Hi, All.
Just wondering if anyone can recommend a good medical oncologist, specializing in lung cancer, in south Florida. My mom just completed her radiation therapy and chemo 8x and next steps will be determined at the end of the month. She'll likely start a new round of chemo, cisplatin and navelbine, 2 weeks on and 1 week off for the next 3 months. First, does anyone have experience with these drugs and what we might expect in terms of side effects compared with the carbo/taxol she received so far?

My parents usually spend the winter in Delray Beach, FL and they'd really like to do that this winter also. The doctor said she can certainly continue the regimen down there, but she'll need to find an oncologist. Wondering if any of you are from that area and can recommend someone or at least a good hospital that she should consider.

Thanks!
Leslie

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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)

If You want try dropping JamminKW a PM and she might be able to help out!

_________________
April/03 My Wife Deborah, age 46, diagnosed adenocarcinoma NSCLC
1/20/2006 Admitted to hospital Respiratory distress
1/23/2006 Ran to the light and is waiting for us to be rejoined in the Kingdom Of Heaven Her journey is Over but mine lingers on for Now!!!
4/23/07 DEb is joined in Peace by her Puppy Dawg Daisy from Cancer
8/30/07 Got new Pup named Mocha!!

"No matter hnow much it hurts, No matter how alone you feel, Your friends will help you get through anything!!"
Scrubs!!!!Yes the comedy show!!!

The Reason I advocate
If you would like to see our family photos Click on this link!
http://deborah-wallin.memory-of.com/

My memory-of Link is good to go now if you want to see it!!

Hi and welcome. I am not familiar with those particular chemo drugs but am sure someone will come along who is. As far as finding a place for your Mother to have treatment, I have considerable experience in that area. My primary oncologist is at MDA in Orlando and I live in Key West. A year ago last Sep, I started getting my infusions in KW with my onc in Orlando remaining my primary. I go to Orlando periodically for scans and a clinical visit with her.

My husband's business requires extensive travel in the summer and I travel with him and get chemo "on the road." I can't recommend any facility in Delray Beach but I can tell you how I did it. Key West, no choice, only one cancer center. Before I travel, I go online and find the centers closest to where I will be staying. I don't do big hospitals. Most areas have cancer centers now and since I have an onc at a primo hospital, I find the cancer centers very user friendly for the purpose of getting treatment. They are usually small and more personal and now I have repeated treatments in Corning New York and in Mt Holly NJ. The only time I had a personal reference was this year in Portsmouth OH. The person managing the campground where we were staying had cancer and recommended her oncologist--again at a small center. In Mt Holly, I go to Virtua hospital and it's fine, but I would opt for the cancer centers I've used as I travel any day.

Good luck and don't hesitate to start your search on the net..

Judy in KW

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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.

Leslie,

I've been to Tampa for one long weekend, so no help there. My first line of chemo was cisplatin and gemcitabine for 4 cycles. I had this after surgery and before radiation. 4-6 cycles of platinum doublet appears to be the most typical treatment. Cisplatin is considered more challenging than carbo, but they are almost interchangeable. I'm not sure why the recommendation is for so many cycles.

You might find it helpful to read some of Grace's posts on NSCLC treatment?
Here's that seems very applicable:
http://cancergrace.org/lung/2010/09/24/ ... e-therapy/

or this thread:
http://cancergrace.org/forums/index.php ... 0#msg41940

Best to your Mom (and you).

_________________
(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 Leslie,

My MIL lives in Delray Beach but has never had any cancer treatments so I don't think she'd have any recommendations. However last year I had 3 months of cisplatin and navelbine. The first treatment I didn't do well at all but after that they lowered the dosage and I did much better. With the cisplatin it made for a very long day since they had to hydrate me for 4 hrs before the chemo and for 4 hours after the chemo. I hope your mom has a port because the navelbine is hard on veins. The nausea was not too bad with all the medicine they give you now. Be sure she stays hydrated - drink lots of water. The fatigue can get really bad - it seemed to me to get worse the more treatments I had. You can also get neuropathy - I have some in my toes. Be sure and let the oncologist know if that starts to happen. My blood counts dropped too but they checked that every time I went for treatment and gave me shots to keep it up.

Good luck to your mom.

Paulette

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04/02/09 family doctor found spot on upper left lung on chest x-ray.
04/03/09 CT scan with contrast - shows 5cm tumor in left upper lobe.
04/08/09 Met with thoracic surgeon.
04/14/09 PET scan - cancer only in tumor. Echo stress test. Cartiod ultrasound
05/01/09 Vats surgery - Upper left lobe and wedge of bottom lobe. Clean margins and no spread to lymph nodes. Staged 1b because of size of tumor. In hospital 7 days due to fluid in remainder of left lung.
06/09/09 Met with oncologist - because of size of tumor adjuvant chemo recommended. Cisplatin/Navelbine, 4 rounds. Some problems 1st round but minor ones after that. Finished chemo August 24.
09/02/09 CT scan of chest with contrast - NED
03/02/10 CT scan of chest and abdoman with contrast - NED
08/25/10 CT scan of chest and brain with contrast - NED
03/01/11 CT scan of chest and abdoman with contrast - NED
09/19/11 CT scan of chest with contrast - NED
02/24/12 CT scan of chest and brain with contrast - NED
08/21/12 CT scan of chest with contrast - NED
02/22/13 CT scan of chest with contrast - NED
_______________________________________
10/13/86 Daddy died of lung cancer after a 8 month fight. Diagnosed 2/86.

I forgot - one of the side effects was a metalic taste in my mouth so almost everything I drank or ate had that taste. I found that ginger ale and chocolate milk to taste the best while I was taking the chemo.

Paulette

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04/02/09 family doctor found spot on upper left lung on chest x-ray.
04/03/09 CT scan with contrast - shows 5cm tumor in left upper lobe.
04/08/09 Met with thoracic surgeon.
04/14/09 PET scan - cancer only in tumor. Echo stress test. Cartiod ultrasound
05/01/09 Vats surgery - Upper left lobe and wedge of bottom lobe. Clean margins and no spread to lymph nodes. Staged 1b because of size of tumor. In hospital 7 days due to fluid in remainder of left lung.
06/09/09 Met with oncologist - because of size of tumor adjuvant chemo recommended. Cisplatin/Navelbine, 4 rounds. Some problems 1st round but minor ones after that. Finished chemo August 24.
09/02/09 CT scan of chest with contrast - NED
03/02/10 CT scan of chest and abdoman with contrast - NED
08/25/10 CT scan of chest and brain with contrast - NED
03/01/11 CT scan of chest and abdoman with contrast - NED
09/19/11 CT scan of chest with contrast - NED
02/24/12 CT scan of chest and brain with contrast - NED
08/21/12 CT scan of chest with contrast - NED
02/22/13 CT scan of chest with contrast - NED
_______________________________________
10/13/86 Daddy died of lung cancer after a 8 month fight. Diagnosed 2/86.

Hi, Leslie. Keeping in mind that everyone is different and there's a lot of variation in what side effects an individual will get from a particular chemo, I'll just say that of all the chemos I've had in the past 4 years (see below), Cisplatin was the roughest and I refused to have more than one infusion of it. On the other hand, Navelbine alone is the easiest I've had, and it's resulted in the first shrinkage my tumors have seen since 2007.

Do you know your mom's lung cancer subtype? If it's adenocarcinoma, Alimta would be a good chemo choice, and it could be effective given alone. And either adenocarcinoma or squamous cell carcinoma might respond to the daily pill Tarceva, even if she doesn't have the EGFR mutation which predicts a very good response to that drug.

As ts indicated, you'll get the very best treatment information at cancergrace.org (GRACE, Global Resource for Advancing Cancer Education). Try entering this in a Google window:

site:cancergrace.org cisplatin navelbine

Aloha,

Ned

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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.

Hi Leslie,

I have the same diagnosis and did the Carbo/Taxol. My first choice was the Cisplatin/Navelbine because I was told it would have less side affects (hair loss, nauseau, numbness, etc). Once discovered that I had 3A they said I need to do the Carbo/Taxol, this was the most aggresssive to save the other treatment for later if needed.

I know the Naveline is easier on you, but not sure about the Cisplatin. Wishing your mom the best during your treatment.

Libby

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43 yr old female with a 12 yr old daughter.
May 2007 - Diagnosed with stage 3A Squamous Cell NSCLC.
5/15/07 - In hospital to have left upper lobe removed. Stage and cancer type was confirmed. Removed several lymph nodes, 2 tested positive for cancer. Home after 5 day.
5/24/07 Went to Oncologist. Did CT/PET scans (praying they got all the cancer out).
6/4/07 Got results, lymph node by main artery showed cancer. Can not remove due to location. Good news was that there was no sign so far that it spread any further than that. Set up an appointment with Radiation Specialist.
6/15/07 Receive chemo every week for 6 weeks ( Carbo & Taxol) and radiation 5 days a week for six weeks, (33 radiation treatments were planned). We stopped at 30 treatments because of 2nd degree burns on my back.
Finished radiation and chemo on 7/26/07. Was in hospital and had 3 ½ weeks off of treatments.
8/15/07 Started chemo every 3 weeks for 9 weeks with larger doses.
9/28/07 Finish final chemo. Will have scans done 11/6/07 and see Dr. for results on 11/9/07.
11/07 Received results, cancer free. Was told this was a good sign considering the stage. need to follow up every 3 months with scans.
8/09 - Now receiving CT scans every 6 months, just had one in Aug so far no signs of cancer. Made the 2 1/2 year mark. Still problems with inflamation with lungs due to radiation damage.
3/10 CT scan no sign of cancer. What a relief!
7/10 still going strong no scan for 1 yr now, next scan is March, I am nervous waiting so long but I will survive. I am a survivor.
3/11 CT Scan, No signs of cancer. Thank you God.