Shortness of Breath

[jhllal]

Over the week end, my father developed shortness of breath. He saw a nurse practioner this morning. They took xrays and said that nothing had changed from the prior x-ray. (He has been stable since the end of October when he completed his 1st course of chemo). I told my dad to ask them about avastin and he said that they don't use it as it has not been approved for lung cancer use and is very expensive.

I would appreciate any insight on the following -

should my dad have something other than x rays to determine whether the cancer has spread?

have others received avastin that was covered by insurance/medicare?

I feel as though sometimes I push too hard, but I feel as though the Dr. is not taking a very pro-active position with my Dad.

[kimblanchard]

I have completed 4 Cycles of Avastin and my insurance (Blue Cross) paid for it.

jim

[myrnalu]

If you arent happy with this Dr,will the insurance pay for a second opinion?

I never had avastin,but my opinion only,your Dad should have a cat scan and pet scan.

Marie

[joanie55]

I've been on Avastin since May of 2005. First United Health Care paid for it and now Blue Cross/BlueShield pays for it.

Joan

[joanie55]

Curious as to where u live. Also, the fact that you were discussing this with the nurse practitioner, you should be speaking with the doctor. Your father should have an MRI, CT scans, etc. above and beyond the X-Ray to see if his cancer has spread. It's upsetting to me to hear someone be so flippant as to a medication they obviously know very little about. My doctor says that Avastin will be approved soon as the protocol for certain lung cancers and he is an oncologist at Sloan Kettering.

Joan

[Welthy]

I can only say that my Husband's doctor does PET & cat scans about every 3 mos to determine status of the tumors. There are so many more drugs available, like Avastin, Tarceva, etc. and they are covered by Medicare. The Doctor will know what protocols are covered, but I'd suggest a second opinion. Just my 2 cents. Good luck and God bless.

Welthy

[cindi o'h]

Hello.

Sudden SOB should be investigated until the cause is known.

There are many things that can cause SOB and most of them are quite serious in nature unless they are controlled.

Could be a Pulm Embolism undetectable by chest xray only by CT scan.

Another reason could be congestive heart failure detected by blood enzyme.

I am sure that there are more reasons for SOB than these. He needs a prompt and thorough evaluation.

Take him to a good ER. The doctor's office is a place where he won't be treated as thoroughly (most doctor's offices). ER docs are trained to pick up what is going on.. I would try that route.

[eppie]

It also could be low red blood cells and low white blood cell counts.

I will be hoping this gets better.

Much love,

Eppie

[blaze100]

I think Cindi makes a good point about his heart since your dad has had heart problems. Are his oxygen levels OK? Barb

[Carleen]

I don't know much about the avastin, but I have heard it is really expensive, but there is no reason to deny it before even checking to see if it would be covered.

Also, my husband hasn't had an X-ray in 3 years. Basically since diagnosis. The reason is that x-rays are not as detailed as CT scans or PET scans. They also can not detect as small of tumors as CT or PET. I would recommend your dad getting one or both of these.

[LibW]

I would recommend you ask his Doctor to have his heart Doctor do a echocardiagram. Sometimes people develope pleural or pericardial effusions. (fluid around the lungs or heart). After my surgery to remove my left lung, I had pain and breathing problems that took almost 8 months for the Drs. to determine it's cause. It often takes just the right test to see what's going on. Just a thought and good luck to you!

[cindy0519]

Oh boy... I could have written much of your email as little as a few weeks ago. My Dad also had a medical oncologist with a less than proactive attitude. Dad has finally changed medical professionals (all doctors except primary are now new)...what a HUGE difference!!! Now instead of feeling he is being sent home to die, we are actually seeing small glimpses of hope..even with new growth. If at all possible, get to another set of doctors. This disease progresses way to fast for nothing other than a VERY proactive approach by the medical team.

Something worthy of note regarding Avastin and why they may not be telling your Dad it is an option. With this new team of doctors we confirmed by internet findings, that Avastin is not used to treat squamous cell NSCLC. Avastin has been found to have a higher risk of serious bleeding from the lung in patients with squamous cell. If your Dad has this type of NSCLC, this may be the reason Avastin is not an option.

Prayers for you and your family. I hope you find answers soon!

Cindy

[michelepal]

I would definitly suggest a cat-scan!! My Dad's doctor said that his tumor was there for at least 3 years and he had a chest x-ray every year. Praying for you Dad! keep us posted!

Michele

[marym]

I don't know anything about avastin. But I get brain MRI every 3 months, and CT severy 2 months and in between I have had abdominal CT, spine MRI and pet scans.

I would request further tests.

Mary

[Elise]

My mothr is also suffering from sob. The doctor said to see a pulmonogist for a functions test but also said that a cat scan was the best test. I don't beleve that. From my readings, and please excuse the spelling, SOB can be caused from low RED blood count (which my mom doesn't have). Also it can develop 2 to 3 months after chemo. and be pneumoitis sP. Dysnpea SP. Or many other lung problems that do not mean cancer. Demand they find the reason why she is having a porblem breathing with whatever tests they have available. My mother has been calling pulmonogists all day today and she can't get in for weeks. What good is having doctors for lung cancer if they can't tell you why she has SOB. Also, most webistes I have come to including this one say remarkable things about avastin. An oncologist friend of the family said it is a great drug and that if a doctor refuses it it may be because they are afraid they will not get reimbursed for it. However, I do not believe Avastin is recommended if you have brain mets.

[jhllal]

Thanks so much for all the great input. I called yesterday and spoke with the oncologist's nurse. She set up an appointment for next Wednesday. I emphasized that I was particularly worried about the shortness of breath. I would have thought they would have scheduled an earlier appointment. The problem with switching doctors is that I believe that this is the only group in the city.

When you mention a CT, is that a CT of the entire body or chest only?

[jhllal]

Thanks so much for all the great input. I called yesterday and spoke with the oncologist's nurse. She set up an appointment for next Wednesday. I emphasized that I was particularly worried about the shortness of breath. I would have thought they would have scheduled an earlier appointment. The problem with switching doctors is that I believe that this is the only group in the city.

When you mention a CT, is that a CT of the entire body or chest only?