a diagnosis of and treatment for lung cancer certainly raise a suspicion of metastases from that cancer, your doctor may want to take some time and scan at short intervals to see if they grow. If they grow over time, that would make it seem very likely that they represent new cancerous nodules. If not, then it may be that they are not cancerous and there is no reason for further treatment. You may want to ask your doctor what his/her reasoning is with regard to the current treatment plan.

Not sure why your doctor would say the only treatment would be a clinical trial; there are other drugs which might be a possibility if it is Stage IV NSCLC. The three drugs approved in the U.S. for follow-up treatment of lung cancer are Alimta, Tarceva and Taxotere, so there may be a couple of options since you've already had Alimta. Of course you would need to consult your doctor to get his/her thinking on that as well. You can read an FAQ on second line treatment here: http://cancergrace.org/lung/2010/10/04/lung-cancer-faq-2nd-line-nsclc-o…

As far as the progression of the disease, it can vary quite a bit. Some patients have very slowly progressing disease, or disease which responds well to treatment, while others have rapid progression and do not respond to treatment. The fact that the new spots have not changed is a good sign that they either aren't cancer or that it is progressing very slowly.

Good luck on your next scan.

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Dr West
Posts: 4735

I would underscore one additional point, and that is that the underlying pace of the disease is very important in estimating the prognosis. Given that there's still ambiguity about whether your situation really qualifies as stage IV disease, it sounds like this may be a slow process that is likely to follow a longer time course along the spectrum of what we see for stage IV disease, presuming it truly is advanced NSCLC.

Here's a blog post that discusses this issue:


Good luck.

-Dr. West