Doc implying chemo and radiation can't be done at the same time

[DrBee]

Okay super confused. After being diagnosed yesterday (stage iv but just lung and lymph right now) and given a treatment plan of carbo+alimta+keytruda every 3 weeks starting next week, we reached out to the doc today just to let him know that we are interested in talking to a radiation oncologist as well about targeted radiation / CyberKnife as well.

It looks like radiation plus chemo is a pretty common combination. So we were really surprised when the email reply today read in part as follows: "For now, we would not want to do radiation because it would be targeted and delay chemo-immune therapy that goes everywhere in the body. So chemo-immune therapy is the priority. "

Any of you veterans out there got any ideas on why radiation would delay chemo/immune?

With gratitude, 

Bethany 

[Robert Macaulay]

 My thought is they want to go full strength with the chemo and when I had radiation and chemo combo it was a reduced dose of chemo as not to interfere wiith radiation side effects and the full dose of chemo is not for the faint of heart I just  had two after six reduced doses with radiation no comparison.

Bob

[Tom Galli]

Bethany,

Conventional Radiation is often given as a primary treatment with conventional chemo in an adjuvant role. 

Immunotherapy complicates things. I don’t think you should interrupt his current treatment but think you ought to reach out to a radiation oncologist and understand how they could play a role. 

I hope I’m not confusing you. 

Stay the course. 

Tom

[BridgetO]

I agree with To,. Consulting with a radiation oncologist (or getting a second opinion from another doc) doesn't mean you're going to stop current treatment and change horses in midstream. 

Bridget O

[eullrich66]

HI,

I don't know your full treatment plan, but in my recent experience, part of my treatment will be surgery to remove a lobe or the whole lung. I was told that radiation could cause scarring which could delay surgery.

I was also told that radiation may be used post surgery on the lymph nodes area.

Just another two cents!

[Judy M.]

On 8/4/2018 at 7:53 AM, BridgetO said:

Don't know if this will help, but I could not have SBRT type radiation concurrent with chemo. The Medical Oncologist wanted to do that, but the Radiation Oncologist refused stating that it would be too toxic. I know conventional radiation is often done concurrently with a lower dose of chemo, but not SBRT. And that's what you were asking about. I'm thinking this is because the dose of radiation is much higher with SBRT. 

Judy M

 

[Judy M.]

I don't think doc is saying you can't have it but only that you can't have it together and the chemo/immunotherapy you are getting right now is the priority. I had both, but consecutively not concurrently. 

Judy M

[DrBee]

6 hours ago, eullrich66 said:

HI,

I don't know your full treatment plan, but in my recent experience, part of my treatment will be surgery to remove a lobe or the whole lung. I was told that radiation could cause scarring which could delay surgery.

I was also told that radiation may be used post surgery on the lymph nodes area.

Just another two cents!

Thank you Eullrich66!  When is your surgery? Will be sending you good vibes that they get it all! Surgery is not an option for us at this point, but possibly if the Alectinib is really effective, it will be! 

[DrBee]

5 hours ago, Judy M. said:

 

For some reason I can't quote you, Bridget or Judy (quoting you) but that is super helpful! ❤️  BTW, update, we learned we are ALK+, so we are not on immuno/chemo but targeted therapy which is working BEAUTIFULLY!. 

[Judy M.]

Great news. Thanks for sharing!! 

Judy M