john

Not sure what the results are of the HKI trials. You might also want to research EKB-569 - it is another irreversible EGFR inhibitor. The trials is phase I, though so you have to take that into account I am not sure if other EGFR drugs like erbitux would be tried or not. Erbitux acts on the outside of the cell instead of the inside like Tarceva

To find your Senator and House of Representative go to http://www.congress.org/congressorg/home/

Size does matter sometimes, but any metastasis makes it stage IV. One thing your friend should find out for sure is that the spine is truly a metastasis and not a false positive. This would change the treatment drastically, since surgery likely would be done if it is stage I. I belive from the research it is uncertain how the size of a tumor is related to the tumor's ability to metastasize. T - size, location N - lymph node involvement M - distant metastasis In the TNM systems, 4 stages are further subdivided into I-III and A or B subtypes. These stages have important therapeutic and prognostic implications. The stages are as follows: Primary tumor Tis - Carcinoma in situ TX - Positive malignant cytologic findings, no lesion observed T1 - Diameter of 3 cm or smaller and surrounded by lung or visceral pleura (see Image 1) or endobronchial tumor distal to the lobar bronchus T2 -Diameter greater than 3 cm (see Images 2-3); extension to the visceral pleura, atelectasis, or obstructive pneumopathy involving less than 1 lung; lobar endobronchial tumor; or tumor of a main bronchus more than 2 cm from the carina T3 - Tumor at the apex (see Image 5); total atelectasis of 1 lung; endobronchial tumor of main bronchus within 2 cm of the carina but not invading it; or tumor of any size with direct extension to the adjacent structures such as the chest wall mediastinal pleura (see Image , diaphragm, pericardium parietal layer, or mediastinal fat of the phrenic nerve T4 - Invasion of the mediastinal organs, including the esophagus trachea, carina (see Image 11), great vessels (see Image 13), and/or heart; obstruction of the superior vena cava; involvement of a vertebral body; recurrent nerve involvement; malignant pleural or pericardial effusion; or satellite pulmonary nodules within the same lobe as the primary tumor Regional lymph node involvement N0 - No lymph nodes involved N1 - Ipsilateral bronchopulmonary or hilar nodes involved N2 - Ipsilateral mediastinal nodes or ligament involved Upper paratracheal lower paratracheal nodes Pretracheal (see Image 4, Image 7, Image 10) and retrotracheal nodes Aortic and aortic window nodes Para-aortic nodes Para-esophageal nodes Pulmonary ligament Subcarinal nodes (see Images 12-17) N3 - contralateral mediastinal or hilar nodes involved (see Image 19) or any scalene or supraclavicular nodes involved Metastatic involvement M0 - No metastases M1 - Metastases present (see Images 20-27) Stage groupings are as follows: IA - T1N0M0 IB - T2N0M0 IIA - T1N1M0 IIB - T2N1M0 or T3N0M0 IIIA - T1-3N2M0 or T3N1M0 IIIB - Any T4 or any N3M0 IV - Any M1

the following is from Lung Cancer Alliance Dear Friends, Last night the United States Senate passed by unanimous consent S.Res.408 which calls for lung cancer to be treated as a national public health priority and lays out a blueprint for a coordinated attack on lung cancer’s high mortality by several federal agencies. A resolution, even one passed unanimously, does not legally force the agencies to act. However, the political message coming from the Senate is loud and clear. The rarely seen speed with which it was passed, just five weeks after introduction, boosts the volume even louder. Clearly we have established credibility and political capital in Congress which we can now leverage into, and in fact we are in the process of doing, authorizing and funding bills for increased lung cancer research, earlier detection and better treatments, and eventually even chemoprevention drugs for pre-cancerous conditions. We are grateful for the leadership of Senator Chuck Hagel (R-NE) and Senator Hillary Clinton (D-NY) who reached across party lines to give the resolution their full support and expedite its passage by the Senate. A similar resolution introduced in the House of Representatives by Congressman Clay Shaw (R-FL) is pending action. Kay Cofrancesco Program Specialist Lung Cancer Alliance 202-463-2080 www.lungcanceralliance.org

This research indicates a risk of secondary cancer after breast cancer http://www.medicalnewstoday.com/medical ... wsid=34738

There has been some research on estrogen and lung cancer. My guess is that it would take a while longer to have a 2nd primary cancer occur due to radiation treatment http://digitalcommons.libraries.columbi ... AI3174822/ Herceptin is a drug that targets HER2. It is one of the 4 Epidermal Growth factors (EGFR) EGFR sometimes called HER1 is a target for lung cancer treatment. Iressa was the first EGFR inhibitor. Tarceva seems to be better. There are other EGFR drugs such as Erbitux, CI-1033 (a pan EGFR inhibitor, it targets more than one growth factor), ABX-EGF, etc Often a biphosphonate such as Zometa are used for bone mets. I just read a new one called Boniva is being used for bone mets from breast cancer. Usually Prophylatic cranial irradiation (PCI) is not used for Adenocarcinoma only SCLC. There are a few clinical trials for brain radiation to prevent brain mets for NSCLC. Usually PCI is used only after a patient has received at least a partial remission, I think.

http://www.medicalnewstoday.com/medical ... ewsid=9255 I *think* like Iressa the combination does not work too well.

There was a clinical trial a while ago using melatonin for brain mets. Not sure how the trial is going though

After the chemo and radiation it might be possible to have surgery. I would ask the oncologist and radiation onc about this because if there is too much radiation or chemo surgery will not be possible. Even if it is close to the heart, there *might* be a surgeon that could do surgery. You will just have to ask enough Drs to find one capable of doing the resection. Make sure you find the best doctors available.

I agree with Connie. The lastest research does seem to indicate that often chemo should be used even in some early stage cancers. There are times when it should not be used though such as with a typical carcinoid and other slow growing cancers which don't respond much to chemo. The SUV going down is probably a really good sign

Certain chemos are worse than others. I think Cisplatin is one of the worst on the kidneys. Carboplatin is a platinum based chemo like cisplatin so that i guess is causing your renal toxcity. I read that hydration is important and sometimes lasix is used to increase urine output. I have read dialysis is only used in severe cases. Maybe another chemo will be tried that is less toxic to the kidneys?

You can find clinical trials at http://www.clinicaltrials.gov

3 mm is tiny. So if it is anything it is hopefully caught early it is mm not cm right?

That is good it was found so early. The web says Kulchitsky cells originate from neuroendocrine cells. Neuroendocrine lung cancers exhibit a large range of aggressiveness. SCLC, large cell carcinoma, atypical carcinoid, and carcinoid are all neuroendocrine lung cancers. Since your doctor recommended chemo, your type is most likely SCLC or large cell. Carcinoids are not supposed to repond well to chemo since they are slow growing. Since it is caught so early that is good and very unusual. I guess the chemo choice is GemCarbo versus VP16/Cisplatin since the side effects are less? Something you could ask your Dr if you want I am not Dr. If you have any concerns get a 2nd opinion or ask your current Dr. Take care

Great news. I was wondering when I saw your bio change from "nodule is 1.4cm" to nodule is still the same size

I think it is a good idea. Unfortunately lung cancer is such a deadly disease that the ones left are the ones who can provide information, support, advocacy, etc. The parents, aunts, uncles, brothers/sisters are needed to keep this site active and full of knowledge and experience. And more unfortunate is that there will be other's who lose spouses, children, brothers, sisters, etc. Support is instinsically part of this site. A special one for spouses and others could be put under the current Grieving Forum. By supporting those left behind it can only strengthen this site. There is bandwidth for jokes, etc and non-deep threads (Which are needed), why not a few threads for special grieving situations?

I think the doubling time for your nodule is about 40 days, which is pretty fast. This would indicate that it is an infection or something else, probably not cancer. Also your Dr said it wasnt cancer. The reason I think this, is that if the doubling time is that fast then it should show on the PET scan because the metabolic rate (I believe) would be high. A PET scan wont always show slow growing cancers, but again since the doubling time is fast your nodule would not be a slow growing cancer and should show on a PET. I am not a Dr, but this is what I would guess. A 2nd opinion is always in order if you feel uncomfortable. I imagine once the C word is mentioned it is hard to shake. There are other characteristics of the nodule that are shown on the CT scan: calcification/non-calcification, density, spiculation that help with determining wheather a SPN (single pulmonary nodule) is benign Good luck.

Joannie, There is pretty good evidence that radon causes lung cancer based on way too many uranium miners getting lung cancer and based on studies of homes with high radon levels. I think based on this and ruling out other things it was a highly likely cause. But as people have said on here I think it is almost impossible to know 100% unless you could run unethical experiments on prisoners. Expose half to randon at differnt levels, don't expose the other half and control as many variables as possible and then get accurate family histories, genetic analysis, etc Even then there maybe a very small chance it is something else or a combination of things. Do 100% of people get LC after a high enough exposure? Of the 1/2% that does not get LC why are they different http://www.cancer.gov/cancertopics/factsheet/Risk/radon

I would get a 2nd opinion. Of course the Mayo Clinic has a great reputation. I believe there are people on this board that have had good expereiences with Cancer centers of america. Sometimes with blood clots a stent is used *I think* It seems like what your mom has in some sense is Superior vena cava syndrome. Maybe not exactly but close. I am not a Dr. When there is compression around the Vena cava it can cause swelling in the face. Again I am not a Dr, but I have read that this is done. Good luck with the 2nd opinion. I wonder if there are people on this board in your area who could provide referrals to doctor they like that might be closer than 4 hours? I have read the lovenox is supposed to be better than coumadin, so that is good she is using that vs coumadin. I *believe* it is quite wrong and UNETHICAL to say that her treatments would stop if she seeks a 2nd opinion. Yes treatment may be changed by the other doctor and *maybe* there would be a short period of no treatment, but it might be better treatment for you mom? That signals to me that you are not dealing with a good doctor. A good doctor would welcome 2nd opinions and not feel uncomfortable by a 2nd opinion request. You might want to call the AMA and ask about this? Is this actually done? Stopping someones treatment because you want a 2nd opinion. I think it is outrageous

Thanks for the article. I wonder why it does not mention that Tarceva seems to work better in non-smokers and especially women. Nor no mention of the gene that seems to identify which people the drug would work best on. I wonder if Dana Reeves was ever offered Tarceva at Sloan? just wondering

keep up the good reports

Did anyone notice the mistake by the "Health Expert". Robert Bazell is a phi beta kappa from UNC but apparently lung cancer is not worth his time to do any research I bet at least half the people on here could find the mistake in the following: The mistake is that he says a CT scan is a helical or spiral scan. Actually they are different. A CT scan is what most people get. A helical or spiral scan is being tested for early detection. A Helical or spiral CT scan can detect nodules MUCH smaller than a normal CT scan. It is a little nit-picky, but a Science editor should be more accurate Also did you notice how he mentioned non-smoking women and then immediately started taking about smoking? No mention of research being done on Estrogen and lung cancer. It is nice to increase awareness but at least I would hope there would be 0 mistakes!

The SUV is the uptake number. I am guessing that as the numbers goe up the spots will become brighter. As they go down they will be darker. Just a guess. You probably know this but the SUV only applies to the PET

That is great news. Sometimes when someone is down staged like that they might be able to have surgery. You might want to ask your Drs about this

I think if it is spiculated it is more likely malignant, but as connie said there are always exceptions. http://www.postgradmed.com/issues/2003/ ... llivan.htm [/b]