Article and Video CATEGORIES

Cancer Journey

Search By

Lung Cancer Video Library - Cancer Growth Rate and Managing Slow-Growing Lung Cancers
Mon, 09/14/2015 - 06:00
Author
GRACE Videos and Articles
 
Note: This is an older video and may contain outdated information.
 
Dr. Jack West, medical oncologist/lung cancer specialist, describes special management considerations for indolent lung cancers that may not require treatment or are at risk for "over-treatment."

 

Transcript

One of the core questions in managing patients with advanced non-small cell lung cancer is addressing the pace of the disease, because it can really vary a lot. In many cases, and in fact, in most cases of advanced non-small cell lung cancer, the cancer will be progressing at a rate at which you can see things getting worse if you don’t do treatment, over an interval of one or two months.

On the other hand, there are also some cancers that follow a more indolent or slow-growing pace, and in patients with a slow-growing cancer, especially if they don’t have symptoms clearly related to it, it might make sense to hold off on treatment for a longer period of time. So, it is worth asking a few central questions about how best to manage a patient with an indolent cancer, even if it is technically metastatic.

The first question is whether you see any progression at all over a period of, say, six or eight weeks, or maybe even longer, three or four months — because, if you’re not seeing progression over that period of time, it’s hard to have the real incentive to pursue a treatment that can have side effects. We don’t want the treatment to be worse than the disease. Again, if you do see progression at all, you need to ask whether it is clinically significant progression. Just being able to measure some degree of progression if you squint carefully — it is not necessarily enough to justify the side effects of treatment in somebody who is otherwise doing well, and may continue to feel well and do well for many months, or potentially many years, with a cancer that just happens to be quite slow-growing.

A second related question is: if you do see areas of clinically significant progression, is it really just one area that’s growing, or two, or is it multiple areas growing at once? Because, if you see just one or two areas growing, it might make sense to pursue a local therapy, something such as surgery or radiation. On the other hand, if you see multiple areas all growing together, it makes more sense to pursue a whole body, systemic therapy that can treat all these areas at once. But if you see just a single area growing, perhaps, even if it’s against a background of several other areas of known disease, if all of the other areas are growing at such a slow pace that you really don’t necessarily need to worry about them as a threat any time soon, it might make sense to just get the lead runner, to borrow a term in baseball, and address and neutralize the only area the really seems to be leading the charge as a threat.

And then, if we do see areas of multifocal progression, multiple areas growing at once, the leading consideration is going to be systemic therapy. If that’s the case, the leading question after that is: what is the best treatment to pursue — and that’s the subject of other videos here.

Video Language

Next Previous link

Previous PostNext Post

Related Content

Forum Discussions

Hi cancersurvivour and welcome to Grace. Congrats on the "previous" aspect of your blood cancer. A haematologist is just the person to keep an eye on you with CT scans. Your...

Thank you for your comments Janine. Makes sense.

Hi survivour, 


 


You have been through a lot already at such a young age, probably too much for someone online to say much. Perhaps your haemotologist and pulmonologist consult to...

Hello and welcome to Grace.  I'm sorry you need to look for this info.  Stage IV rectal cancer survival rate depends on whether cancer is contained regionally or has spread to...

Recent Comments

JOIN THE CONVERSATION
Thank you
By cancersurvivour on Tue, 08/16/2022 - 14:07
Hi survivour, You have been…
By JanineT Forum … on Tue, 08/16/2022 - 11:12
Hi cancersurvivour and…
By cancersurvivour on Tue, 08/16/2022 - 09:30
Hi, I'm so glad your dad was…
By JanineT Forum … on Thu, 08/11/2022 - 08:21