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What Does NSCLC Do With Interruptions to Treatment?


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I hope I phrased the topic header well enough. Mom has squamous cell NSCLC and her last CT scan showed a 30% tumour reduction after 6 chemo sessions. Since that time, she had to miss two chemos because of health issues (and another hospital stay) and now it looks like we are going to be waiting at least 2 weeks on radiation to begin....she was originally to have 12 chemos, with 6 of them where the chemo and radiation would overlap and then finish up with a period of time on radiation only (2 weeks or so).

Mom fell three days ago and as a result, she cannot adequately lift her right arm up for radiation needs (nothing broken, thank goodness; just bruised and sore with a possible minor tear in internal shoulder tissues). The radiation doc. saw her yesterday and said to get her physical therapy and we'll see how she recovers: if she isn't recovered enough in a couple of weeks, he is going to have her re-staged to do the radiation with her arms down -- not ideal, he says, for what he'd like to be able to do....and he didn't sound too happy about this situation with the amount of tumour reduction she has so far (the main tumour is still huge from the CT picture he showed us yesterday). In the meantime, she is still scheduled for her chemo to continue.....

So far, mom has had 8 or 9 chemo sessions (taxol/carbo)total. I am a little concerned about the total number of chemo sessions increasing due to the radiation delay (but we'll see what the chemo onc. says on Monday with this latest development) -- in my opinion, her effects from chemo may have contributed to her falling (among other things I'm not too happy about) as she isn't near as steady on her feet as she used to be (but mom doesn't recognize that) and her mental status isn't trustworthy (she doesn't even remember falling and no, she didn't hit her head). I am also a bit nervous that she might not be getting enough tumour reduction response from the chemo regime by itself, so I am a little anxious to see the radiation get going as they are saying that that is where she will get the most help. It sounded like if radiation cannot commence soon, any radiation treatment would have a pallative effect rather than curative (not sure if I understood that right though).

Anyway, I thought squamous cell was slowest growing kind of NSCLC. At dx, we were told she had this for lots of years......can delays like this really change a curative path to perhaps becoming pallative? Does chemo invoke an adverse impact on the nature and behavior of her tumour?

Thanks in advance,


P.S. :D:D:D The radiation doc. said to have mom's family doc address the order for PT/OT and to re-evaluate her pain management needs from the fall. :D:D:D Me and the cabulance guys got it done within 2 hours of the visit with the radiation doc......ever heard of that happening before? I actually called from the cancer center, got to actually talk to a person (not a message machine) at the doctor's office, hit a day when her doctor was actually in seeing patients, and get her "squeezed in" immediately -- we smoothly went directly from one place to the other on a moment's notice...well, I played O2 transport delivery lady as it didn't look like the cabulance guys were going to have enough on board, but that's another story.....I was so happy, for once....something actually went right!!!!! :D:D:D

I'm doing my part, just need the cancer to behave itself and comply!!!!!!

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I wouldn't think a short delay would make a huge difference. It's common for people to get infections, etc. and have to take a break from chemo. Now about the falling-- it could be that she is dehydrated and that is why she fell and doesn't remember. My mom did the exact same thing and hurt herself pretty bad and it was due to being dehydrated. Get a lot of water and Gatorade in her and see if she isn't more steady on her feet.

Also, when my husband started treatment our doctor explained that radiation and chemo together worked best. Hopefully the PT will help her so she can get going on radiation. Hang in there.

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Re: dehydration.

That is something we are watching and something I have been concerned about too (I am learning well here :wink: ). She isn't over the "runs" effect from the Keflex/Lomotil escapade yet in my signature and she did test positive for C-diff, so another med is in the mix for that now.

Her meds soup also makes her prone to being dizzy when she first sits/stands up, but she doesn't listen to advice like "when you get out of bed, sit up and count to 20 before you try to stand"....she just gets up and goes and forgets about that sort of thing.....plus, not likely to happen when you have to hurry to the bathroom without warning anyway. She's down to a bedside potty now. From what I have seen, she has been a fall hazard for quite some time (another frustration issue of mine when I communicate this sort of stuff to the powers that be). She may have actually tripped on her O2 cord from her concentrator (it's long and a hassle).

Though she appears to be taking in adequate fluids, I am doing the usual dehydration monitoring (skin response test, is she having any headaches, etc.) when I see her at the nursing facility (which is very, very often and I spend hours there just observing what she's doing, how she's eating, what/how much she's drinking, etc. etc.).

It's really hard for me to tell exactly what's what with the dehydration issue. Any other key ways to tell on this?

By last doctor's orders, we can't just give her uncontrolled amounts and types of fluids either without doctor input (it's the dangers of what happens with her bloodwork chemistry and her meds-induced diabetes). Another reason I am asking more on this issue.


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Linda--My understating is that one can miss chemo treatments as well as take breaks in between and still have the same effect. I did not even start chemo for almost 7 months after my diagnoses. Of course everyone is different. Hope this helps. Prayers for the best. Rich

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Keep an eye on the C.Diff Deb was in hospital for 3 weeks with that andd because of it Her chemo was stopped and I believe may have led to her passing. Chemo stoppage that is not c.diff. Proobably on Vancomycin for C.diff.

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