IIIB nsclc with malignant pleural effusion

scungileen

My dad is 75. Two years ago he was diagnosed with lung cancer in his lower left lobe. He was given surgery and 19 of his nodes were removed, which all came back clean. Because his nodes were clean he was not given chemo, which we now regret we didn't insist upon. This last April 2005 his blood levels were elevated which alerted the oncologist he may have cancer again. From April until October 2005 he was given a pet scan and ct scan every few months. In October he was told that he fluid that they spotted in the center of the chest, which right along was not enough to biopsy, had now spread to the lymph nodes in the shoulder. His lymph node in the shoulder was biopsied and it came back that he had the same cancer as before, supposed slow moving Stage IIIB. My dad started chemo on January 24th. He was to get a stronger combination the first week and the next two weeks would be weaker, with the third week off. His white count was lower the second week, so he received a very mild dose and by now he was experiencing labored breathing and fatigue. By week three when he received his third round he was told his red count was low and that was causing the breating discomfort. Week four he was off the chemo but not doing well. By week five he was in the hospital with a blood clot in one lung and a pleural effusion. When they drained his chest they found the effusion was mixed with blood. They had to go in surgically and remove three more litres and put in a temporary drain. They inflated his lungs and sprayed a talc to keep his lungs inflated and eliminate more effusions. We were told by the surgeon that he was sicker than his oncologist made us believe and his prognosis was not very good. His oncologist is on vacation until today. We are waiting to hear back regarding the cells found in the effusion. We were told the cancer spread to the chest cavity and he has a malignant pleural effusion. Can anyone offer some good news. Does anyone out there have something similar.

rpatt

My husband was diagnosed almost a year ago with stage 3b NSCLC with pleural effusion. The most recent PET scan and biopsy indicate there are no more tumors, just areas of possible activity, and no cancer in the effusion, although a non-cancerous fluid continues to fill up even after it was drained due to damage from the cancer as well as the radiation he received. This will soon require the same procedure your dad just went through. His breathing was greatly impacted by the effusion and improved dramatically after it was drained. He just hasn't had it "sealed" yet. Your dad may have the same experience once he has had some time to recover and at least he now doesn't have to worry about it coming back. What I guess I am getting at, is don't give up hope. My husband has had set-backs here and there which seem like the end, but then we move on and realize how well he has responded to treatment. There are days when he seems just as he was before, playing with our chidren, etc. He has already achieved partial remission and now we are hoping for complete with the new chemo he is on. It is a hard road, but if you are getting results, worth every step. Keep us posted on your father!

scungileen

rpatt said:

My husband was diagnosed almost a year ago with stage 3b NSCLC with pleural effusion. The most recent PET scan and biopsy indicate there are no more tumors, just areas of possible activity, and no cancer in the effusion, although a non-cancerous fluid continues to fill up even after it was drained due to damage from the cancer as well as the radiation he received. This will soon require the same procedure your dad just went through. His breathing was greatly impacted by the effusion and improved dramatically after it was drained. He just hasn't had it "sealed" yet. Your dad may have the same experience once he has had some time to recover and at least he now doesn't have to worry about it coming back. What I guess I am getting at, is don't give up hope. My husband has had set-backs here and there which seem like the end, but then we move on and realize how well he has responded to treatment. There are days when he seems just as he was before, playing with our chidren, etc. He has already achieved partial remission and now we are hoping for complete with the new chemo he is on. It is a hard road, but if you are getting results, worth every step. Keep us posted on your father!

Thanks so much for your reply. Sounds like your husband is young. I am so glad to hear that he is in partial remission. God Bless him. I was wondering if your husband ever had malignant cells in his pleural effusion before his partial remission? They believe my dad does - we are just waiting to hear. I was also wondering what chemo he was on and what new chemo he will be on. My dad's oncologist is not offering radiation. I believe that is because there is no tumor to radiate. Thanks for your encouragement. Hoping your husband receives the new treatment with a full recovery. Keep me posted.

rpatt

scungileen said:

Thanks so much for your reply. Sounds like your husband is young. I am so glad to hear that he is in partial remission. God Bless him. I was wondering if your husband ever had malignant cells in his pleural effusion before his partial remission? They believe my dad does - we are just waiting to hear. I was also wondering what chemo he was on and what new chemo he will be on. My dad's oncologist is not offering radiation. I believe that is because there is no tumor to radiate. Thanks for your encouragement. Hoping your husband receives the new treatment with a full recovery. Keep me posted.

My husband is young...43. His pleural effusion was malignant to begin with. The effusion cells were the last ones to respond to treatment.
My husband started chemo in April '04 and initially received cisplatin and etoposide (a radio-sensitizer) at the same time as radiation. In hind-sight, the radiation ended up causing more problems than help because most of his response was to the chemo and the radiation just killed off the good cells he had and added to the effusion. After these rounds ended, he began a combo of cisplatin and taxotere, which he finished at the end of October '04. He then had a PET scan which indicated significant response but still had cancerous cells in the effusion. At this point he was placed on Alimta until the end of December. He had another PET scan which indicated no remaining tumors, no cancer cells in the effusion, but areas of potential growth remained (hotspots). He was then put on Tarceva, on which his breathing declined, so the doc then put him on Navelbine. This is what he is doing now. I don't know if it is because he is young and otherwise very healthy, but he has not had too many neg. effects from chemo. The doc will scan again after the Navelbine and then possibly place him on a combo of Gemzar and Cisplatin.
Poor guy! He has been hit a lot but is hanging in.
I hope your dad has a similar response to the treatment! Good news for you and your family, you stated that the cancer your dad has is slow growing which means if he responds to treatment, he can remain with stable disease or full remission for sometime...or at least until they find a better treatment (maybe CURE) for this nasty disease!

scungileen

scungileen said:

Thanks so much for your reply. Sounds like your husband is young. I am so glad to hear that he is in partial remission. God Bless him. I was wondering if your husband ever had malignant cells in his pleural effusion before his partial remission? They believe my dad does - we are just waiting to hear. I was also wondering what chemo he was on and what new chemo he will be on. My dad's oncologist is not offering radiation. I believe that is because there is no tumor to radiate. Thanks for your encouragement. Hoping your husband receives the new treatment with a full recovery. Keep me posted.

Thank you for your very informative briefing on your husband's illness. He has been through a lot. He is a real trooper. My dad has received carboplatinum and abraxane. Unfortunately, he had only just started when this whole pleural effusion thing came up and delayed further treatment. His oncologist called this evening and he is scheduled to see him this coming Friday to go over his hospital stay and findings. Your words have given us much hope. We will press on and pray and add your husband to my prayers. God bless him and we hope he will soon be cancer free. Keep in touch.

reinstones1

rpatt said:

My husband was diagnosed almost a year ago with stage 3b NSCLC with pleural effusion. The most recent PET scan and biopsy indicate there are no more tumors, just areas of possible activity, and no cancer in the effusion, although a non-cancerous fluid continues to fill up even after it was drained due to damage from the cancer as well as the radiation he received. This will soon require the same procedure your dad just went through. His breathing was greatly impacted by the effusion and improved dramatically after it was drained. He just hasn't had it "sealed" yet. Your dad may have the same experience once he has had some time to recover and at least he now doesn't have to worry about it coming back. What I guess I am getting at, is don't give up hope. My husband has had set-backs here and there which seem like the end, but then we move on and realize how well he has responded to treatment. There are days when he seems just as he was before, playing with our chidren, etc. He has already achieved partial remission and now we are hoping for complete with the new chemo he is on. It is a hard road, but if you are getting results, worth every step. Keep us posted on your father!

I'm glad to read your post, as my mother was diagnosed with stage IIIB NSCLC with malignant pleural effusion in 12/05. She has had 2 rounds of chemo so far and is tolerating it well; she'll have a CT scan next week to see how things look. I will have you and your husband in my thoughts and prayers, and wish him continued improvement and a happy long life!