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Stage IV Lung CA mets to brain

Posts: 10
Joined: Oct 2004

I've tried to post a message here a couple of times, I'm new to this & the first ones didn't show up, so here goes another attempt.

My mother-in-law developed non-small cell adenocarcinoma 3 1/2 years ago. She was treated with a lobectomy, radiation, chemo, with good results even though it had spread to the lymph nodes. She found a full year of remission before the cancer returned in the other lung last year. Then, she was placed on an oral chemo pill which actually had worse side effects than the IV chemo therapy. It did a good job of stopping the cancer in her lungs, but the side effects were difficult--diarrhea, lethargy, that tin taste in her mouth, skin rashes & peeling, etc.

Just last week we found out the CA has mets to her brain. She is now undergoing full brain radiation due to the location and number of lesions involved.

I see her growing weaker daily, but am hopeful she will rebound soon. Anyone else out there that has survived this same type of circumstance? I think we're all too scared to ask how much time we're looking at. At this point she's been through so much, we just want some quality time with her. She is so confused and disoriented right now, not herself at all. The doc's seem to think that will improve with the radiation, but she has changed so much in the past few weeks, I just don't know.

I just worry about what is to come, where it will go next. We've been so hopeful, she's had such a time with this, but has remained positive through out. This time is different for her. She seems to want to keep fighting, but I sense a change. Nothing she has verbalized, but there is so much she doesn't care about anymore. I hope it is only this phase of her illness talking, not her spirit breaking. Time will tell.

Posts: 25
Joined: Mar 2004

leeinkc, First of all prayers sent to you and your mother-in-law.

I was diagnosed with Stage 3A non small cell lung cancer in 3/04. I had chemo & rads and then surgery on 9/04 (removal of upper left lope and lymph nodes) The pathology report came back no cancer - all cancer cells dead. Before the surgery the cancer has spread to my brain. I did stero tactic radio surgery (novolice) twice. They found one lesion and then 3 more. I just finish with whole brain radiation and I won't know until the end of the month. The chemo pill is worst than the iv. I have felt sick to my stomach a lot. The radaition gets worst (3rd & 4th week you get very tired). They have told me that once this is done, it will be a few weeks until I am back to myself. What is her onocologist saying about this? And the radiogolist onocologist? Please be patient with her. It is hard when you think you have kicked it and then have a set back. It can be depressing!

My prayers are with you.

Fatboy (gini)

nodawgs's picture
Posts: 117
Joined: Mar 2001

I've posted a few before similar to this one to demonstrate NSCLC is survivable (so far), though my case is a tad odd, to say the least:

I was diagnosed with stage IV (end stage) in July 2002. I had no pre-op or post-op chemo...no chemo or rads whatsoever. My only significant medication was anti-seizure meds and steroids, the latter to reduce edema to a level allowing neurosurgery. A neurosurgeon removed the brain mets and about 7 weeks later, a cardiothoracic surgeon removed the upper, left lobe and 6 adjacent lymph nodes (2 were cancerous).

Here it is November 2004 (2 years and 4 months later) and I'm still clear as a bell according to the most recent M.D. Anderson Cancer Center-Houston MRIs and scans.

I was never given a doomsday prognosis, but when transferring my med records to M.D. Anderson, I ran across a document called a "Conference Report." Based on pathological reports (degree of progression and aggressivness, etc.) and opinions of both surgeons and an onco, it cited a 6-9 month expectation for survival. Offhand, I'd say they missed it by quite a bit.

I wish all having this stuff the same incredibly good luck.


Posts: 5
Joined: Jan 2005

I'm happy to hear how well you are doing. My husband also has Stage IV. He was dignosed March 2003. we are coming up on 2 yrs and we are still fighting! We are also at MDA Houston. How in the world did you succeed such hopeless odds? I would call this a miracle!

gdpawel's picture
Posts: 525
Joined: May 2001

Chemosensitivity Testing

When a patient has an infection, doctors often send a sample of infected blood or tissue to a lab where they can grow the bacteria and see which antibiotics are most effective (called Bacterial Culture and Sensitivity Testing). Chemosensitivity testing is an attempt to do something similar for cancer; fresh samples of the patient's tumor from surgery or a biopsy are grown in test tubes and tested with various drugs. Drugs that are most effective in killing the cultured cells are recommended for treatment. It is highly desirable to know what drugs are effective against your particular cancer cells before highly-toxic agents are systemically administered to your body.

One approach to individualizing patient therapy is chemosensitivity testing. Chemosensitivity assay is a laboratory test that determines how effective specific chemotherapy agents are against an individual patient's cancer cells. Often, results are obtained before the patient begins treatment. This kind of testing can assist in individualizing cancer therapy by providing information about the likely response of an individual patient's tumor to proposed therapy. Chemosensitivity testing may have utility at the time of initial therapy, and in instances of severe drug hypersensitivity, failed therapy, recurrent disease, and metastatic disease, by providing assistance in selecting optimal chemotherapy regimens.

All available chemosensitivity assays are able to report drug "resistance" information. Resistance implies that when a patient's cancer cells are exposed to a particular chemotherapy agent in the laboratory, the cancer cells will continue to live and grow. Some chemosensitivity assays also are able to report drug "sensitivity" information. Sensitivity implies that when a patient's cancer cells are treated with a particular chemotherapy agent in the laboratory, that agent will kill the cancer cells or inhibit their proliferation.

The goal of all chemosensitivity tests is to determine the response of a patient's cancer cells to proposed chemotherapy agents. Knowing which chemotherapy agents the patient's cancer cells are resistant to is important. Then, these options can be eliminated, thereby avoiding the toxicity of ineffective agents. In addition, some chemosensitivity assays predict tumor cell sensitivity, or which agent would be most effective. Choosing the most effective agent can help patients to avoid the physical, emotional, and financial costs of failed therapy and experience an increased quality of life.

Fresh samples of the patient's tumor from surgery or a biopsy are grown in test tubes and tested with various drugs. Drugs that are most effective in killing the cultured cells are recommended for treatment. Chemosensitivity testing does have predictive value, especially in predicting what "won't" work. Patients who have been through several chemotherapy regimens and are running out of options might want to consider chemosensitivity testing. It might help you find the best option or save you from fruitless additional treatment. Today, chemosensitivity testing has progressed to the point where it is 85% - 90% effective.

Chemosensitivity testing might help you find the best option, or save you from fruitless additional treatment. Another situation where chemosensitivity testing might make particularly good sense is in rare cancers where there may not be enough experience or previous ideas of which drugs might be most effective.

Finally, there has been a veritable deluge of new approvals of cytotoxic drugs in recent years as the tortuous FDA process has been speeded and liberalized. In many cases a new drug has been approved on the basis of a single very very narrow indication. But these drugs may have many useful applications - and it's going to take years to find out. Chemosensitivity testing offers a way of seeing if any of these new drugs might apply to your specific cancer.

Another Name

Cell Culture Drug Resistance Testing refers to laboratory testing of a patient's own cancer cells with drugs that may be used to treat the patient's cancer. A group of lab tests known as human tumor assay systems (HTAS) can aid oncologists in deciding which chemotherapies work best in battling an individual patient's form of cancer. The assay is a lab test performed on a biopsy specimen containing living cancer cells. It's used to determine the sensitivity or resistance of malignant cells to individual chemotherapy agents. Depending on how well the tumor cells respond to each chemotherapy agent, they are rated as sensitive, resistant or intermediate to chemotherapy. The concept is that you are better off using a chemotherapy drug that your tumor reacts to strongly than one your tumor resists.

There have been over 40 publications in peer-reviewed medical literature showing correlations between cell-death assay test results and the results of clinical chemotherapy in more than 2,000 patients. In every single study, patients treated with drugs active in the assays had a higher response rate than the entire group of patients as a whole. In every single study, patients treated with drugs inactive in the assays had lower response rates than the entire group of patients. In every single study, patients treated with active drugs were much more likely to respond than patients treated with inactive drugs, with assay-active drugs being 7 to 9 times more likely to work than assay-inactive drugs. A large number of peer-review publications also reported that patients treated with assay-tested "active" drugs enjoyed significantly longer survival of cancer than patients with assay-tested "negative" drugs.

Listing of "Reputable" Labs USA:

These labs will provide you and your physician with in depth information and research on the testing they provide.

Analytical Biosystems, Inc., Providence, Rhode Island. Ken Blackman, PhD. Solid Tumors Only. 1-800-262-6520

Anticancer, Inc., San Diego, CA. Robert Hoffman, PhD. Solid Tumors Only. 1-619-654-2555

Impath, Inc., New York, NY. David Kern, MD Solid Tumors and Hematologics. 1-800-447-8881

Oncotech, Inc., Irvine, CA. John Fruehauf, MD. Solid Tumors and Hematologics. 1-714-474-9262 / FAX 1-714-474-8147

Sylvester Cancer Institute, Miami, FL. Bernd-Uwe Sevin, MD. Solid Tumors Only. (especially GYN). 1-305-547-6875

Human Tumor Cloning Laboratory, San Antonio, TX. Daniel D. Von Hoff, MD. Solid Tumors Only. 1-210-677-3827

Oncovation LLC, New York, N.Y. Howard Bruckner, M.D. Solid Tumors Only. 1-212-514-2422

Rational Therapeutics Institute, Long Beach, CA. Robert A. Nagourney, MD Solid Tumors and Hematologics. 1-562-989-6455

DiaTech Oncology, Brentwood, TN. Vladimir D. Kravtsov, MD, PhD Medical Director 1-615-294-9033

Weisenthal Cancer Group, Huntington Beach, CA. Larry M. Weisenthal, MD, PhD. Solid Tumors and Hematologics. 1-714-894-0011 / FAX 1-714-893-3659

Anecdotal Case

When 43-year-old Philadelphia pharmaceutical consultant Mark Fisher was diagnosed with late-stage lung cancer a year ago, he insisted his cancer be tested with a CSRA. In the lab, his tumor didn't respond to standard drugs, and instead the test showed an odd combination of five different drugs had the biggest impact. The drugs eliminated cancer from his body and he is undergoing further radiation therapy for a brain metastasis. "The thing that has surprised me since my chemo is the number of people I've met who haven't even heard of it," says Dr. Fisher.

Dr. Fisher has posted his experience on this web site some months ago.

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