[Could Have Been a Lot Worse]

I do hope that WBR really worked for you !

wiesia

[Father's update]

I wanted to update you on how my father is doing. The scans in December (after two cycles of Gemzar/Cisplatin) showed tumors stable and some fluff

gone. Considering father's bad reaction to Cisplatin, our doctor felt that we should proceed with Gemzar alone and add Avastin to it.

After one cycle of that father started to be SOB (never before) and his cough got worse. Yesterday (before the second cycle infussion of Gemzar) our doctor took an x-ray to check what's happening and the result was that the left lung tumor has shrunk some but that there were some new infiltrates coming out of the right lung tumor. The left tumor always looked like a very solid tumor, the right one always seemed foggy and fluffy.

Our oncologist suggested that perhaps the small progression on the right side (and he thinks that it is this progression that is responsible for father's new symptoms) can be treated with radiation. But the radiologist (my father is treated in a comprehensive cancer center) felt that the tumor needs first to shrink some. It is large but I do not know the exact size at the moment. In the end father's chemo was postponed for a week because he felt so miserable (he was never before SOB and feels very weakened and scared by it; crying a lot).

Our doctor seems to want to continue with the current chemo (Avastin was given only three weeks ago). We are thinking that perhaps we should add carboplatin to the mix: it has better side effects profile than cisplatin and my father's cough was always much better after the infussion of cisplatin so perhaps the platinum drugs are effective on the tumor in the right lung. Or should we just change chemo altogether ? Any comments on that would be welcomed.

On the top of everything, my father has difficulty getting the food down. Literally, he says it feels like it gets stuck somewhere along the way. Our doctor believes that this is also the result of the new infiltrates. We will try to get it checked early next week.

wiesia

[Cisplatin]

My father had a very bad reaction to cisplatin as well. He had sharp pains going through his stomach area, fainted at some point after that. Strangly, cycle two was much easier with no pain.

wiesia

[Dad's scan results tomorrow]

I will keep my fingers crossed for your dad !

wiesia

[chemotherapy and chest pain]

We have noticed that after cisplatin my father coughs a lot less than after gemzar. Why would that be ? Now, two days after gemzar, he has pain in the chest. Just where the tumor is he is saying. His temperature seems ok (37C). My mother is really worried about this pain. Is it normal to experience pain at the site of the tumor during chemotherapy ?

Thanks,

wiesia

[Your mortality]

Last July my best friend went to a doctor for a stomach pain and came saying that she has a pancreatic cancer that has already spread to her liver. The doctor said "maybe three months". She lived only seven weeks. Then in September my mother's breast cancer came back and a month later my father was found to have lung cancer.

My girlfriend getting sick and dying so quickly (just like your mother) was a terrible experience. It did cast a shadow of not only death but also fear over my life. Fear that you never know when you can get hit with a terminal cancer that will take you in just a few weeks.

It is a very egoistic thought, I know, but what keeps me sane these days is telling myself that however terrible it is that people you love are disappearing you are still here. And as long as you are here you are alive and, for what you know, you might be alive for a very long time to come.

So it is something to be happy about.

wiesia

[cisplatin or carbo]

Thank you everyone. My father has a terrible time with cisplatin. The first cycle he even fainted. A lot of vomiting etc. And his WBC is waaay down. We are searching for alternatives.

wiesia

[neulasta and WBC]

Could you tell me at what level of WBC your doctors started

using neulasta ? My father's dropped today to 0.95 and I am

worried that the doctors are just trying to save money by not giving him neulasta.

Thanks,

wiesia

[cisplatin or carbo]

Could anyone compare for me cisplatin vs carbo as far as side effects are concerned, effectiveness etc ?

thanks

[Tarceva in UK]

Dawn,

I was checking Tarceva plus chemotherapy on the web for my father and have found some research showing lack of advantage. I am sorry I do not have a link at the moment.

On the other hand there is evidence that avastin pluc tarceva could work well together as well as some evidence for radiosensitization using tarceva

during radiation.

wiesia

[my father has lung cancer]

Thank you for your message ! And I will say "powodzenia" to my father.

I am so glad to hear that your blood counts are doing better ! Hopefully for good

wiesia

[antiimpotence drugs unmask cancer cells to immune syst]

ABSTRACT: Phosphodiesterase-5 inhibition augments endogenous antitumor immunity by reducing myeloid-derived suppressor cell function [Journal of Experimental Medicine]

Phosphodiesterase-5 (PDE5) inhibitors (sildenafil, tadalafil, and vardenafil) are agents currently in clinical use for nonmalignant conditions. We report the use of PDE5 inhibitors as modulators of the antitumor immune response. In several mouse tumor models, PDE5 inhibition reverses tumor-induced immunosuppressive mechanisms and enables a measurable antitumor immune response to be generated that substantially delays tumor progression. In particular, sildenafil, down-regulates arginase 1 and nitric oxide synthase-2 expression, thereby reducing the suppressive machinery of CD11b+/Gr-1+ myeloid-derived suppressor cells (MDSCs) recruited by growing tumors. By removing these tumor escape mechanisms, sildenafil enhances intratumoral T cell infiltration and activation, reduces tumor outgrowth, and improves the antitumor efficacy of adoptive T cell therapy. Sildenafil also restores in vitro T cell proliferation of peripheral blood mononuclear cells from multiple myeloma and head and neck cancer patients. In light of the recent data that enzymes mediating MDSC-dependent immunosuppression in mice are active also in humans, these findings demonstrate a potentially novel use of PDE5 inhibitors as adjuncts to tumor-specific immune therapy.

[antiimpotence drugs unmask cancer cells to immune syst]

'Erectile dysfunction' drugs heighten natural anti-cancer activity [Eureka News Service]

Sildenafil and other "impotence drugs" that boost the production of a gassy chemical messenger to dilate blood vessels and produce an erection now also show promise in unmasking cancer cells so that the immune system can recognize and attack them, say scientists at the Johns Hopkins Kimmel Cancer Center.

Tests at Hopkins on mice with implanted colon and breast tumors showed that tumor size decreased two- and threefold in sildenafil-treated animals, compared to mice that did not get the drug. In mice engineered to lack an immune system, tumors were unaffected, proof of principle, the scientists say, that the drug is abetting the immune system's own cellular response to cancer.

In a report published in the Nov. 27 issue of the Journal of Experimental Medicine, the Hopkins team says boosted levels of the chemical messenger nitric oxide appear to dampen the effects of a specialized cell that diverts the immune system away from tumors, allowing swarms of cancer-attacking T-cells to migrate to tumor sites in the rodents.

Lab-grown cancer cells treated with sildenafil showed similar results, as did tissue samples taken from 14 head and neck cancer and multiple myeloma patients.

Sildenafil, marketed under the trade name Viagra, is one of a class of drugs used to treat erectile dysfunction in millions of men, and in recent years, its ability to stimulate the production of NO has been investigated by experts in diseases linked to the activity of blood vessels and blood components.

The new Hopkins study homes in on a tactic used by cancers to avoid detection by the immune system by turning elements of that system to its own advantage, says Ivan Borrello, M.D., assistant professor at the Johns Hopkins Kimmel Cancer Center.

Borrello and his colleagues found that tumors exploit nitric oxide-producing immune cells to create a sort of "fog" that keeps them hidden from white blood cells (T-cells) that mount attacks on tumors.

[bone mets]

I have two questions concerning bone mets.

(1) Is radiation only used for pain or severely damaged bones ? My father has two spots: on L4 and a clavicle. Our radiotherapist did not want to radiate those (since they cause no pain). My mother has a breast cancer with bone mets: on L1 and a rib. The one on the ribs was achy but the one on L1 was not (it showed up on a PET/CT scan). Our radiologist treated both of them. That is the same woman !

Now I am wondering whether she does not undertreat my father because stage IV and lung cancer has so much worse prognosis than stage IV breast cancer.

(2) There seems to be some evidence that Doxycycline

might inhibit bone mets of solid tumors. I think there is a Phase II trial in Canada on that and the rumors on bc support groups are that they have some very good results. Are any of you on doxycycline for bone mets ?

Thanks,

wiesia

[Mom just diagnosed]

My father was offered cisplatin/gemzar (this seems to be the standard first line treatment in Europe)

and I have researched the question of effectiveness as well. It seems that the best combinations have to include a platinum drug. But otherwise they were quite comparable (as mentioned before here).

wiesia

[my father has lung cancer]

Thank you all for warm welcome. We tried several antinausea medications by now: Zofran, Setronon,...

Gemzar just makes him nauseaus but it is cisplatin that makes him vomit. Well... we will keep trying.

At the moment his bone mets showed up on bone scan but do not cause pain so no radiation for now. But we will do MRI on L4 to see what kind of damage the cancer has really done.

My mother has breast cancer. It has returned in her bones last summer. Exactly almost five years after the original dx. Just when we were hoping it went away for good So we are rather versed in dealing with cancer.

I am a scientist myself (a mathematician), so i watch my parents doctors carefully and compare what they recommend with what I read. The cancer care in Poland I think is very good. After all, everyone reads the same research journals and papers. What is more difficult is finding individual doctors that would be willing to do Cyberknife on stage IV patient, radioablation, etc. Also it is not clear that some of the long-awaiting clinical trials (Stimuvax, for example) will be conducted in Poland.

But... it is unheard of to ask for second opinion. The doctors are so offended !

wiesia

[my father has lung cancer]

Hello Everyone !

Many thanks for this wonderful site. I have learnt great deal about lung cancer from you all.

My father, Henryk, was found to have NSCLC a month ago. He lives in Poland (I live in Salt Lake City).

So far so good. Two small mets to the bones that made us very sad. Treatment is cisplatin/gemzar for now with tests scheduled for December 15'th. Hopefully it works. He is not dealing with the chemo so well. It is mostly nausea that we do not seem able to control. As a result he does not eat much and is loosing weight.

Wiesia