My current situation is that I have been on Tagrisso 80 mg for 13 months. First scan showed the 15+ nodules I had in my lungs all disappeared with the exception of 1 which was reduced to a 1/3 of its size (from 1.8 cm to 0.6 cm). This was consistent until Feb 2018 CT scan showed a small spot on a rib, which was referenced in the May 2018 as stable. I was not told about this spot, but experienced severe pain in this area in Jan 2018 with chest xrays done and nothing revealed. Oncologist told me it was likely muscular in nature. Last month at a regular follow up, I told the PA I have had intermittent pain in the rib and that it was becoming more frequent. I was sent for a CT scan which stated that the spot in the rib appeared to be a healing fracture, possibly pathological (I've not had injury to that area.). Unfortunately, the scan also revealed the lung nodule, which had been stable for over a year, was now double the size it had been (1.2 cm).
The treatment recommendation has been radiation to the lung nodule, and to defer treatment on the rib (We will reconsider if pain becomes unmanageable.). The MD resident who reviewed my scans with me did a wonderful job of walking me through the scans and explaining to me when the spots first appeared and their development. He asked if surgery or biopsy were being considered. I told him that the tumor board had been consulted and radiation was the recommendation. I told him I would follow up about the biopsy because I understand that the growth of this nodule and the rib issue might mean progression on Tagrisso and new treatment may be in future sooner than I hoped.
I have asked my radiation oncologist about biopsy who deferred since it is the decision of my primary oncologist. An email and phone call to him have been unreturned thus far. I am very curious about what the standard of practice might be for a situation like mine. Would a biopsy be typical?
Thanks for any information you can provide.