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Dr. Jack West is a medical oncologist and thoracic oncology specialist who is the Founder and previously served as President & CEO, currently a member of the Board of Directors of the Global Resource for Advancing Cancer Education (GRACE)

 

Case Discussion with Drs. Blumenschein and Curran: Trying to Interpret Imaging after Chemo/Radiation
Author
Howard (Jack) West, MD

Here is the second case in my expert round table discussion on locally advanced NSCLC with medical oncologist Dr. George Blumenschein froMD Anderson Cancer Center and radiation oncologist Dr. Walter Curran from Emory University.

We focus in this case on the decision of which patients with a Pancoast tumor should undergo surgery or a nonsurgical approach of chemo/radiation, the challenge of trying to define the right time to repeat scans after chemo/radiation in locally advanced NSCLC, and we also debate the merits of close observation vs. further interventions in the face of worrisome but still ambiguous imaging findings.

I'll add that I do find it instructive how varied the advocated treatment approaches are among the various experts when discussing not only this case but so many others I present. These are admittedly challenging cases that don't fit into any "classic" treatment approach, but these discussions of the range of alternatives offered by experts from so many places speaks to the fact that there is rarely one best strategy.

As always, here is the podcast in both audio and video formats, along with the transcript and figures.

imaging-issues-after-chemoradiation-case-blumenschein-curran-audio-podcast

imaging-issues-after-chemoradiation-case-blumenschein-curran-transcript

imaging-issues-after-chemoradiation-case-blumenschein-curran-figures

Our final case in this discussion series, which will follow shortly, is of someone who has locally advanced NSCLC on the outer reaches of what we can feasibly treat with curative intent.

This program is supported by an educational grant from OSI Pharmaceuticals. We thank them for their support.

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Canyil, I'm sorry your father and you are going through this. While we can't give urgent help we are her to help offer info and resources to help make the best...

Hello and welcome to Grace.  I'm sorry you're going through this worry.  It is normal to watch a small very slow-growing solid nodule with once-a-year CT scans.  Anything less than a...

Thanks you very much. So in summary the course of action taken suggested by lung specalist (re scan in 12 months) seems appropriate? And a PET at this stage is probably...

I can't say what is appropriate for you that's only something your professionals with all your information can do.  However, when someone has a solid nodule less than a cm that...

A doctor wouldn't nor shouldn't suspect a pancoast tumor with the info you've given.  It's like being in Colorado and hearing hoof beats and assuming it is zebras and not horses. ...

Hello and welcome to Grace.  I'm sorry you're worrying about this but it probably isn't cancer. 

 

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