Tom Galli

Kristy, I too offer condolences for your loss. There is only one slim ray of goodness in your loss story. Your mother didn't linger with her complex symptoms. For that I am thankful but I morn your loss. Stay the course, Tom

I just completed a most unusual intellectual assignment—evaluating molecular biology and pathobiology research grant applications. When I learned of my assignment, I wondered how I’d make the academic stretch from civil engineer to biologist. Sure, on a good day, I can spell pathobiology correctly without aid of a spell checker. Why would someone deliberately assign me to review molecular biology stuff? I’d forgotten. I was a lung cancer survivor and expert, not by education but by experience. Those who survive have relevant first-hand experience that can’t be learned in any university. Some research grant institutions require a “consumer” evaluator to assess the impact of applications. In the case of lung cancer, the consumer is a lung cancer survivor. My experience came in handy. We were asked to score the impact of each proposal. Even basic science research has discernible impacts. Knowing, for example, Squamous Cell Lung Cancer does not benefit from adenocarcinoma-targeted therapy enabled me to assign higher impact scores to proposals aimed at immunotherapy advances against Squamous Cell Lung Cancer. Might scientific researchers know this? Perhaps, but I know it; I live with it every day. In a pre-evaluation conference, a veteran consumer evaluator suggested I start a technical term dictionary, capturing definitions of technical terms in a spreadsheet for easy reference. My biology vocabulary is substantially expanded by understanding hypermethylation, epigenetic, methylation, and cytosine to name a few. Technology makes understanding these terms simple—Google the term and add the word “definition”. Modern technology astounds me. I was a “slide rule jockey” through college going blind multiplying, dividing, and deriving roots and powers. But it was slide-squint-copy, and rinse and repeat. Now one Googles up the equation, substitutes values, and presses enter! Try it yourself. Google “what is the square root of 2356875.6” Simple! So computer-aided understanding allows even a novice to discern the complexities of biological expression. And, our participation in evaluating research is essential. Why? Because there is a vast difference between experiments performed in vitro vice those performed in vivo. We are the in vivo! We should be a check and balance before a path of discovery is established that subjects us to poking, prodding, discomfort, or worse. After all, we are not concrete. Stay the course.

LUNG CANCER ACCOUNTING—A METHOD TO WIN THE BILLING BATTLE Treatment for lung cancer was, hands-down, the hardest thing I ever endured. What’s the second hardest? Without a doubt, it is settling treatment bills. After nearly 13 years, I still get them. Despite all of the advances in information technology, medical invoices, including medical insurance invoices, are the most unnecessarily complex documents ever created. Their level of useless intricacy bests even lawyer generated minutiae. I've got a method, a foolproof way to organize, understand, and pay. This avoids both double payment and long periods on hold listening to elevator music while waiting to talk to someone who knows absolutely nothing about your problem. Here are my ten steps to winning the lung cancer treatment billing battle. 1. At your time of treatment, ask the treating physician to tell you the treatment code or codes to be reported on your medical record. Write this information down, including the date of service (DOS) for each code. A smart phone calendar application is the perfect way to capture this vital information. Just put the codes on the calendar. 2. Also ask if a third party provider (someone outside your doctor’s practice) will provide lab or diagnostic work. Get the names of these providers and treatment codes used for their services. 3. Build a record of information for data captured in steps 1 & 2. I use a computer spreadsheet but an old-fashioned pencil and paper ledger will work just fine. Here’s an example: DOS - Date of Service, PC - Procedure Code, PROV - Provider, MS - My Share, PD BY - Paid By, PD DT - Paid Date 4. As bills come in, add new information to the spreadsheet. I record as I open so I don’t miss anything. Highlight the DOS and PC on each bill with a bright colored highlighter, then staple or paper clip together by DOS. 5. On arrival of your insurance statement, update your spreadsheet adding INS ALOW, INS PD and MS. Don’t worry about amounts insurance reduced or denied. If your provider accepts your insurance carrier, they must abide by insurance allowable charges. Attach the insurance claim to bills by DOS. You may need to make copies because insurance claims often cover multiple DOS. 6. Do not pay anything to anyone (exception COPAY) until your insurance pays. Then only pay (MS) and complete PD BY and PD DT on your spreadsheet. 7. Keep all this paperwork together in a single manila folder. I keep mine on my desk along with a supply of paper and binder clips to keep things together. 8. I use this method for hospital bills but there could be pages of procedure codes covering several dates of service. Make an entry for each DOS and record all the PCs per DOS. You’ll need to mine this information from the statement because hospital visits often consist of many dozens of PCs. Consulting doctors who treat you in the hospital must cite DOS and PC on their invoice. You may never meet these doctors (radiologist, pathologist and etc) but you’ll track them to the hospital stay by matching up the DOS. 9. Hospital invoices take months to arrive while attending physician invoices take weeks. Match them up and wait for the insurance claim before paying anyone. 10. This method simplifies claiming federal income tax medical expense deduction. Come tax time, filing will be a snap. I’ve paid thousands of medical bills. The only thing worse than the assault of bills is assault by bill collector. In the days before organization, I’d hunt through piles of paperwork and bank records trying to find information on a bill I know I paid. Not being organized means I likely paid twice just to stop the telephone calls. I recall the day I received a bill collector call after I stood my method up. My data shut him down. I went from hello-to-cancelled-check-to-good-by in seconds. It felt so good! Stay the course.

Chances are you pay attention to new treatment developments. I was aimlessly scrolling through a social media app when I happened on a dramatic interview. Everything was staged to look legit. The interviewer looked like a TV reporter, the background scene looked like a doctor’s office, and the set up question “doctor, let me talk about cancer a little bit” got my attention. The camera changes views to the doctor as the reporter says, “what are some of the things you’ve seen in terms of your patients?” Then we see the doctor. He looks like a doctor, well dressed with a confident assuring voice. He changes the subject saying “a better thing to talk about“ and his name and titles flash and disappear on the screen: Peter Glidden, BS, ND (note not MD). He cited an unnamed study published in the Journal of Clinical Oncology in 1994, a 12-year program that looked at adults who had developed cancer, further clarifying adult cancer as “the main type of cancer we get here in the United States.” He described the study as a “meta analysis of people all around the world for 12 years who were treated with chemo…and the result?” “Ninety-seven percent of the time chemotherapy does not work.” Dramatically and shaking his head for emphasis, he repeats the same statement, then he asks “so why is it still used?” “Money”, he answers. “Chemotherapeutic drugs are the only classification of drugs that the prescribing doctor gets a direct cut of…the only reason chemotherapy is used is because doctors make money from it…period…it doesn’t work…97-percent of the time.” Continuing, he says: “We have lost the war on cancer in the United States…why…when you try to bring a reductionistic phenomena like drugs and surgery to bear on a holistic phenomena, you will completely miss the boat each and every time.” Further he emphatically states, “if every girl in this country took 200-micrograms of Selenium, in one generation, we’d eliminate breast cancer by 82%; now why aren’t we doing that?” So, let’s take a deep dive into Peter Glidden’s claims and supporting data. First, consider his probability predictions: 97-percent of the time chemo doesn’t work and 200-micrograms of Selenium eliminates breast cancer by 82% in one generation. These predictions sound authentic, like there was a test to determine outcomes. But, no scientist, doctor, or engineer would ever describe a statistically based probability outcome using just a naked percentage. There is always uncertainty and professionals bound uncertainty with a confidence level. An engineer might say that concrete will achieve a 6,000 psi end strength but will disclose the testing sample size, mean, standard deviation and confidence level that justify the end strength statement. Test results never exactly replicate. The end strength will vary between some acceptable range. But Glidden’s claim is precisely 97-percent. It is unsupported. Moreover, it is debunked in the literature. Here is a good on-line summary about the unsupported claim . But, to even make a 97-percent statement, one would need to know, with certainty, the cause of death of each of the thousands of people who had chemotherapy. Were autopsies performed? Might some have died of natural causes, traffic accidents or other illnesses? A statistically significant record of “meta data of people all around the world treated for 12 years” does not exist. Do they have data in the Fiji Islands, Kenya, Somalia, Bangladesh or North Korea? How about his 200-microgram Selenium cure for breast cancer? He says it would eliminate breast cancer by 82% in one generation. I’m not even sure I know what eliminate by 82-percent means. Think about how imprecise this claim is. How long is one generation? How did you determine it was 82%? How sure are you it is 82%? I could drive a main battle tank through the gates of this claim’s imprecision! Now to his claim that cancer is not a reductionistic phenomena, suggesting that drugs or surgery misses the boat “each and every time.” I’m one of those “each and every time” and my survival from drugs and surgery proves him wrong. Does naturopathic treatment actually cure cancer? I don’t know but neither does Gladden. Here is some interesting reading about Naturopathic Doctors. Peter Glidden’s video extolling a simple nutritional supplement as a cancer cure is compelling. He is dramatic, confident and to a diagnosed lung cancer patient facing an arduous regime of chemotherapy, persuasive. Why bother with the chemotherapy if I can take Selenium and cure my cancer? If you are reading this, you or someone you care about has lung cancer. Time is of the essence. You have but three choices: do nothing, conventional medicine, and holistic medicine or some derivative of the same. Do nothing is the least expensive alternative. You pay nothing and might live. Miracles happen. Conventional medicine and holistic medicine will cost your money. How do I make the choice? I put my money on science-based conventional medicine treatment because treatment outcomes are repeatable. Mark Twain said it best: “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” Gladden is trying really hard to convince us he’s 97-percent sure chemo doesn’t work. It just ain’t so. Stay the course.

The summer Olympics kindles an unpleasant anniversary. I was in hospital recovering from a failed bronchopleural fistula surgery complicated by pulmonary embolism, further complicated by pneumonia, and then aspirational pneumonia. After surgical mayhem and ensuing coma, I settled into a nil per os or NPO recovery from a uncooperative epiglottis. July, August, and early September of 2004 were clearly the worst days of my life. The only joy was watching Katie Couric’s daytime TV Olympic broadcast from Athens. Two weeks of Olympic distraction amid repetitive admissions to the ICU as my doctors, nurses, and respiratory technicians struggled to keep me alive. I don’t have specific memories of the games or any athlete. I can only recall the TV setting for Couric’s broadcast -- a shoreline location framed by Greek coastal mountains in the background and the deepest blue ocean I’ve ever seen. I’d wait for her show to come on and the camera to pan along breathtaking vistas while smelling coffee and food deliveries. I longed for so many things in that time. The smell of hospital-grade coffee was so tantalizing, it almost undid me. Till I met the hospital speech pathologist. She delivered the undoing. Lung cancer patients learn a lot about hospitals. Doctors, excepting surgeons and anesthesiologists, do very little hands on patient care. This is the realm of nurses and medical technicians. But, who treated my lazy epiglottis -- a speech pathologist. A young woman, as I can recall, small in stature but with the confidence and swagger of an army SERGEANT MAJOR. For those not acquainted with a sergeant major, it is best you not cultivate a relationship. They make the army THE ARMY. They are not nice, friendly, kind or cuddly. They are confident, demanding, curt, and irascible, in the extreme! My speech pathologist was the hospital’s SERGEANT MAJOR. She chewed out my surgeon for slipping me a cough drop. “Can’t you read the NPO sign”, she barked in a voice that made doc jump out of his skin. The ENT doc who scoped my defective epiglottis deconflicted his visits to stay out of her range. She was the only one in the major medical center who knew anything about treating a uncooperative epiglottis? And, like army sergeants major, she was a taskmaster. Indeed talking (screaming) was the therapy. She wrote out weird, difficult, nearly unpronounceable guttural sounds that I had to recite despite the discomfort of a nose-to-stomach feeding tube. She appeared 4 times-per-day to drill me, then often 2 or more surprise visits to ensure I was properly bellowing. This guttural workout, combined swallowed-thickened-liquid observed by a timid radiologist manning a fluoroscope in the presence of the sergeant major, lasted nearly a month. But it worked. The 2016 Olympics are in Rio, but the games take me back to Athens and my speech pathologist sergeant major. Thank you Sergeant Major! Stay the course.

Lisa, welcome here. Shocked. I've been there. My surprise diagnosis was similar to yours. To clarify, are you diagnosed with small cell lung cancer? I also assume your stage of disease is not yet confirmed because you mention another CT scan Wednesday to see if other tumors can be located. If it is any consolation, we had nearly the same sized tumor but mine was discovered nearly 13 years ago. And, my initial survivor rate was pegged at somewhere around 18%. So your first conclusion you might want to consider is if I can live, so can you. Now consider some details. Information is power, especially when a lung cancer survivor, and you are one of those. Here is some easily read information that ought help you understand our disease - https://www.lungevity.org/about-lung-cancer/lung-cancer-101 In your reading, pay close attention to the Types of Cancer and Stages of Cancer. During you next chemo session or consultation ask the nurse or doctor to confirm both your type and state of cancer, then tell us. Each type gets a little different treatment. My type - non small cell, Squamous cell - is treated differently than non small cell adenocarcinoma. And, both of these are treated differently than small cell lung cancer. So confirm your type and stage and tell us about it. Those of us with experience with your type and stage can then provide some "inside information." Oncology is a tough medical practice. My oncologist during my first several consultations was remote but as my treatment progressed, I realized his remoteness was not reflective of his attitude, it was an indication that he was thinking, particularly, thinking about what to do next. Even today in almost 13 years of association with my oncologist, I wouldn't call him a "warm and fuzzy guy" but he is intelligent and up to date on state-of-art treatments. Treating cancer is very hard and perhaps your sensing of a lack of bedside manner is your doctor thinking about your case. Also, perhaps asking questions about your cancer spurred from information you've read may help break the ice at the next consultation. A confession, I am a very inquisitive guy, but in early consultations, was too afraid to ask many questions. My wife took the lead in that department and this points to "inside information" - bring someone along to your next doctor consultation to help you ask and understand answers to questions. When newly diagnosed, all these medical terms are hard to understand so take notes. You may find some additional information of use here - Stay the course. Tom

Lana, I took Tarceva for 18 weeks as a part of my combination chemotherapy during my 4th line treatment. Once daily doses of Tarceva and every third week of infused Taxol and Carboplatin. This was back in 2006 and Tarceva what new on the market. Doctors didn't yet understand why it worked. Tumor marker testing did not yet exist so doctors were using it because it displayed dramatic results in some lung cancer patients. I was not one of them. But, I know a lady (Lilly W.) who survived for 10 years taking Tarceva on a daily basis. It shrank some of her tumors and kept others in check. It was so effective, she passed away from a heart attack despite being in stage IV active lung cancer treatment. So it can be very effective and I've read of others who've had a similar experience. So I believe there are many people who exceed the 12 to 18 month effectiveness period you cite. Who knows? You could repeat Lilly's experience. Stay the course. Tom

Lena, This is a fine place to introduce yourself. From what I read, the words poorly differentiated carcinoma result from a pathologist visual description of a biopsy. Can you tell us more about your disease? Did the report contain the type of lung cancer, for example, non-small cell or small cell. If non-small cell was the subtype disclosed, for example, adenocarcinoma or Squamous. Knowing these descriptors will allow us to give better feedback on our experience with lung cancer. Glad you've joined our site and look forward to you sharing more information so can tell you details about our experience and treatment. Stay the course. Tom

Lana, What a great story and outcome! Headline: "Daughter doctor rescues mom and Tarceva works as advertised". You are doing fine on this site and most importantly are telling a story that brings hope to the newly diagnosed. So many of us at stage 4 have difficulty understanding that treatment success is possible with late stage diagnosed adenocarcinoma. There are even immunotherapy advances for stage 4 Squamous cell. I assume you are still taking Tarceva. You might want to tell us your strategies for living with its side effects, be they minimal. Stay the course. Tom

Cynde, We know you are doing the right things. Please remember to take care of yourself. Try and get a break for an hour or so a day so you can refresh your mind and spirit. I see very good news with the lung mass gone. As you sort through the next best chemo recipe, ask about radiation for the C7 and T2 mets. Perhaps stereotactic radiation could fry the spinal mets, reduce bone pain, and improve quality of life. Stay the course. Tom

Halley, Welcome here. Baffled by complacency, I well understand. My first several weeks experience with lung cancer could be summed as ignore it and it will go away! My wife didn't allow me to ignore it and took charge and steered me to diagnosis, then treatment, and then became the decider in chief of during treatment. Why? I was overwhelmed by fear. I was a deer in the headlights staring at a 18-wheeler barreling hell-bent to run me over. I was paralyzed into inaction. I don't know what is going through your friend's mind but over my long years of association with lung cancer survivors, suggest he may be that same deer in the headlights. What do you do with a reluctant patient? Granted every situation is different but what worked for me was someone who stepped up to be large and in charge. Is that you? Is it someone in his immediate family? You might try a summit with his family and close friends to nominate one or several to spur him to action. Volunteering to go with him to a doctor's consultation might be a good way to apply the spur. Having said all of this, there are some of us, even after application of the spur, who decide against treatment. If that is an informed decision that includes complete understanding of the consequences, then so be it. I think support efforts are no longer effective once someone reaches the plateau of an informed decision. Stay the course. Tom

Anna, Welcome here. Lung cancer and lymphoma, that is a combination! I didn't have the lymphoma but managed to survive the lung cancer. You are doing much better than I seven months after diagnosis if you feel great and lead a normal life. Already a 70% shrinkage of tumors is a great result; I'm looking forward to your reporting the Tarceva's eliminated your cancer after your next scan. Stay the course. Tom

Well said Susan. It is an interesting ride with opportunity for a whole new appreciation of life and its meaning. Stay the course. Tom

Madam, From your description, your husband has a serious case. You asked if anyone here can help and indicated that you feel the need to speak with someone. At Lungevity, we have a LifeLine program that can put you in telephone contact with a caregiver like yourself who has experienced similar circumstances. Here is the information about LifeLine and a contact form to complete to get started with our program - https://www.lungevity.org/support-survivorship/get-connected/lungevity-lifeline In the mean time we have a section of our forum titled Caregiver Resource Center. It has more than 30,000 posts and you might skim through these to glean helpful information that may be of use to you. Stay the course. Tom

“Terminal stage IV lung cancer patient miraculously cured by cannabis oil.” “Frankincense oil kills cancer cells while boosting immune system.” “The real reason pharma companies hate medical marijuana is because it works.” If you are a lung cancer survivor, you’ve read these pronouncements. Hopefully, you don’t believe them. The purveyors of miracle cures are so persuasive that some people avoid conventional treatment and rely instead on the unconventional. I remember my frantic web search for treatments after diagnosis. I explored conventional methods and learned about lots of downside and little upside. Reading the benefits of aromatherapy, guaranteed to cure my lung cancer by simply breathing a fragrant substance, was so appealing. Then as others learned of my diagnosis, I was bombarded by emails suggesting holistic medicine, Breuss diet, and magnetic therapy, to name a few. All that need be done to cure my lung cancer was move a powerful magnet over my chest for 30 minutes a day! Of course, one needed to spend thousands of dollars to purchase the special magnet but it was a money-back guaranteed cure. There are miracles. These are medically documented instances where cancer stopped growing and spreading without treatment. But those touting magnets, cannabis oil, or a multitude of other treatments, methods, or substances (check Wikipedia’s list of unproven and disproven cancer treatments) are selling miracles. A miracle, in case you are wondering, is an event that defies explanation. No one knows why, including the seller of miracle cures. When stricken by lung cancer, time is of the essence. We are often diagnosed at late stage and effective treatment must be prompt. Consuming time to undergo Miracle Mineral Supplement or Orthomolecular Medicine at great expense eats into this now precious time. Here are three tests one can apply to sniff out a phony cure: (i) drugs and procedures not FDA approved; (ii) drugs and treatments not covered by insurance, and (iii) the patient needs to pay large amounts of cash in advance of receiving treatments. Oh, and check out Quackwatch. Our world is plagued by conspiracy as in: “big pharma has a cure but is withholding it from the market to boost profits.” Sure! Think about it. A publicly traded corporation has a cure for cancer and is not selling it—that would never happen. Recall how quickly we learned of Cuba’s cancer vaccine, and Governor Cuomo’s ex-officio trip to Cuba before restoration of diplomatic relations to negotiate putting the vaccine under accelerated FDA testing. A sure-thing cancer cure would be front page news on every paper around the world! Oncology is a medical discipline founded on science and grounded by rigorous studies that are openly published and reviewed by doctors and scientists around the world. New treatment and diagnostic methods are well vetted to ensure both safety and effectiveness. An oncologist dedicates his or her life to treating people with cancer. When a board-certified oncologist tells me about a miracle lung cancer cure, I’ll believe it. Till then, it walks like a duck. Stay the course.

I’m reading of a Yale University study that advocates we choose primary care physicians by testing their political views. It is political open season and medical reporters want to join in the feeding frenzy. The danger is some will believe a political test (views on motorcycle helmets, pot smoking and firearms to name a few) is necessary physician competency criteria, especially since the test is aimed at our closest and most important connection to the medical system—the general practitioner. Although medical specialists (surgery and oncology) treat our lung cancer, we often develop illness unrelated to cancer, or just as likely, a side-effect runs wild. So a general practitioner (GP) is a very important part of our treatment team. Presuming you just realized you need one, what are factors a lung cancer survivor should consider in selecting a GP? Here is my list. A Good Listener. Does your GP listen? This trait is essential for we have a serious ailment with complex symptoms. During chemotherapy, I didn’t have one symptomatic complaint, I had many and they overlapped and changed day-to-day. A listening GP will hear you out, then asks clarifying questions about symptoms before launching into an exam or grabbing the prescription tablet. Off The Clock. Does your session seem rushed? Some I know complain their doctor is “on the clock” like a game show contestant during consultation. That’s not good. Part of the consultation should be reviewing the reports of specialists involved in your cancer treatment. And, questions should arise after reports and test results are digested. A proper review with understanding takes time, not a beat the clock contest. Renew Specialist Prescribed Medications. Murphy’s Law of medicine is your nausea medication runs out just when your oncologist is booked solid. Do you have a GP that will come to the prescription rescue? Some doctors don’t want to intrude on practice privileges of other doctors. That may be a fine philosophy but when you are suffering and a simple renewal script solves the problem, your GP ought to write the script. This is a good question to ask when interviewing a prospective GP. Cancer Aware. In lung cancer treatment, there are medical treatment effects—say radiation burns; medical side effects—nausea, pain, numbness; and related medical problems—depression, chest infections and even common colds. Your GP should understand the complexity that a simple chest cold might mean to a lung cancer survivor. Questions and observations to ferret out depression is an important diagnostic role and treatment or referral are essential. Known and Respected. My GP was the quarterback of my treatment team. He selected the players (specialists), monitored their treatment, and intervened to steer the team to a solution that saved my life. Your GP needs to know practitioners and be able to influence their actions when medical timidity breaks out. That speaks to a seasoned professional well known in the local medical community. Politics and medicine should be like oil and water—never to mix. Medical doctors have a higher calling and abide by the Hippocratic Oath. They swear to share medical knowledge, act always to benefit the sick, and to treat those ill warmly with sympathy and understanding. In stark contrast, I can name quite a few politicians who forgot taking an oath of office the instant after administration.

Simply wonderful news Sherie! Stay the course. Tom

Scotti, I was diagnosed with stage 3A Squamous cell Non-small cell lung cancer in February 2004. I had pre-surgical conventional radiation and Taxol and Carboplatin chemotherapy to shrink my tumor to allow a pneumonectomy. Following surgery, I had a year's worth of surgical complications, all caused by suture healing problems from radiation. Then after recovery from surgeries, 3 tumors were discovered in my left (remaining) lung. I had 6 infusions of Taxol and Carboplatin over the course of 18 weeks that knocked back the tumors. But one returned and I had 6 more Taxol and Carboplatin infusions along with the newly approved (2006) oral chemotherapy drug Tarceva. Once again, the tumor was eliminated but I had an additional recurrence. This was addressed by newly approved stereotactic radiation (CyberKnife) and after more than 3 years of continuous treatment, achieved a NED (no evidence of disease) state. So nearly 13 years of life since diagnosis. How does this relate to you? If I can live, so can you. You'll have many questions and this is a good place to ask them. We are the lung cancer experts, not by education, but by experience. Stay the course. Tom

Thank you Susan. I am humbled. St. Michael, I've responded to you on another part of our forum but I want to highlight a very important point Susan raises - the faith she has in her oncologist. Cancer treatment for most is an EBGO (everybody gets one) affair in that most of us get what is termed a standard of care. Present with Stage X, Type Y lung cancer and you get Drug A and B. But, as standard of care treatment fails to arrest or, more importantly, if there is a recurrence, the EBGO approach is no longer as important a factor. The art of oncology - what to do next - starts to become more important than the how of oncology - the science of oncology. So the intuition of the oncologist, my view, becomes very important criteria. I can tell you my oncologist has a high degree of medical intuition and so does Susan's. I wouldn't know if your mother's oncologist has that characteristic. But, here are some clues to watch for to discern the intuitive nature of your mother's oncologist. Does the oncologist openly discuss a range of possible treatments and outcomes during the consultation? Does the oncologist invite discussion of the aforementioned? Is the oncologist forward thinking? By that I mean he might say "this is working now but if it stops working, we could try this". Or, "the chemo is having an effect but we might add this drug...." Writing about intuitive clues is hard but I can give you an analogy that might help you understand my point. There are two kinds of weather forecasters on TV. Those that may have some meteorology training but who are mostly broadcasters. Then there are those who have a PhD in meteorology. Their explanation of the same storm forecast is vastly different. The broadcaster tells you the facts; the PhD explains the storm, its causes, its effects, and the uncertainty about future-storm behavior. You get the feeling the PhD meteorologist is inside the storm. You want that same feeling after your oncology consultation. Stay the course. Tom

St. Michael, You are right, adeno-squamous lung carcinoma is rare and I am not able to find much in the literature about response to chemo. Is that because it is a very rare form of the disease or is it because few have undergone treatment? I don't know. I have first hand experience with nanoparticle research and note the literature on nanoparticle use as delivery mechanisms for therapy into cancer cells but the complexity of the literature is way beyond my engineering-based nanoparticle knowledge base. Your questions about vulnerabilities of adeno-squamous lung cancer to chemo are best addressed to your mother's treatment team. Let us know how she progresses with the chemotherapy. Stay the course. Tom

St Michael, Welcome here. We don't endorse physicians or treatment facilities in this forum but you can Google the Dana Farber Cancer Institute and easily find useful information to validate its reputation. I'm not a doctor but a lung cancer survivor who experienced a reduction in tumor size and numbers from chemotherapy alone - twice. My second line therapy, the drugs Taxol and Carboplatin, was administered after tumors appeared in my left lung after my right was removed. After 6 infusions administered over the course of 18 weeks, the 3 recurrent tumors in my left lung were declared NED (no evidence of disease) by both CT and PET scans. Unfortunately, a year later, one tumor returned to my left lung and I again had 6 infusions of the same drugs. Again, the tumor was deemed NED, but it returned again and I had stereotactic radiation (CyberKnife) to finally eliminate the tumor. So, if your objective is to shrink the tumor to allow surgery, then your mother is on the right treatment path. From what I read, Cisplatin and Pemetrexed are the standard of care for treatment of NSCLC when surgery is not possible. So be optimistic; this combination of drugs can be very effective. Surgery is indeed the best way to deal with lung cancer but it is not the only way. There are emerging therapies called targeted treatment and immunotherapy that are very effective treatment methods. Here is some information about them. https://www.lungevity.org/about-lung-cancer/lung-cancer-101/treatment-options/targeted-therapy and https://www.lungevity.org/about-lung-cancer/lung-cancer-101/treatment-options/immunotherapy My nearly 13 years of surviving lung cancer taught me that the primary effect of chemotherapy is to extend life. No one knows how long, but no one really knows how long one will live. I've learned a better approach is to enjoy the life I have and the extension I'm granted rather than fret over how much time I have left. This is so important because it took me a while to realize this prospective and I wasted a lot of life fretting and worrying. Be optimistic but help your mother enjoy her life every day. And, spend time enjoying her company. Stay the course. Tom

Cynde, You are truly hoeing the hard row. From what you've told us, your wife is getting all that medical science can offer. Her high fever side effect was something I never experienced during my 18 infusions but pain was almost unbearable. So I know what she is feeling. I can't offer you any advice but to stay the course. Tom

Welcome Gail, I confess I needed to do a bit of reading to learn about your atypical carcinoid tumor before responding. I also had a complete pneumonectomy but because of surgical complications and a serious infection, had surgical complications. But, a persistent cough was indeed a symptom I experienced after my surgeries were complete. My surgeon explained it was due to irritated tissue in the airway. While hospitalized, I had breathing treatments about 4 times per day that helped with the irritation and after discharge, my doc prescribed an inhaler that also helped. However, my airway is still very sensitive to irritation. In particular, I've developed seasonal asthma and high spring and fall pollen counts make me wheeze and cough. Further, avoid school age because a chest cold will be a very difficult event for you. Get your flu and pneumonia shot. A chest cold, now more than 12 years after lung removal, puts me in bed for weeks so I do everything I can to avoid it. My oncologist has me keep a ready prescription of Leavaquin 500 mg on hand and orders me to start taking this antibiotic if I develop chest cold symptoms and if my expectorant turns dark. Of course, I promptly see my GP but I start the antibiotic right away in the event I can't get in to see my GP quickly. Keep up the inspirometer work and keep exercising. Both are helpful for recovery. Stay the course. Tom

Suepm, Welcome here. To your question, given a little more than a month after an upper lobectomy, should you be concerned about coughing and shortness of breath? First a disclaimer, each of us responds or reacts differently in recovery from thoracic surgery, and my experience may not necessarily mirror yours. I had a pneumonectomy, a complete removal of my right lung. I also had two surgical repairs of a fistula (an opening) in my sutured airway. After the surgery and each fistula repair surgery, I indeed had a persistent non-productive cough. My surgeon explained its cause as an irritated airway. Additionally, before my surgery, I didn't have asthma symptoms but have them now because tissues in my airway are now very sensitive to irritation. So my experience suggests coughing due to irritation, a dry scratchy feeling deep inside my airway, is normal. How long did the coughing last? That is hard for me to answer because I had almost back-to-back-to-back thoracic surgeries. As for shortness of breath, yes of course I experienced it post surgery and still experience it. One half my lung capacity was removed. About one fifth of yours was removed. It is normal to experience shortness of breath after part of the lung is removed. There is some recovery. I now can do day-to-day activities without experiencing shortness of breath but climbing extensive steps or any kind of aerobic exercise has me gasping for air. I think you will find a new normal activity level after your recovery as your body adjusts to your new lung capacity. One caution I'll offer, especially now with the turn of the season and the start of the school year. Avoid school aged children. I didn't and it put be back in the hospital about a week after discharge after my pneumonectomy with a very serious chest infection. Do everything you can to avoid catching a cold. If you do catch one, don't be surprised if it puts you in bed for a lengthy period and expect long recovery times. Get your flu shot and pneumonia vaccination. And if you develop cold or flu symptoms, see a doctor promptly. Keep those semi-annual CT appointments. Lung cancer is persistent. Stay the course. Tom

Well done Richard! Stay the course and I look forward to your year 11 celebration! Tom