mom just diagnosed

masspa

Hi,
I'm new to posting, but I've been reading your stories of hope since my mom was told of a "shadow" on her lung. The long and short is that her CT showed a tumor around her L mainstem bronchus and pulmonary artery, and a satellite lesion higher in the same lung. SOme lymphadenopathy on that side, and enlarged nodes on the Right (the other side). The PET confirmed that the activity on the Left was malignant, but none of the node on the right (or anywhere else in her body) lit up. I haven't seen the official PET report, but the medical oncologist at Dana Farber ssid there was no evidence of spread. So, I guess she's IIIA (although IIIB can't be definatively ruled out without mediastinoscopy) She's chosen to forgo that test, since she's not a candidate for surgery. Her doc thought that Chemo AND radiation concurrantly might be a little tough on a 83 year old, so she decided to start chemo for 2-4 cycles (depending on the response) and then radiation later. SHe's scheduled for her first Chemo tomorrow (carboplatin/taxol). she does have an appointment with a radiation oncologist next week.
I guess I'd love to hear what those of you with experience think of this plan. ANyone know an older patient having both Chemo and radiation and doing OK? Mom's a tough old bird. NO other medical problems, tons of support to get to treatments, and take care of day to day stuff.
She has been reading a book on cancer and told me that she thinks she should think about doing both as it gives her the best chance.
Will chemo alone shrink the tumor? Will both treatments concurrantly be significantly more difficult that if they are done sequentially?
I know everyone reacts differently, but any feedback you can offer will be appreciated.
thanks in advance for your advice and support
jen

itrustgod

hi,
i'm very sorry to hear about your mom. it must be a really tough time for you. I don't know well enough to give you any feedback or advice, but my mom is also undergoing treatment for stage IV NSCLC. My mom is currently taking Tarceva (I dont know if you've heard of it). Tarceva is usually taken only after a first round of failed chemo, but her doc asked us if we would like to give Tarceva a try to see how it works as a first-line defense. She's only been on it for a month, but as of her XRAY yesterday, her onc said that she couldn't see anything. of course, these results aren't conclusive because CT/PET scans would definitely produce more accurate results. still, it's nice to hear that the onc couldn't see anything on the XRAY. I brought Tarceva up because it is chemo in the form of a pill. It goes directly to cancer cells instead of killing all the cells in the body. that's why the side effects of Tarceva are very minor - my mom broke out, she had rashes in her upper body, as well as some diarrhea, but that's it. no hair loss, no nausea. My mom's only 45 so I don't know how different it would be for your mom. Maybe you can ask your onc about Tarceva and see what they thought about it. A lot of the people on this site have some experience with Tarceva so they can give you info about it as well.

I hope you're all doing okay, despite this trial. Cancer is definitely beatable, so hang in there. I'll keep in you, your mom and your family in my prayers. God bless you.

ernrol

Jen,

I had chemo only, for four cycles and when they thought they could use radiation, there was nothing left but scar tissue. You can type ernrol in the search box at top of screen, then click on any place you see ernrol to the right of screen. This will take you to my web page. If you would like more info about the things I did let me know, and I will post them.
Stay positive,

Ernie

Plymouthean

Hi Jen.
I'm a five year survivorof NSCLC, 3a. I was 67 at diagnosis. I was inoperable until tumor was shrunk by 75% by concurrent Cisplatin/Etoposide chemo and radiation. The chemo was a little rough, but the radiation was the tough part. Based on my experience, I would agree with the doctor, that concurrent treatment might be a lot for an 83 year old to handle. And Ernrol's experience shows that consecutive treatment is very often a good way to go. Of course, you have to listen to the doctor's recommendation, while ultimately it is your mother's call. Her attitude is very important to the outcome. You say that she's tough, and if you believe that she's realistic in her feelings about treatment, then go along with her wishes. It is also very important that she feels that she is in control of her treatment. My best wishes and prayers to you both.

masspa

Wow,
y'all are great - thanks for the prompt advice.
yes I've heard of Tarceva - I mentioned to the oncologist, and she said it's an option in the future if the chemo doesn't have the desired results, but that it's mose effective in asian non-smokers with adenocarcinoma, that she doesn't think it should be first line treatment. I mentioned that I'd heard of male smokers who'd responded and she said it wasn't out of the question, but that she'd rather wait.
I'll chat with her again today.
thanks again - Mom will be happy o her your input
Jen

kaitek

Hi masspa,

To answer your question, my mother who is 77 is undergoing chemotherapy alone with Taxol and Carboplatin. Pretty rudimentary compared to the treatment combinations many of the cancer patients and survivors have undergone. Truth be told, I'd like for my mom to be put on a third cancer drug - whether Tarceva or Avastin. But her current simple combination of Taxol and Carbo is working with tumor shrinkage. We will always have as our backup plan of Tarceva, which as your oncologist has noted works most effectively for Asian non-smokers who mostly have that EGFR mutation Tarceva pairs up well with. But don't let that alone discourage you only that demographic is suitable for Tarceva. Many people without the EGFR mutation and/or who aren't Asian non-smokers respond well with Tarceva. It's all genetics and cancer cell types in what treatments work for which. With your doctor's experience and knowledge, and lab tests, she can best determine what will be best for your mother without harming her.

Tarceva does seem to be the godsend of modern cancer treatment for certain people.

Oh, regarding how old is too old for chemo, don't worry much about your mother not being able to withstand because of her age. My mother's oncologist mentioned having older patients undergoing Taxol and Carbo. If I can recall correctly, he said 86. To repeat his joke, you're mom is a young'un.

Do the best you can for her to keep her well nourished. Keep in mind, 40% of cancer patients die not from the cancer itself but from mal-nutrition. If you need any advice, please feel free to email me (though I haven't been checking in as often as before). I try to keep the diet routines simple.

Good luck to your mom. The best thing you can do for yourself and your mom is to stay hopeful and optimistic. It'll keep your head in the right place.

CHG

I was staged 3A. I had a 2.7 tumor in my upper right lung and two lymph nodes lit up on my PET scan. At age 56 I had 6 weeks of daily radiation and weekly chemo (carboplatinum/taxol). At the end of that time my tumor had all but disappeared and there was no cancer in my two lymph nodes. It has been 16 months since my surgery. All my scans have been clean. Prayers and positive thoughts for your mother.
Carol

masspa

THanks again for all your responses and support. Mom went for her first chemo but seemed to have some shortness of breath when they began the Taxol infusion (they tried a second time after some extra steroids and antihistamines, but it happened again) Unfortunately we were unable to continue, and the plan is to start with a different regimen next week. I think they mentioned carbo and Gemfib (I think that was the second one - it was definately gem something - is anyone familiar with this combo?)
So here's hoping that that works as well for mom - at least with this one she's less likely to lose her hair (although she seemed a little disappointed not to have to go wig shopping)
Otherwise she's doing well - eating well, not losing weight - her cough still bugs her, but with any luck as the tumor shrinks that will improve.
Jen

masspa

OOPS,
it's gemzar (gemcitabine) and carbo
jen