What does Tarceva actually do to the tumor(s)? - 1263511

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kcarn0927
What does Tarceva actually do to the tumor(s)? - 1263511

My husband has been on Tarceva 150 mg for 4 months. In January he had his first scan since starting it. He had 30% shrinkage of the 4 cm primary tumor (50% previously with traditional chemotherapy). At that visit the oncologist said it looked like a "donut hole" and she showed it to us which it did look like that. Had a scan just this Monday and she said unequivocally that it showed scar tissue. The nurse practitioner called the next day and said that it has "slightly increased but is stable" which is not what the oncologist said.

My question is what does Tarceva actually do to the tumor?

Thank you!

Kathy

Dr West
Reply To: What does Tarceva actually do to the tumor(s)?

Tarceva can lead a cancer to shrink, or sometimes the cancer will grow on it. It sounds like you're getting mixed messages, so I think the most helpful thing would be to get some clarification between the nurse practitioner and the oncologist of what has happened. At the same time, perhaps the oncologist can explain why she is sure that what she is looking at represents scar tissue. If that's what the nurse practitioner was saying has slightly increased, scar tissue shouldn't do that.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

kcarn0927
Reply To: What does Tarceva actually do to the tumor(s)?

Hi Dr. West:

My husband's results showed an "increased size of a partially cavitary right lower lobe primary lung cancer" (1.6 x 5.3 cm, previously 1.6 x 4.6 cm; it also measures 2.6 x 3.4 cm, previously 2.5 x 3.0 cm). Being laypeople we feel that's a significant increase.

Do you feel that is a significant increase being on Tarceva?

Thank you for your input!

Kathy

kcarn0927
Reply To: What does Tarceva actually do to the tumor(s)?

So we got some clarification re: mixed messages. Re: my post above, per oncologist nurse practitioner called us the next day due to the fact that she wanted to give us the completed results because the completed results were not complete at the time of oncologist visit. The onc was just looking at it on the computer and she said what she thought it looked like (scar tissue).

We spoke to the onc today, she feels the Tarceva is still working and the next scan in June will be the real telling point. Apparently, as I said before, the mass has a hole in the center which I think is why there is a discrepancy in the size of the mass. We have looked back at the previous scans and the radiologists' measurements do not jive. What matters the most is the size of the mass but due to a donut shape the measurements are not exact.

Have you heard of this before?

Thank you!

Kathy

Dr West
Reply To: What does Tarceva actually do to the tumor(s)?

I have, and I think that the question of whether progression is clinically significant or not is in the eye of the beholder. Don't forget that a picture is worth a thousand words, and sometimes the measurements or reported comments overstate or understate the progression. There's no substitute for directly visualizing the scans.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education

kcarn0927
Reply To: What does Tarceva actually do to the tumor(s)?

Can you explain what a partially "cavitary" right lower lobe primary lung cancer. What does "cavitary" mean??? At first diagnosis it was "not" mentioned as cavitary, but then in January is when it was first mentioned, but not as cavitary rather as shaped like a doughnut. Is this a result of chemo or is this how it presents on diagnosis and it was just never reported like that on initial diagnosis???

Thanks for your help!

Kathy

JimC
Reply To: What does Tarceva actually do to the tumor(s)?

Hi Kathy,

A cavitary lesion is one in which the treatment has killed cancer cells from the inside out, forming an area of dead cells in the center of the lesion. It would not have appeared that way at diagnosis.

JimC
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>