On April 3rd when my mother and myself were
out shopping she started to complain of severe nausea. My wonderful incredible mother is 90 and a shopoholic!. By the time we returned home she was worse. I decided to call 911 and by the time they arrived my mama was in full respiratory failure. At that point they gave us little to no chance for her to survive. I felt like my life was over. She was then put on a vent for two weeks, had 7 thoracentesis's and then a pleurodesis. Back on the vent for another week and then 8 bronchoscopys. Then on April 22 the doctor told us the news that would break our hearts into a million pieces-mama had a 2cm tumor in her left lung. None of the 7 thoracentesis showed any cells until the last one which only showed a few. They were not sure how to stage her but they guessed a 3a. My mothers lung walls are not thick so they said maybe it wasn't as bad as they thought. My mother was a Captain in the China Burma theatre in WWII she stopped smoking cold turkey in 1972. She is blind, almost totally deaf and suffers from dementia as a result of a long Hernia surgery last year. We have not told her of her diagnosis as she also suffers from severe anxiety disorder and will probably just give up. She is now only getting 5 liters of oxygen and breathing at 99%. Her heart is in great shape, kidneys are excellant and just has mild BP issues that are under control with medicine. The docs however do not want to treat her because of her age. This is a woman that up to a month ago went to the gym 4 times a week and had more energy then me! She told me today that she feels great and can't wait to get home. I cannot give up that easily! I know that she would want to fight this. She had Colon CA 8 years ago (early staged) and fought like a trooper. The docs say that the sides from the chemo are horrible. He also stated that even with chemo she would only have 6 months! I am praying that some of you can help me give my mama the chance she deserves. What Chemos worked for you? Are the side effects that devastating? My God I can't just give up on her! We lost our Dad at 63 from this horrible disease. Thank you all in advance!! God Bless You.

Hi, welcome to LCSC. I'm very sorry to hear about your mother's illness — she sounds like a real trooper! As an ex-military person myself, I have a huge respect for the ladies who led the way in "degenderizing" (I thought I was coining a word, but now see it's in the dictionary!) our armed forces back in the 1940s and thereabouts. Please give her a nice arm-squeeze for me.

Her doctors' hesitation in giving chemo to a 90-year-old patient is well founded. For someone in a debilitated condition, chemo is far more likely to do harm than good, and that's true for younger patients as well. But if she recovers enough to get around without much difficulty, they might be willing to try one of the less challenging treatment options.


Not necessarily. Do you know the subtype of her lung cancer? More options are available if it's adenocarcinoma, and one of the gentler chemos effective for that subtype is Alimta. Another possibility is a daily pill, Tarceva. I've seen both of these recommended for patients over 80.

May I suggest that you visit cancergrace.org (GRACE — Global Resource for Advancing Cancer Education). GRACE is led by Dr. Howard "Jack" West, a Seattle oncologist who is an internationally-recognized expert on lung cancer and who gives high priority to promptly answering questions online. A lot of us are "dual citizens" and have the same usernames there as here.

Best wishes and Aloha,

Ned

_________________
Ned is just my nickname, though it would be nice to merge it with the other meaning eventually...

Aloha means "Hello, goodbye, love, compassion, welcome, good wishes." It means belonging to others with a common humanity. It's defined better as a feeling in the heart than by words.

Dx NSCLC adenocarcinoma IIIb Sep 2006, now stage IV. Taxol+Carboplatin+Avastin 4 mo., Avastin 8 mo., Tarceva 16 mo., Alimta 12 mo. (sometimes combined with Cisplatin or Carboplatin), Navelbine since Feb 2010, 10 sessions of WBR in March 2011. See My Cancer Journey: viewtopic.php?p=351369#p351369 — UPDATED 03/05/2011.

Above left: Our golden retriever Rosie, who joined the family on 3/5/08 at the playful age of 2.

Below: Hannah, our golden companion 1994-2007.

She really does sound like an incredible woman.

One thing to remember - no doctor can predict how long she will live - with or without treatment. They can tell you the average or median for a big group of people, but not for a single individual.

90 is really pushing it for harsh chemo - it's really worth considering quality of life and know that if she wants to undergo treatment it is her desire - not something she is doing for others. I don't want to sound harsh, but hope you can separate out your desires from hers. I think that might be very difficult with her dementia? We have a difficult enough time with this with my 91 year old Dad and he doesn't have dementia - just a series of difficult illnesses - and yes, he continues to fight, so I can understand it if you say she wants to as well. But he has also opted to not undergo invasive surgery for the past year, understanding that the two conditions he has may take his life.

If you want to pursue treatment, a second opinion may be in order. Ned has suggested a couple of good options for chemo and for a consult with the good doctors at GRACE.

Best.

_________________
(photo: me in '61)
Female never smoked, 52 at diagnosis, otherwise healthy
09/08: false cardiac event = finding of 3 cm tumor upper right lobe plus two .5 cm nodes elsewhere on chest x-ray at ER
09/08: CTScan with IV contrast confirms.
10/08: Pulmonary referral for EBUS - bronchoscopy - confirms NSCLC - adenocarcinoma, with bronchoalveolar features
10/08: PetScan - further confirmation, classified T1N0MX (false negative) VATS scheduled.
11/08: full open surgery - revised to T4N2MX with positive spread to 2 lymph nodes, removed upper lobe with 3 cm tumor and partial mid lobe with (1) .5 cm tumor, 3 lymph nodes on trachea - 1 lymph node and margins negative.
5 night hospital stay.
12/08: Port-a-cath implanted
12/08: Brain MRI and hearing test - good other than minor high end loss in left ear
12/08: start (4) 21 day cycles of chemo - day 1 cisplatin and gemcitabine, day 8 gemcitabine alone, day 15 off - tolerated it pretty well - a little hair thinning and follicle inflammation, some ringing in ears and vertigo, much fatigue, and nausea. Kept my taste-buds almost intact.
02/27/09: completed 4 cycles of chemo!
03/03/09: removed port-a-cath
03/27/09: tattooed for radiation
03/30/09: start radiation (IMRT) 5x/wk for 6 weeks - fatigue, moderate esophagitis
5/08/09: completed treatment
6/22/09: NED
9/18/09: Recurrance in the liver and scattered in lungs. No symptoms. Rx Tarceva.
9/25/09: start Tarceva
11/20/09: clear lungs, shrinkage in liver.
2/24/10: still good on Tarceva
6/3/10: graduated to 6 month scan
12/9/10: new 6 cm tumor in liver
12/28/10: stop Tarceva
1/10/11: carbo/alimta/avastin
3/11/11: scan after 3 cycles 72%ish met reduction, stay the course
5/26/11: scan after 6 cycles, stable.
5/31/11: begin Avastin maintenance.
8/17/11: met growth, stop Avastin. Start Alimta.
10/25/11: met growth, stop Alimta. Wondering what to do next?
1/24/11: start hospice

Welcome. Sorry you have the need to be here. I would also suggest talking to the docs over at cancergrace.org. I don't know why your doc would say chemo is to harsh for somebody in your Mom's shape. It really varies from person to person how they take to chemo, some people it doesn't bother at all, some people get deathly ill. Nobody really knows how your Mom would do on chemo. You said she fought the beast once and won, maybe she would be up for another round? Good luck to you and your Mom,

Dana

_________________
Mar. '08-Routine xray found Spot tip of upper left lung.
Dr orders CAT. growth confirmed.
Sent to Pulmonolgist who orders PET.
Pet results-my spot lights up like a Christmas tree.
Can't reach spot for biopsy referred to surgeon.
Surgical Biopsy scheduled for Apr. 28th '08
Apr. '08-Surgeon found SCLC, removed upper left lobe and surronding lymph nodes.
Everything biopsied no other cancer found, declaired NED by surgeon on Apr.28th '08
ONC wants me to start adjuvant therapy.
June '08-MRI brain scan and CAT NED
Chemo cisplatin/vp16 3 days every 3 weeks 4 sessions ended Aug. '08
Partial hearing loss due to Cisplatin
Sept. '08 1st CAT after treatment NED
Dec. '08-2nd CAT after treatment NED
Apr. '09-MRI (brain) and CAT NED
Aug. '09-CAT NED
Dec. '09-CAT and MRI NED
Apr. '10-CAT and MRI NED
Oct. '10-CAT and MRI NED
Jan. '11-XRay NED
Oct. '11-CAT NED

They dx'd me in 07 as 3b because of my pleural effusions. Altho I had the big guns in the beginning (Carboplatin/Taxol/Avastin), I choose to go off Avastin maintenance after six months in remission. I got six more months but the cancer came back stronger. This time I went on one of the chemos Ned mentioned, Alimta. Once I got the hang of handling the constipation it causes (everyone needs to find the routine that works best for them but it MUST be handled), Alimta has been a relatively easy chemo to do.

Your mother sounds like an amazing woman and hopefully, in spite of her dementia, can make a decision as to treatment or no. I don't think the doctors should decide without at least a second opinion.

Keep us posted.

Judy in KW

_________________
Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.

Hi
My mom was 76 when she was diagnosed and is 80 now. The chemo was doable for her. It really does depend more on her overall health status than on her age. At the very least, I'd seek a second opinion. At some point you are going to have to tell your mom because she is really the only one who can make the decision on whether to undergo treatment or even any more tests.

Susan

_________________
76 year-old mom diagnosed with stage IV lung cancer January 5, 2007.

15 radiation treatments to the spine and four rounds of chemo, Jan-May, 2007.

Stable disease May, 2007-May, 2008.

Bone scan May, 2008 shows new mets in the spine, pelvis and ribs.

July, 2008--finished radiation and has a Quadramet treatment.

October, 2008--Scans show mild progression. Began chemo (carbo/taxol/avistin). Will have four rounds of threatment (every 21 days) and scan in January.

01/05/2009--TWO YEAR SURVIVOR!

4/2009--STABLE! No treatment. Next scan in July

7/2009--Scan shows pleural effusion. Fluid drained and malignant. Cancer has spread to other lung and a 13 mm lesion is seen on the liver. Mom to begin Alimta on 8/3

11/2009--Alimta was hard on mom and scans showed progression.

12/2009--began Tarceva, noticed almost immediate improvement.

2/25/2010--Celebrated Mom's 80th birthday!

5/15/2010--Mom watched her oldest granddaughter graduate from college and then paritied well into the night! She's still feeling great.

6/15/2010--Mom watched her youngest granddaughter graduate from high school. Still feeling great!

8/2010-10/2010--Mom begins feeling tired and stays in bed more and more. Scans reveal that the cancer is moving rapidly throughout her body.

10/13/2010--Mom wins her battle once and for all, and passes to a place where the cancer can no longer touch her.

For a more detailed timeline see:

http://www.lungevity.org/l_community/viewtopic.php?p=360385#360385

I dont know what to say ...You are some of the bravest people I have ever encountered. Mama came out of intensive care yesterday but we have a long road ahead. She hasn't walked for over a month and standing on her feet alone is difficult for her. We are taking her to a geriatric oncologist at Moffitt in Tampa as soon as she get stronger which means I will have to place her in a rehab for a few weeks. We met with another Oncologist who is doing some gene testing to see if mom can take a drug called Tarceva? He also stated something I found very interesting. I asked him point blank what happens if we just do nothing? He said that he has had some stage IV adnocarcinoma patients come walking in a year later with no additional disease. He also stated that he has had other patients that only made it 6 months without treatment. He said he sees miracles everyday. Well so do I so I can't give up. I think I have cried more tears in the past few days then I have cried in my entire life! Seven years ago I was diagnosed with stage 3-4 Hep C and cirhosis of the liver I can tell you I went through 54 weeks of chemo and really only cried the day I was diagnosed. But with mom I am like a two year old child...Crying all the time. Its so hard because everyday with her dementia she says "I feel better can we leave this Hotel now? I really feel good and want to go shopping" and all I can think of is that one day soon I will have to tell her ...or not. We shall see. Please pray for us and I will pray for each and everyone of you. God Bless All of you.

I was going to ask (or really more wonder aloud) about Tarceva. I'm glad they're looking into that as an option as from what I understand it's milder, but still very effective for many folks!!

I am praying for you and your Mom. Your game plan sounds good for talking to docs and getting the most information. You are advocating so well for her.

_________________
"All shall be well, and all shall be well, and all manner of things shall be well... No matter what."
--Julian of Norwich/Madeleine L'Engle

My Mom, Carol, was diagnosed with Stage IV NSCLC with several mets to the bones in November of 2004, when she was 57. Treatment included radiation to relieve the bone pain, Zometa to strengthen her bones, Cisplatin/Gemzar as a first line treatment, and Alimta as a second line treatment. Mom was referred to hospice while waiting for a Perifosine trial to begin, and she died July 19, 2005. Not a day goes by that I don't long for my mama.]

www.digtoesin.wordpress.com
www.newwaylc.blogspot.com

I wish for the best for you and pray for you and your Mom. It really is so difficult when they are 90, with dementia, and now this complication. I pray for peace, and healing.

Judy in MI

_________________
6/07 DX NSCLC, Left Upper Lobe wedge resection: Stage 2.3/4, (2B?) Adenocarcinoma, measures 2.5x1.5x1.1cm. Involving visceral pleura but not through it. 5 rounds chemo, carboplatin and Taxol. Subsequent scans NED.

1/11 3.5 mm node found. 10/11 CT node now 8 mm, and new 6 mm node. 11/11 CT Pet shows slight uptake. 1/4/12 Biopsy - Pneumothorax complication. 1/14/12 Lobectomy of upper rt. lobe. NSCLC Adenocarcinoma in situ, nonmucinous (bronchioloalveolar carcinoma) 1.4cm involves pulmonary parenchyma.
3/14/12 Begin 4 cycles of Cisplatin/Navelbein, with Neulasta shot
4/6/12 Chemo changed to Carboplatin/Navelbine without Neulasta shot. Reduced chemo by 50% due to intolerance.
7/5/12 CT scan is clean, NED for lung cancer! There are issues with liver and stomach that will be investigated but not believed to be because of cancer. Wait and see!

*Avatar was taken 7/3/12 on our way out to see the Fireworks on a friends boat on their lake!

Mom dx SCLC 1/96, passed 10/19/96, age 62
Dad dx Brain cancer 4/87, passed 6/87, age 57
Sister dx Brain cancer 4/83, passed 12/83, age 25

I'm glad you mom is out of ICU and will be seeing a geriatric oncologist. He is right there are people with very slow growing cancers who do well for long periods of time without treatment. You will feel better knowing you mom's case is being reviewed by someone who can take into account your mom's age, health and diagnosis inrecommending the next steps.

I went into a months long depression after my mom was diagnosed. In some ways I think I reacted more negatively than she did to her diagnosis. It's normal and you will learn the "new normal."

Susan

_________________
76 year-old mom diagnosed with stage IV lung cancer January 5, 2007.

15 radiation treatments to the spine and four rounds of chemo, Jan-May, 2007.

Stable disease May, 2007-May, 2008.

Bone scan May, 2008 shows new mets in the spine, pelvis and ribs.

July, 2008--finished radiation and has a Quadramet treatment.

October, 2008--Scans show mild progression. Began chemo (carbo/taxol/avistin). Will have four rounds of threatment (every 21 days) and scan in January.

01/05/2009--TWO YEAR SURVIVOR!

4/2009--STABLE! No treatment. Next scan in July

7/2009--Scan shows pleural effusion. Fluid drained and malignant. Cancer has spread to other lung and a 13 mm lesion is seen on the liver. Mom to begin Alimta on 8/3

11/2009--Alimta was hard on mom and scans showed progression.

12/2009--began Tarceva, noticed almost immediate improvement.

2/25/2010--Celebrated Mom's 80th birthday!

5/15/2010--Mom watched her oldest granddaughter graduate from college and then paritied well into the night! She's still feeling great.

6/15/2010--Mom watched her youngest granddaughter graduate from high school. Still feeling great!

8/2010-10/2010--Mom begins feeling tired and stays in bed more and more. Scans reveal that the cancer is moving rapidly throughout her body.

10/13/2010--Mom wins her battle once and for all, and passes to a place where the cancer can no longer touch her.

For a more detailed timeline see:

http://www.lungevity.org/l_community/viewtopic.php?p=360385#360385

Thank You Thank You Thank You..

Happy Mothers Day everyone!

Have to tell you I am a business professional workaholic
and always "on" so to speak. All I do is cry now. Went to pick up flowers, cards, etc. and just collapsed in the middle of the Halmark Card Store.Everyone just stared.. I sobbed in the store until I could make it out to the car. This new reality sucks I know I have to be strong..since she doesn't know she is so incredibly happy..she keeps telling the doctors how good she feels..I guess thats the blessing really. But then these sadistic docs keep coming in saying don't get overly excited she is going to die anyway...I an talking day after day after day. Finally yesterday I yelled at one and said "yes we know and so is your mother and so are we" We are all going to die one day but you truly need to just stop rubbing our noses in it" This Hospital life is another thing entirely..2 months today.

God Bless All of You...Val

Willow, I don't know if you are a mother but know this will be a special Mother's Day for you with your Mom.

Right on giving those drs the business! I say people get away with the things they say and do and repeat them over and over because people allow them too. Enough of the "no bedside manner" excuses, you are absolutely correct to tell them they are rubbing your nose in it if they insist on repeating over and over what they cannot predict in time anyway. Hang in there.

Judy in KW

_________________
Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.

Hi Willow,
Sorry to read about the experience with doctors casual and unkind remarks,I have received similar treatment myself from a doctor who refused to sign me fit to work,after I told him about being depressed from cabin fever at home,lacking human company,he told me to spend quality time with my wife instead,since I only had 2 years left to live,I accidentally bumped into him recently and he complemented me on how well I was looking,I replied well not bad for someone who has only six months left to live,and he said "Who told you that?" I replied "You did"" no I didnt" he said looking somewhat embarassed he excused himself and walked away before I had time to include a reminder of his rejoinder,about a previous lung cancer patient of his surviving 5 years ,what a character he was the doctor says adding -but you are not him.
Willow please disregard these uncaring idiots,focus instead of the pleasure you have in your mothers company,no one knows how many days,weeks,months or years each of us have, except God

_________________
Regards,
Eric Byrne

To read my story, please follow the link : http://lungevity.org/l_community/viewtopic.php?t=43268