Blue Fish

Thanks for the advice! Good thing my mom has green card so coming to US is not an issue. Thinking about buying individual policy, but with the volatile individual market it is not sure if Houston will still have a marketplace next year.I know it is annual enrollment so I need to wait until the end of year to enroll for next year. It will be a problem if preexisting condition is part of the underwriting process. So much uncertainty with the regulations on healthcare market. It is literally life or death for some patients with some potential changes. Very sad but it is a reality.

Thanks Tom! We were fortunate enough to have an MD Anderson lung oncologist review my mom's medical record and she came up with the same recommendation. So Tom you are right that the solution is quite standard, but given the severity of the situation it is nice to have the confirmation. The doc also recommend CT scan after three months and decide whether to add radiation therapy. The doc in China plans to do CT one month after taking Gefitinib, which is even better. CT is a lot less expensive in China. My mom has started taking her first pill so we'll see how it goes. At the same time I'm trying to see what is good time for her to come to US since subsequent treatment options are much more abundant here. I know she takes the pill once a day. It might take a while to transition from China's doc's care to a doc here. The doc here may want to redo some tests. I'm trying to figure out the logistics so she will not have gaps of care. Also insurance coverage is an issue too. I plan to buy individual policy on the marketplace. Do the health insurance policies cover all the treatment options: first line, second line, third line? Thanks for the encouragement! Blue Fish

Thank you so much for both comments! I know some friends from MD Anderson and they are helping me with the diagnosis as well, but the initial thoughts are similar to Tom's which is that the discovery of mutation of EGFR L858R itself is sufficient to decide the medicine to be used for targeted treatment. In China there are two medicines available as first line treatment: Erlotinib (Tarceva) and Gefitinib (Iressa). Beijing and Shanghai may have more options. The doctor prescribed Gefitinib, but the doctor seemed to be indifferent to these two drugs and asked the patient to choose. Initially I planned to ship my mom's pathology slides and the paraffin blocks (remaining of the biopsy tissue that is left for future studies) to here and let MD Anderson's oncologist to give a second opinion, but it looks like it is a pretty cut and dry case. Should I be more cautious? The doctor in China says the treatment is quite standard around the world. My current plan is to start the treatment as soon as possible for her to stabilize her condition, once it is stable she can travel to US since it is almost sure she'll develop resistance. The question is: is it feasible to travel while under the Gefitinib treatment?

Hello everyone! My mom was just diagnosed with stage 4 Adenocarcinoma in her right lung. I felt so helpless with so much information but so little time. I'm glad to have found the support group. My mom's cancer has spread to bones, liver, and brain. Her gene analysis just came out an hour ago showing EGFR L858R mutation. She is currently in China. The doctors there seem to have decided on the targeted therapy based on this report. Don't they need to find out if there are other types of mutations? Is it enough to know what medicine to use? Thanks for any information you may offer. We'd like to ask intelligent questions when we talk with the docs.