john

It could be that the drug is actually working and causing the fever/rash. Certain drugs and foods may cause an increase in the amount of drug in the body, so make sure there is not any food or drug interaction. Talk to the doctor, maybe as people said 100mg maybe is better. Don't know. Good luck. Ask the Dr.

There is a thing called a paraneoplastic fever or neoplastic fever. Nothing alarming as far as I have read. It means a fever can be caused by the tumor. From what I have read no one is exactly sure of the cause. One theory is that dead tumor cells could cause the fever or cytokines (an immune response) is causing the fever Tarceva can also cause interstitial lung disease (ILD). This can be serious, but since your mom went to the hospital and the lungs are clear they probably ruled this out Good luck

Hypersentitivity reactions can be handled using rapid desensitization for many cancer treatments (besides chemo) Background: The purpose of the study was to investigate the safety and efficacy of a rapid desensitization protocol used in the inpatient and outpatient settings for patients with hypersensitivity reactions (HR) to carboplatin or paclitaxel. Methods: The 3-solution, 12-step protocol combined gradual increases in the rate of infusion and concentration of the chemotherapy, infusing the target dose over 5.8 hours for inpatient and 3.8 hours for outpatient administration. Patients were premedicated with antihistamines without additional corticosteroids. Results: Between February 2000 and December 2004, 45 patients with history of ovarian (n=39), fallopian (n=3), endometrial (n=2), and peritoneal (n=1) cancer who had moderate to severe HR to either carboplatin or paclitaxel were evaluated. The 26 patients who reacted to carboplatin received a median of 8 courses before developing their initial HR while 16 of 19 patients with HR to paclitaxel reacted on their first exposure to the agent. 17 of 22 patients with HR to carboplatin had positive skin tests. All 45 patients successfully completed 195 planned courses of desensitization (88 courses of carboplatin and 107 of paclitaxel). After undergoing successful inpatient desensitization, 6 patients thus far have received 22 desensitizations in the outpatient setting without adverse reactions. Of 26 patients receiving carboplatin desensitization for recurrent cancer, 10 had a radiographic response (partial or complete response) and/or >50% drop of initial CA125 value, 11 had stable disease radiographically and/or CA125 response (<50% drop), 1 is still unevaluable for response, and 4 had progressive disease after 2 cycles of carboplatin. Conclusions: The rapid desensitization protocol has proven to be safe and effective in the inpatient and outpatient settings for patients with HR to either carboplatin or paclitaxel. This protocol has allowed appropriate patients to continue chemotherapy in the setting of moderate to severe HR, and the study warrants the incorporation of the protocol into standard clinical practice.

Donna, Yes that is typical. The tumor gets so big it cuts the blood supply off to itself so it dies inside. I think it is called cavitation. Take care

Yes doing "neo adjuvant chemo/radiation" (chemo and/or radiation) before surgery has shown to be I think more effective in some cases. A central mass that is big is sometimes squamous cell cancer which has a slightly better prognosis (from what I have read) than other types Of course trying to quit smoking is important if surgery is going to happen because of the lung function will be affected Good news and good luck

I think it is because the doubling time for cancer is over 1 month that a scans are not given every month. Maybe at least two months. Since CTs only have a certain resolution it won't help doing scans too often. Also for younger patients the radiation exposure may be an issue.

A big problem is that there is not a lot of research on this. Clinical trials cost a lot of money and since drug companies can not make money from vitamins there is little research. NIH and the goverment need to offer more grants to find out the what vitamins are good / what vitamins are bad / when they should be taken, etc. Unfortunately the answers are not clear so and Drs don't have time so they just say no as Ernie said.

I think it is normal to see a surgeon first, but I also think it probably is good to form a "board of doctors" or tumor board with different specialties that can consult with each other. I think at some major cancer centers it is done this way. That way everyone is on the "same page" and can discuss the case face-to-face http://cancer.stanfordhospital.com/forP ... rd/default

You might want to research HKI-272. It is in clinical trials. Also sometimes people develop two primaries. I am not sure how rare this is but it can happen. *maybe* there are two different types of cancer. Another thing that could be happening is that one area has become resistent and the other has not. Also maybe the tarceva needs more time to work. Not sure how fast responses are. Maybe it is working in one area and has not started in the other. Just guesses. I would ask the Doctor any questions you have.

http://www.oncolink.upenn.edu/resources ... &year=2007

Most Drs I believe do not warn against a daily vitamin. But also don't think high doses are good. I think this is the most common view. Some Drs say no vitamins during chemo, so it is confusing. A lot of research does seems to support that it does not hurt. There have been no large trials that are "statistically significant" One researcher, Prasad, says vitamins are good. Randy just posted an article that says vitamins and chemo lead to better outcomes. http://www.jacn.org/cgi/content/full/24/1/16 http://www.doctormurray.com/articles/Chemotherapy.htm There are drug companies that are trying to make synthetic vitamins to use with chemo, so maybe there is something to using vitamins. Search for Vitamin D and lung cancer http://www.novacea.com/610.asp?id=47&nav=news http://www.psa-rising.com/prostatecance ... ntar07.htm

There was an interesting article in the Washingtonian magazine (it is a local DC mag) about melatonin, circadian rhythm and cancer risk It is also interesting that there is a researcher that is invesitaging the timing of chemo or radition. That cancer may actually be more suseptible to treatment at certain times of the day http://news.bbc.co.uk/1/hi/health/1602131.stm http://jnci.oxfordjournals.org/cgi/cont ... l/92/9/686

I've read that CoQ10 might help with cardio toxicity that can occur with certain chemo such as adriamycin (sp?)

Some of the information says that the PH has to be lower than 5? Dr West, how high (basic) does the stomach get after taking a PPI or TUMS? How fast is Tarceva absorbed into the bloodstream. Yirol, It seems like if he needs antacids then there might be a better time to take them. It seems best to not take them around the same time as the Tarceva. Dr West could you provide more input. thanks From one of the tarceva clinical trials:

It appears that anti-acids may reduce the effectiveness of Tarceva Erlotinib is characterised by a decrease in solubility at pH above 5. The effect of antacids, proton pump inhibitors and H2 antagonists on the absorption of erlotinib have not been investigated but absorption may be impaired, leading to lower plasma levels. Caution should be exercised when these medicinal products are combined with erlotinib. http://emc.medicines.org.uk/emc/assets/ ... ntID=16781 Agenta Effect Mechanism -------------------------------------------------------------------------------- CYP3A4 inducers (e.g., phenytoin, carbamazepine, rifampin, barbiturates, St. John’s Wort) Decreases gefitinib/erlotinib plasma concentration and reduces efficacy Enhances gefitinib/erlotinib CYP3A4 metabolism CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin, protease inhibitors, grapefruit juice) Increases gefitinib/erlotinib plasma concentration and increases toxicity Decreases gefitinib/erlotinib CYP3A4 metabolism Proton pump inhibitors (e.g., omeprazole) Reduces gefitinib absorption (not documented for erlotinib) Sustained elevation of gastric pH Histamine H2-receptor antagonists (e.g., ranitidine, cimetidine, famotidine) Reduces gefitinib absorption (not documented for erlotinib) Sustained elevation of gastric pH

There are drugs that are being developed called irreversible EGFR inhibitors. They are *supposed* to work once Tarceva stops working One that is in trials is call HKI-272

If it is BAC there is a better chance that it will work. There is a genetic test that should show if the cancer is susceptible to Tarceva. http://www.genomenewsnetwork.org/articl ... r_drug.php Mass General Hospital might have more info on the test

I *think* you should avoid St Johns Wort

In very rare cases SCLC can be resected. It might be worth a 2nd opinion at a place like Fox Chase or other cancer center. Etoposide and Cisplatin are standard chemos for SCLC Take care

Multiple nodules could mean many things: A SPN (single pulmonary nodule) I think is more likely lung cancer than a MPN (mutiple pulmonary nodule). You can google on SPN or MPN to get more info 1) infectious granulomas 2) sarcoidosis 3) Wegener's granulomatosis 4) rheumatoid nodules 5) benign nodules 6) Churg Strauss Syndrome 7) metastic malignancy bronchioaveloer carcinoma "8)" turns in to a smile sorry Hopefully it is benign. Take care

Basically I belive it is scaring of the lungs Sometimes steroids are given (I think) There are other drugs in trials for idiopathic pulmonary fibrosis. Idiopathic (means the cause is unknown). In your case it is not idiopathic the cause is probably radiation. Prifenidone is being tried for IPF (dont know if it applies to other pulmonary fibrosis) Good luck

From what I was told by Drs (and if my memory is correct). A person can usually go into a trial after a number of days of not taking any drugs that might affect the results of the trial. For example my mom was taking a vaccine that did not work. She had to wait 30 days until another trial could be started. The people running the trials want try to make sure there arent old drugs that will affect the results. Even if a trial fails there usually are some other options. I think the most important thing is that for people who are interested in trials, make sure that clinical trials are investigated right away, because previous treatment can exclude a person from some trials

The fact that there is calcification is a good thing. Non-calcified nodules are more likely malignant. As everyone has said CT and even PET scans are not 100% If it is malignant it could be early stage so there is could be a high change of cure. Take care.

Dr Andrew Weil is a proponent of Astragalus

Iressa is like Tarceva. Iressa caused interstitial lung disease in some patients (l% or less) It may be nothing but you probably should contact the Dr with any concerns