john
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Posts posted by john
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According to the link below, 5% of SCLC may be eligible for surgery.
http://www.emedicine.com/radio/topic807.htm
If you google "sclc resection" you will find a lot of info
http://www.ersnet.org/ers/lr/browse/vie ... tach=10016
This states the the Veterans Administraion stagint system might not be good for SCLC versus another one
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I believe I read that Iressa helped with brain mets, so Tarceva might also.
Found it. Tarceva produces responses in Glioblastoma Multiforme (brain cancer) so hope it helps with mets
Good luck
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New from Mayo
http://www.oncolink.com/resources/artic ... &year=2006
Pulmonary resection extends survival in early small cell lung cancer
Reuters Health
Posting Date: June 1, 2006
Last Updated: 2006-06-01 12:12:00 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Pulmonary resection of small cell lung cancer (SCLC) safely improves long-term survival, notably with early-stage disease, according to a report in the May issue of the Mayo Clinic Proceedings.
Long-term survival in SCLC is poor despite good clinical responses to combination chemotherapy and radiation therapy, the authors explain, with most relapses coming from local recurrences.
Dr. Vidhan Chandra and colleagues from the Mayo Clinic College of Medicine, Rochester, Minnesota investigated the postoperative outcomes of 77 patients who underwent surgery for SCLC.
Curative resection was done in 46 patients (60%), the authors report. There were only two perioperative deaths -- one from pulmonary embolism and another from unknown causes. A total of 19 patients had complications, including atrial arrhythmia, pneumonia, and persistent air leaks.
After a median follow-up of 19 months, the results indicate, 20 patients were still alive. Excluding the 10 patients who only underwent biopsy, the estimated 5-year survival was 36% for patients with stage I disease, 40% for stage II patients, 17% for stage III patients, and 0% for stage IV patients.
Median survival was higher for patients who underwent curative surgery (25 months) than for patients who had a palliative procedure (16 months), the researchers note.
"Although we were unable to demonstrate that pulmonary resection significantly influenced survival," the investigators write, "our patients survived longer when curative pulmonary resection was performed. Our inability to show a statistically significantly difference is likely because of the limited number of patients."
In a multivariable analysis, only postsurgical tumor stage (III/IV versus I/II) significantly predicted survival.
"Pulmonary resection in patients with stage I or stage II SCLC is safe with low mortality and morbidity," the authors conclude. "Curative resection is associated with long-term survival in early stage SCLC and should be considered in selected patients."
Mayo Clin Proc 2006;81:619-624.
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As you might know Herceptin has been used as a breast cancer drug, it targets HER2. This is a epidermal growth factor. HER1 or EGFR is the target of Tarceva
http://www.genomenewsnetwork.org/articl ... ceptin.php
It is interesting your Dr is trying this it is not the usual drug. I think that is good, he must be thinking "out of the box"
I am not a Dr, but I think that he is trying other drugs is probably good.
You might want to ask the Dr what he/she thinks about CI-1033.
It targets 4 growth factors, HER1, HER2, HER3, HER4.
Not sure if more is better.
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I don't think surgery is used for Stage 4 after chemo.
There are certain stage 4 patients that qualify for surgery such as an isolated brain or adrenal met. This is not usual though.
For stage IIIa and maybe b, sometimes radiation/chemo is used first and then surgery may be done if there is a good response.
Surgery and radiation (in general) is a "local" therapy. Patients that are stage 4 have a "systemic" disease so the whole body needs to be treated.
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Another option that it is probably a small one is trying to get a drug under "compassionate use"
You have to remember though that a clinical trial might actually make QOL and life shorter than longer so it is difficult decision.
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It is the Washingtonian not Washingonian magazine.
www.washingtonian.com will have some of the articles in the magazine but not all. Since it came out this month in print it probably wont be on the website and it may never get there.
As Randy said a google search will find a lot of info
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There is an interesting article in the Washingonian. It is a DC area magazine so it might be hard to find unless you are in near DC.
It was about melatonin and its cancer fighting properties and also sleeping and breast cancer.
Basically, it showed evidence that women whose sleep pattern was disrupted (night shift nurses) and a higher incidence of breast cancer.
It also showed some eveidence of melantonins ability to increase survival when given with chemo.
I have not read the whole article throughly but it looked interesting
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Jill Siegfried, PhD. is one researcher that has been looking into this for a while
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Isn't it fairly standard to go on aromatase inhibitors after tamoxifen, because tamoxifen stops working
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It is being tried in clinical trials in the US
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Given the recent evidence that HRT may be responsible for some breast cancers or at least be a catalyst.
I wonder if a study will be done on non-smoking women, HDT and lung cancer?
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There are radiopharmecuticals that are being tried. They target the bone mets
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I am guessing that gamma or cyber could be used for 3 mets, though it might depend where they are located.
Some chemos do seem to pass the blood-brain-barrier.
Topotecan is supposed to be one.
There is a fairly new drug called Temodar temozolomide that is used for mets.
There are also radiosensitizers. I think one is RSR13? That are used to make the tumors more sensitive to the radiation.
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As Ry mentioned hopefully the Adrenal met is not cancer. Since they are removing the Adrenal that is good. There is a case study that I'll try to find that showed long term survival for a patient with an isolated adrenal met that was resected
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PSK - Coriolus versicolor is supposed to be one mushroom that has undergone some research
Reishi is another one.
Dr Weil offers supplements. You may have heard of Dr Andrew Weil
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I would try to do as much research as possible and get a few opinions from Drs. Being in NYC you have access to some of the best cancer centers
BTW I have no idea if you should be afraid or not. two years seems to be pretty good without a recurrence. Personally I would just try to get as much info as possible. There are other drugs in clinical trials besides wbr and chemo
Take care
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I think Kelly had a very good answer.
Also it depends greatly on each individual case. If there are many brain mets then I believe Gamma or Cyberknife is not an option.
It seems in your case Karen that there was one met that was isolated and encapsulated so the neurosurgeon got it all.
So again I believe there is no general answer that can answer each case. I just spoken in general terms from what one Dr told me and what I have read.
Sometimes gamma is given and then the "field" is made bigger to cover more area.
The trade off is more is covered with WBR but possibly there is more damage also. The good thing about SRS is that it is targeted, but it will not get distant mets.
Unfortunately there are no pat answers and that is why the Drs have to be consulted for each individual case
Karen I am glad things are going well for you.
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1) Zometa is often given for bone mets. cyberknife might be an option
2) PETs don't do well for brain mets. MRI with triple-dose gadoteridol is the best I believe
I am not a Dr. so I would ask your current Dr or get a 2nd opinion at a good cancer center, such as one designated by the NCI
Good luck. I think ask the experts forum on here is back up so Dr West may offer answers
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I think the main problem which happens to be the main benefit is that radiosurgery is very focused, so it will zap the mets that are seen but any micrometastsis that are there is does nothing to them.
I have heard sometimes radio surgery is done then WBR to take care of anything the radio surgery misses.
There are radio-sensitizers like rsr13(?) and xyctrin (sp?) that are in trials and other drugs like temador for brain mets
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I seem to recall that CPT-11 (Irinotecan) is supposed to work a little better in Asians, because of some genetic differences.
Not 100% on this though
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BAC?
in NSCLC GROUP
Dr West what do you think of the irreversible EGFR inhibitors? Does the latest trials look promising?
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BAC?
in NSCLC GROUP
I believe that there is a "pure" BAC which will usually stay confined to the lungs and adeno with BAC features. So there are different forms of BAC
Cancer mutates all the time I believe so I guess it is possible for the cancer to change somewhat.
There is a mutation that is found in cancers that make Tarceva not work.
Degree of uptake on PET scans
in NSCLC GROUP
Posted
There was a doctor on here that would answer questions and he would always say you have to look at the whole picture not just one number.
I think some studies have shown a "likelihood" of aggressiveness for high SUV. The key word is likelihood and were the studies done on the same type of cancer. Most are probably for adeno since I think it is now the most common
Squamous cell I have also read has better survival rates than adeno, so again, one number is not the whole picture.
I am not a Dr, but I dont know if Tarceva is that affective with Squamous. You might want to investigate photodynamic therapy and Alimta?
I would try to get 2nd opinions if possible.
Good luck.