LindaD reacted to Judy M. in Back On the Testing Track
In my experience my Medical Oncologist has also been more dependable on reading my scans. He actually caught the first false positive on my liver scan. He said he didn't see a problem and gave me the option of having a biopsy or waiting 3 months and scanning again. The original radiology report after my treatment said my lung tumors were unchanged. My Pulmonologist called both previous and current scans on her computer and let me look for myself. I could actually see for myself with no medical education at all that they had diminished. Which I suppose just reinforces that it's good to pay attention, do your research, and ask questions.
LindaD reacted to Judy M. in Hormones and Lung Cancer
This is just a general F. Y.I. post. Everyone else may have been aware of this, but I wasn't and it was a significant piece of information for me. While reading someone else's post the other day I ran across an answer by another member saying HRT could play a role in developing lung cancer. He gave a link in his post to do further reading on it and I did. I've tried to find that post again to thank him, but so far haven't found it. If you read this "Thank you, thank you, thank you." I was diagnosed with hormone positive breast cancer last year and lung cancer this year. Having had that happen, I began to notice that I wasn't as alone as I thought I was. I saw a number of other women, one I know in this forum, who had the same experience. Enough of them that I began to think this wasn't coincidental. I actually began to wonder if my breast cancer treatment had caused the lung cancer. I have adenocarcinoma NSCLC. My Oncologist's A. P. actually commented that both my beast and lung cancers were adenocarcinoma. A link has been hypothesized between lung cancer in women and HRT. I did take HRT for many years as I had an early menopause. The big eye opener for me was seeing that they have discovered that lung cancer has estrogen receptors and they're trying to see if aromatase inhibitors used to treat hormone positive breast cancer may also help to control adenocarcinoma in women. I won't go into any more details since I tend to be far too long winded. If any of you are taking or have taken HRT you can do a Google search for estrogen and lung cancer and find the studies. Hope this helps someone and that the person who wrote that original post sees this. I had not been taking the aromatase inhibitor I had been prescribed for my breast cancer because it was pumping one more drugs into my body and from research didn't think it improved the chances of my breast cancer not returning all that much. Obviously now a poor decision on my part. You can bet your bippy I'll be taking it from here on out.
LindaD reacted to Tom Galli in Clean Scan
I had my annual CT scan with contrast on August 22nd and my consultation with my medical oncologist today (Aug 28th), and the result: clean scans and continued NED.
Yes I am a long tenured survivor but during today's consultation we spoke of how persistent lung cancer is. Moreover, I learned that one cancer diagnosis often begets another. So there is good reason for me to keep the twice yearly oncology consultations and the annual CT.
We also spend a lot of time reminiscing my time in active treatment. Doc has a superb memory and he filled in my gaps and provided additional insight into how and why he suggested stereotactic radiation after my third line chemotherapy failure. We also discussed the radio oncologist's aggressive treatment of Stage IV tumors in multiple locations of the body using SBRT and IMRT techniques. This new approach is moving the survival needle for late stage diagnosed survivors to the right!
So I'm celebrating clean scans and declare an end to scanziety for 11 months!
Stay the course.
LindaD reacted to Tom Galli in Carbo / Pem Round 1 Questions
I traveled extensively during chemo and after treatment, even with a challenging susceptibility to catching chest infections. My medical oncologist wrote a note to explain my treatment details and medical history and provided a basic load of fourteen days Leavaquin, This was to be used if I developed symptoms and was delayed in seeking or finding medical treatment. I had to use it several times.
Go see the world.
Stay the course.
LindaD reacted to CindyA in Have You Had Genetic Testing for Your Lung Cancer?
If you've been diagnosed with lung adenocarcinoma, or another form of non-small cell lung cancer, your doctor may have recommended genetic testing. But from people I've spoken with lately, this is very confusing.
(First of all, if you have non-small cell lung cancer and your doctor hasn't ordered testing, talk to her. There is now a general consensus that everyone with advanced or metastatic lung adenocarcinoma have genetic testing (biomarker testing) of their tumor. Yet a recent study found that only 60% of oncologists are following these guidelines.)
The confusion comes from what many of us think about when we think of genetics and gene mutations - something is passed down through families. There are 2 basic types of mutations. The first is hereditary. This is the kind of mutation you inherit from your parents, and is the kind of mutation that is getting a lot of attention in regard to breast cancer. The second type of mutation is acquired. In the process of becoming cancerous, cancers develop many gene mutations, and in fact it is these mutations that cause the development and growth of cancers. These mutations are not present from birth and are not passed on to children.
The importance of testing for mutations is that treatments are now available - both approved drugs and those available in clinical trials. The approved targeted therapies include Tarceva (erlotinib) for people with EGFR mutations, and Xalkori (crizotinib) for people with ALK positive lung cancer.
Since this topic is so confusing, the article below takes you step by step in understanding why genetic testing may be important for those with lung cancer.
LindaD reacted to KatieB in A surprising side effect of lung cancer treatment is turning heads.
Patients' Gray Hair Turns Dark After Immunotherapy for Lung Cancer
A surprising side effect of lung cancer treatment is turning heads.
BY MINDY WAIZER
Cancer treatments can have some terrible side effects. But one recent immunotherapy treatment for lung cancer has turned up a surprising — and not unwelcome — result. The patients’ gray hair turned significantly darker.
The study, which was published in JAMA Dermatology, examined 14 patients who have non-small cell lung cancer (NSCLC) and were receiving immunotherapy treatments including one of the following agents: Opdivo (nivolumab), Keytruda (pembrolizumab) or Tecentriq (atezolizumab) at a hospital in Spain. Adverse effects of these kinds of treatments are likely to include cutaneous toxic side effects or dermatological problems, so the patients were being monitored by dermatologists.
What doctors didn’t expect to see was that over the course of the treatment, the patients’ hair returned to youthful-looking, darker shades — the shades the patients’ hair had been before their hair turned gray. The average age of the patients was 65.
Hair repigmentation is very rare. It has been reported before in relation to drugs such as Thalomid, for example, but it has never before been reported in relation to immunotherapy treatment for lung cancer.
The reason for the darkening of patients’ hair color in these cases is still unclear. The number of patients in this study is small, and of course, more studies must be conducted.
“This was totally unexpected, so it was exciting,” Noelia Rivera, M.D., dermatologist, Department of Dermatology, Hospital Universitari Germans Trias i Pujol, one of the authors of the study, said in an interview with CURE.
“The high rates of good response to therapy in these patients was also an exciting finding. We are surprised at the results, and we are encouraged to keep on with the study,” she said.
Thirteen of the 14 patients responded well to the immunotherapy treatment, reporting either partial or fully stable disease states. One had to stop the therapy after four cycles of treatment because of a life-threatening progression of the disease.
The dual, positive implications of this study could be far-reaching. First, of course, it is good news for many patients with lung cancer, who may be able to benefit from these effective therapies. Second: just imagine if researchers could isolate the method for turning back the clock on graying hair. A whole new wave of age-defying hair solutions could be born.
Rivera urges a cautious approach to the news of these patients’ hair repigmentation. “A lot of research is yet required, first to come up with a study, and after that, to get funding to develop the project,” she said.
LindaD reacted to BridgetO in Carbo / Pem Round 1 Questions
Risk of infection is largely due, I think, to low neutrophils, and you won't know what that is unless it's tested. Have you had low neutrophils during your chemo? Have you been on a "neutrophil booster" such as neupogen or neulasta?
I'm a big fan of travel. I had chemo and radiation (for an earlier non-lung cancer), followed by additional different chemo. Between those two, I took a trip across country by train, something I'd been wanting to do for a long time. This was against the advice of my medical oncologist, not because of infeciton risk but because she wanted me to start the second chemo regimen right away. I told her it would have to wait a week.
If it were me, I'd be inclined to go on the trip, unless I'd had severe neutropenia after rounds of chemo. Ir would partly depend on where I was going, also. I'd be disinclined to go to less developed countries or some adventurous outdoor activities for fear of unaccustomed bacteria and also because of the difficulty of getting medical care if you do become ill. I'd also think about how to reduce airplane germs--those cause me colds and such often. You can take antibacterial wipes to wipe doen your armrest, tray table, etc, and I'd consider taking my own pillow or pillow cover and blanket. And definitely take and use hand sanitizer.
A couple of women who were in my support group continued to travel a lot, despite advanced ovarian cancer and ongoing treatment. One went to China between rounds of chemo. Another went on a tour to the Galapgos Islands, became ill, and had to be airlifted out. She recovered and was philosophical about it " Oh, well, I had good travel insurance". She continued to travel . Both these women were big role models for me. They continued to live actively, rather than waiting to die.
I think it all depends on your risk tolerance, Nothing is risk free. If you decide to go, I wish you safe and happy travels.
LindaD reacted to Julie in SoCal in Carbo / Pem Round 1 Questions
I've done 3 rounds of Carbo / Pem. I stayed very close to home for the first 2. It was important for me to get a feel for how I would feel when. After about 10 days into the 3rd cycle I took a long weekend road trip up north of San Francisco. It was wonderful and a needed time of refreshment. I was a little tired, but I was able to do what I wanted to do. I'll have round 4 on Tuesday and 10 days after that I'll take a business trip to the UK. I'm expecting to be tired (and jetlagged!!) but everyone knows I'm in treatment and will give me grace (as long as I do my thing of course!!)
I figure risk for infection is a constant - unless you just stay home. So depending on where you're going you'll have to figure what the risk level you're willing to take on.
I'd say, see how the first round falls. What sides do you get and how well can you manage them? Then if you're able to manage well -- go for it, but plan it late in the chemo cycle-- after day 7
LindaD got a reaction from Julie in SoCal in Carbo / Pem Round 1 Questions
Hello Julie in SoCal, I am going to have 4 cycles of Carbo/Alimta, 1 in every 3wks. Would you give me insight as how you prep yourself to you getaway? How long after your last cycle for you to travel? I planned a getaway ( international) months ago and really want to do it but now with the treatment scheduled, one oncologist says I will be ok to go while another oncologist says it's risky for infection if I go 2-3 wks after the treatment . I will be doing 2 -3 cycles first, then travel, come back for last cycle, but not sure if I can handle it. Thank you for your help. Linda
LindaD reacted to JulieG in Carbo / Pem Round 1 Questions
Hello Julie, another Julie here. I had 4 cycles of Alimta and carboplatin between Nov. 2016 and Jan. of this year. Chemo day was Thursday. On Friday I felt well enough to go to work (thanks, decadron!), and by Sunday afternoon I began to get the "hit by a Mack truck" feeling. I didn't experience nausea, just some queasiness, easily remedied with Compazine if it got bad enough. I went to work on Monday and Tuesday the following week, again, I wasn't 100% but was functional and able to do my job. My coworkers and bosses were very supportive. I'd get through the day, go home and flake out on the couch (my husband and sons would fend for themselves for dinner). By late on Tuesday I'd start to feel a bit like myself again, and then by Thursday or Friday I'd be pretty much OK. So, nearly a week of not feeling great. As others pointed out, this played out pretty much the same for each cycle, which made it much easier to plan how active I could be during the week. By the time the next cycle rolled around I felt pretty good.
LindaD reacted to Judy M. in Carbo / Pem Round 1 Questions
Am presently doing Cisplatin/Alimta cycles. Very tired and nauseated day 2-5. Then the tiredness gets better. But for me the nausea hangs on until about day 9 or 10, just not as severe. And then there's the nasty tasting food. This goes on from day 1 to about 7. I don't have the issue with not wanting to eat. Probably because I have 3 says of steroids each round and it eating seems to hold back the nausea somewhat. To me, my second round seemed easier than my first, but that could be because I was farther out from radiation and had found some ways to cope. I've actually gained weight through all my chemo treatments. In fact, I'm very swollen after each treatment. Each on ours about 6 lbs. on me that gradually subsides over the next week. I eat watermelon and cucumbers which are natural diuretics to try to get rid of the water bloat. Had a few mouth sores so make a habit of rinsing mouth with salt/baking soda solution at least every morning and if one pops up more often. For me the nausea that seems to hang on has been the worst. But I've been in an antibiotic that can also cause stomach upset so I'm hoping not having to take that will help next round.
Sent from my SM-J100VPP using Tapatalk
LindaD reacted to Tom Galli in Back again
Hi Brenda, welcome back.
So, let's review the bidding. As I recall, you have a nodule in the right upper lobe of your lung that biopsies as adenocarcinoma. Is that correct?
Suggestions on helping you quit smoking? I tried every which way there was and nothing worked for me till I wanted to quit. Then I found the courage to overcome the withdraw symptoms. I might reinforce the importance by saying I cannot imagine drawing tobacco smoke into a lung with sutures in it. If sutures break because of excessive coughing, you'll be in real trouble! I'd also suggest, since you ask, that there is a vast difference between trying and achieving. If you want to be a non-smoker, talk and act like a non smoker.
Another thing to think about is the surgeon's view on operating on a current smoker. My thoracic surgeon would not. You might have difficulty finding a surgeon who will operate because cigarette smoke is an irritant that will inflame an already inflamed lung and will complicate healing.
I don't want to add to your bundle of nerves, but you have lung cancer and smoking will complicate its treatment. I wish there was a kinder, gentler way of communicating this information. There is not and believe I owe you an unfettered understanding of the consequences of continued smoking.
I know you can stop. Just do it!
Stay the course.
LindaD reacted to Judy M. in Hi my name is Suzanne
Welcome. Our stories are SO similar. Which you know if you've read my posts. I also just recently joined this group and it's been very helpful. I was diagnosed with breast cancer February last year. Had surgery and radiation and everything was going great. Then developed pneumonia in Jan. which eventually lead to disgnosis of stage IV adenocarcinoma in March. Not a spread of the breast cancer, but an actual primary lung cancer. My birthday is also in March and had the P.E.T. scan the day before my birthday. I also quit smoking 17 years ago. Ironically, if my research is correct my cancer is the type nonsmoking women usually get. This certainly wasn't a part of my plan for my life. I'm still waiting to get started on my treatment. See my Oncologist again tomorrow, so maybe things will get rolling then. I've been ( as another member put it so well) freaked out off and on. It's a stunning thing to get hit twice with 2 separate cancers. But my Oncologist's N.P. says both are adenocarcinomas. I didn't know that. Don't know that I have any great advice or info. But I can certainly assure you that you aren't alone. Right now my faith in God is holding me together. It goes like this: I freak out, I run and cry out to Him in prayer, He gives me peace in my heart and mind, repeat. Then repeat again. He knew this was coming and I'm trusting that though it wasn't part of my plan it is part of His and He knows what He's doing. Please, keep us updated on how things are going with you. I'm so glad you've become part of this group! No the reason for joining of course, but the choice to join and share your journey.
Sent from my SAMSUNG-SGH-I337 using Tapatalk
LindaD reacted to Tom Galli in Hello
I responded to your first post yesterday, and not realizing you were from Croatia, I sent you a link that compared lung cancer to American baseball! I am sorry about suggesting that analogy but my point was to prepare you for a long period of treatment, because lung cancer often recurs.
Your husband is receiving drugs that are often used in the US to treat SCLC and also most SCLC patients undergo preventative whole brain radiation. Is your husband receiving radiation treatment to treat the tumors in his lungs?
Stay the course.
LindaD reacted to BridgetO in New here -- Hi there!
I'm not a newcomer to cancer either. I was diagnosed with a rare and aggressive cervical cancer in 2011. My routing surveillance CTs turned up a slow-growing thing in my lung that didn't look like a met, but they couldn't tell for sure without a biopsy. Due to its location, they had to take out my lower right lobe, which was done last November. Sure enough, it was an adenocarinoma. I recovered pretty fast from surgery (VATS- laparoscopic, which is much easier than open surgery.) I also had breast cancer in 2008. So I've ben around the cancer block a few times.As I've said on this site before, I think cancers should be one to a customer- or better yet, NONE!
You're right that there's a lot to learn about lung cancer. I've found this site to be a good source of information and support. Hang in there!
LindaD reacted to BridgetO in Waiting too long?
Hi Lbelle. Successive CT scans showed that my tumor was very slow growing. My pulmonologist said that it needed to come out, but there was no big rush. I opted to go on a long-planned vacation and so it was a couple of months before I got in to see the surgeon, None of the medical team seemed to think this was a problem. In contrast, I had another cancer (not lung) that was a very aggressive type Everybody dropped everything and I was in surgery within about a week of the diagnosis. So I guess it depends on what the tumor is doing. If your doctor(s) say it's OK to wait to get a second opinion, it probably is.
It is important that YOU feel comfortable with your choice. Not to say that what your family thinks/feels doesn't matter, but it's your body. Can you get everybody to take some deep breaths, pray, exercise, meditate, talk to their pastor or spiritual advisor or counselor or whatever might help them calm and be a support to you?
For me, it's important to learn as much as I can and make my own decsions about my treatment. I have also learned that the way I talk to others about my cancer and the way I talk to myself about it also (if that makes any sense) is important.
Hang in there Lbelle. It's your life, your decisions, your story.
LindaD reacted to Suepm in Waiting too long?
Hi Lbelle ,
I had asked my Surgeon if we could wait 3weeks for my surgery . I had been sick for several months and I was trying to clear up my lungs . He didn't have any problem with waiting . I will be interested in hearing about your second opinion . And praying for peace comfort and wisdom . Suepm
Sent from my iPad using Tapatalk
LindaD reacted to LaurenH in LUNGevity Launches Groundbreaking Platform for Patient Voices
LUNGevity Foundation has launched Patient FoRCe, the first-ever critical bridge to connect the voices of lung cancer patients — a significant population — with health care professionals, regulators, policymakers, and developers of drugs. “Lung cancer is the #1 cancer killer, taking the lives of 157,000 Americans every year. LUNGevity is leading the way in changing the paradigm of cancer treatment ─ from assuming patient wishes to evidence-based conclusions about what patients value,” said LUNGevity Chairman Andrea Stern Ferris. “Through Patient FoRCe, lung cancer patient voices will be heard and heeded as policy is developed, research is conducted, and treatment decisions are made.”
Patient FoRCe, LUNGevity’s Patient-Focused Research Center, will undertake never-before studies of those living with lung cancer, collecting and sharing robust qualitative and quantitative data about lung cancer patients’ preferences and experiences to inform treatment, as well as relevant policy and research protocols.
Patient FoRCe’s immediate focus will include continuing a study of patient preferences and experiences regarding access to care, treatment and diagnostic options, and the impact of symptoms on daily living, as well as conducting studies to facilitate patients’ access to biomarker testing, which is essential to implementing precision medicine. Patient FoRCe will also initiate a study into increasing adherence to lung cancer screening protocols for people at high risk for lung cancer. Additional projects will be based on stakeholder input and the guidance of an external advisory board of survivors, academic and community clinicians, industry partners, patient advocacy groups, and community partners.
LUNGevity formally announced Patient FoRCe at the American Association for Cancer Research’s 2017 Annual Meeting in Washington, DC, on Sunday, April 2. Andrea Stern Ferris spoke to the urgency of the initiative, saying, “For too long, public policy, the practice of medicine, and drug development have not adequately integrated the viewpoint of patients. LUNGevity is determined to change that paradigm. By incorporating the patient’s voice into every step of the process – in policymaking, in trials, in treatments – we will improve outcomes for those diagnosed with lung cancer.”
“Our goal is to uncover gaps in information, misperceptions about patient attitudes, and areas of unmet patient need,” explained Dr. Upal Basu Roy, Director of Patient FoRCe. “LUNGevity is the only organization driving this type of change for the lung cancer community, and we anticipate that our findings will shape the future of lung cancer care.”
For more information about Patient FoRCe, visit www.LUNGevity.org/patientforce.
Click here to read the full press release.
LindaD reacted to Tom Galli in My cancer is progressing
OK, so let's take your questions one at a time. On Iressa, start your reading here, then here, then some general background information on adenocarcinoma here.
On PET scans, they measure the level of metastatic activity. So a PET reveals if cancer is present; a CT shows the size and shape of the tumor or tumors. Fortunately, there is a combination PET-CT scan (and you've had one) that is now in use and that would answer both the metastatic and tumor size, shape and location with precision. Perhaps you might ask your doctor for a combination scan because of your concern about kidney spots. Here is more information on imaging. I've had a number of combination PET-CT scans and they were very helpful for questionable spots. Sometimes doctors are reluctant to order PET scans after surgery because inflamed tissue can masquerade as metastatic activity. I've had that problem also.
You've had breast cancer and I've read about it but the vocabulary and terminology is vastly different. So take some time to read into lung cancer. Moreover, from your continuation on Tamoxifen suggests your doctor may be concerned about residual or metastatic breast cancer. Clearly the tissue from your lobectomy revealed lung cancer by pathology examination but one never knows, so it is good your doc is being cautious.
You will likely have more questions and this is a good place to tee them up.
Stay the course.
LindaD reacted to Susan Cornett in Newly Diagnosed
Good morning. I was diagnosed last year at age 46 with stage IV adenocarcinoma. I had surgery for both my primary tumor and my metastatic tumor and four rounds of chemo. For better or worse, I didn't have any tumor markers, so my cancer and treatment are just the plain vanilla variety. I just celebrated my first cancerversary. My suggestion to you: listen to the long term survivors on this forum. They know. They understand. They empathize. This forum has been my anchor for the last year. Your friends and family mean well, but they can't fully comprehend what you are feeling both mentally and physically. That's why we're here.
LindaD reacted to CIndy0121 in Newly Diagnosed
Tom, as always, has given you a lot of good information to help bring some structure to your steps forward. We are all able to empathize, and there's always agreement that the initial diagnosis and staging and getting your treatment plan in place just adds to how overwhelming the thoughts and emotions are when you're probably still in some degree of disbelief about the whole situation. What additional information did your PET results provide that you didn't have in January. I too was diagnosed at stage IV and chemotherapy was my only option. We all have loved ones who are always first and foremost in our minds...both for them to understand, but also to protect them. But you used the word "fight" and ultimately it is your fight. Women, wives, moms, grandmas, etc. aren't accustomed to putting themselves first. It's okay to be more assertive and insist on your needs being met with your medical team. Relationships and communication will settle down somewhat, but you need to know that there is hope, that many people have been successfully treated and are still living their lives with cancer and you can too! Please stay connected with us here. I know you will find it very supportive.
LindaD reacted to Tom Galli in Newly Diagnosed
lvs2crossstich (love the name BTW),
I completely understand how you feel. My diagnosis was also a complete surprise. Ok, let's talk about two topics you might want to try and neck down your focus on: treatment and attitude. First, you have one of the most treatable forms of lung cancer -- adenocarcinoma. You don't mention it but I imagine you must have had a biopsy somewhere along the diagnosis trail because you identify adenocarcinoma and a type of lung cancer does not result from a PET scan. Ensure your biopsy is tested for the presence of tumor markers. Some forms of adenocarcinoma tumors display genetic portals that are open to attack in newly emerging targeted therapy. You can read more about targeted therapy here. But postpone reading that link till you've read this one. Steps three through ten are applicable to you. Step six -- getting an infusion port is something I strongly recommend, and steps eight and nine are also relevant just starting chemotherapy. But, the most important reading you should do is in steps five and ten -- attitude.
I just celebrating surviving 13 years since a surprise diagnosis of non small cell Squamous cell lung cancer. Many of us on this site are long term survivors with a late stage diagnosis. The most important take away from that statement is if we can live, so can you. I fundamentally believe the most important factor in surviving a lung cancer diagnosis is attitude towards treatment and outcomes. I have no medical proof to bolster my belief but developed it about halfway through my 3-year treatment journey. Since then, my outcomes improved dramatically. Here is a youtube link of Dr. Gould's essay mentioned in the step five discussion. I still listen to it frequently and find it reassuring.
I'm not going to "put a good spin" on your diagnosis. Treatment will be difficult and it will likely not be "one and done." Lung cancer is persistent. Most of us have had recurrences since achieving a "no evidence of disease" or a NED result from treatment. But, for me, the persistence was worth it. I lived to walk my daughter down the aisle when she married and just recently celebrated the birth of my first grandchild. So put your battle rattle on, lock and load, and proceed purposefully into treatment with the objective of more than surviving, but thriving in life.
You'll have many more questions and this is a good place to ask.
Stay the course.
LindaD got a reaction from Tom Galli in My cancer is progressing
I was diagnosed with Left side Breast Cancer 2A in Oct 2015, during radiation treatments found something suspicious on my right lung (never drink or smoke), after PET/CT scan, it was confirmed Lung Cancer NSCLC stage 3, had lobectomy in March 2016, chemo and radiation at the same times in April and May. In Oct 2016 bone biopsy confirmed Lung Cancer metastatic to bone. Started Iressa on top of Tamoxifen in Nov. 2016. started Zometa in March this month, I didn't know about Xgevia, but it seems it's better outcome than Zometa when I did some web search. With the first Zometa treatment, I was very tired, and had flu like symptoms. On my last CT scan, there were small spot(s) on my kidneys, but we're not sure what it's. I pray for the Negative results. Will see in next CT or Pet scan as we're waiting to see if Iressa and Zometa helps.