Hi Everyone!
So glad I found this site- everyone seems so helpful!
My mom was just diagnosed with Stage IV NSC Adenocarcinoma. Never smoked.

They did most tests but it will take 2-3 weeks for the mutation testing to come back- if it tests positive Dr. will recommend Tarceva.

My question is this: Are there any pros or cons that you know of to starting chemo in the meantime? Of course my mom is hoping to do Tarceva instead but I would think it is beneficial to start chemo in case she tests negative.

Has anyone gone through this? Any answers would be deeply appreciated.

God Bless you all!

Hi. So sorry about your Mom. I'm sure others will respond with much more helpful info than I -- there are so many people with so much to share on this site. I can only tell you that my mother started treatment without any kind of genomics testing (I was very anxious for her to get started right away) and she went through a whole course of treatment without any real success. Then, a new doctor sent her biopsy out for the genomics testing to determine the best course of action, and she is now undergoing a different combination of drugs. We'll see how that goes. So, I'm not sure how to answer your question. It probably can't hurt to start the chemo, but on the other hand, my Mom's doctor then needed her to wait a month to get the current treatment through her system before starting the new drugs, so it may be better to wait the two weeks. I assume that the test will not just tell her whether Tarceva is an option, but perhaps tell which other chemo drugs she'll be most likely to respond to. That was the case for my Mom. Best of luck with this difficult decision making. Wishing the very best for your mother.

_________________
Mom, age 65, Dx July, 2010, Stage 3a NSCLC Squamous Cell
10/6/10: Just completed radiation therapy x37 and chemo (carbo/taxol) x 8
Next CT scan 10/28 to determine next steps
12/6/10: Started new round of chemo (cisplatin/navelbine)

I think they are just testing for the EGFR mutation to determine if Tarceva would be a good first line therapy. Over on Cancergrace, the doctors just wrote up an answer to this question. Look at responses 9 and 10 from the doctors. Very helpful.
http://cancergrace.org/forums/index.php ... 4#msg54494

How is her current health status? Waiting two weeks if she has serious symptoms and is getting worse may not be advisable. If she has no symptoms and is feeling well, it might be worth waiting rather than get into the chemo cycle. Few go through it without some serious side effects.

Best to you and your Mom. I hope whatever treatment does the trick.

_________________
(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

Hi and welcome. Sorry you have to be here. I wish they had enough tissue to test me for the mutation. In the meantime, I've been on several other chemo and am finally on Tarceva. I would wait. Everytime you start a different treatment, each has it own set of side-effects and problems to deal with. It gets exhausting. If this test can offer her the treatment with the highest likelihood of success, it's a good thing. Most of us rush into treatment because we are scared to death and sometimes second-guess it. Keep in mind Adenocarcinoma is relatively speaking typically a slow growing cancer.

Good luck to your Mom.

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 Ariel,

I'm with KW Judy. Any kind of chemo has potentially harsh side effects. If she starts now and the testing shows she needs a different kind of treatment, she may have to delay that treatment due to the side effects of the one she would take now.

Two weeks is a short amount of time. I'd wait. I agree that most of us are so anxious that we want to start something immediately. But I think they are wise in doing the testing and waiting for the next course of action.

Cancergrace.org is an excellent place to get more information!

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'd definitely ask the medical experts over at GRACE but adeno is known to be a slower growing cancer - and I dont think it would be a detriment to wait until the test came back in a couple weeks before starting chemotherapy unlike small cell lung cancer which has a double growth rate of about 30 days, unless of course there are issues with tumors in certain areas.

I'm not a Dr. so definitely ask at GRACE if you want an online opinion or your mom's medical team. (www.cancergrace.org)

Please keep us updated. We are here for you!
I'll be looking for your posts!
KatieB

_________________
- Katie Brown, Co-Founder and Director of LCSC-

15 yr cancer survivor.

"Any of us who have experienced the cancer journey- and survived it-
have an obligation to make the path clearer and aid those that come after us."
- Lance Armstrong

In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


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