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Dad just diagnosed with NSCLC-Can you help


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Hi Everybody,

First of all, thank you all for this great forum, I have been reading a lot in the last few days and learned so much from you all. My dad, who is 58 has just been diagnosed with NSCLC. We were devastated at first but now is the time to be strong and learn as much as possible about our options. I live in the Chicago area but my dad lives overseas. What his doctor told me (over an e-mail) is that he is diagnosed with locally advanced adeno cancer, there is a big 5.7X6.4 c.m. tumor on his right lung and it has not metastasized. The doctor thinks it is resectable but they started neo-adjuvant chemo. I will write down whatever I was able to traslate from his report. What stage do you think he is? I am not sure if there is lymph involvement or any sign of metastasis. Any help in understanding his status and probable course is highly appreciated. Thank you so much for your help.


Age: 58 Male SMOKING HISTORY: 37 years, 1.5 packs/day


57.5 X 64 mm. tumor on the right main bronchus and on the anterior of the upper lobe bronchus. Upper lobe bronchus has narrowed down almost completely due to the tumor. Right main bronchial back wall and upper lob bronchial wall has thickened. There is thickening on the right upper lob, around the bronchovascular structures.

A spicular mass of 32 mm. on the apical portion of the right upper lobe. Linear extensions from this mass to the pleura. (01/17/06)

45 mm. mass on the right hilus, wrapped around the upper lob bronchus, invading the the surface of the right main bronchus and the main pulmonary artery.

Enlarged right hilar and subcarinal lymph nodes. A 3X1.5 c.m. mass with irregular sides in the right apex. (01/23/07)


Pathologically increased 18F FDG uptake on the nodular lesion in the right lung upper lobe apical region (SUV Max. 25). Occasional moderate uptake in the fibrotic structures on the right upper lobe (SUV Max. 3.4). Patologically increased 18F FDG uptake on the mass legion in the right hillar region, on the anterior of right main bronchus and upper lobe bronchus that extends to the paratracheal and subcarinal region. Low increased 18F FDG uptake in the vertebral column and pelvic bone structures. (01/29/07)

BONE CINTIGRAPHY: Increased focal activity in the joints of both hands, no obvious pathologic proof of metastasis.


Bronchial lavage samples negative in malignancy (01/23/07)

Bronchial bronchial brushing samples negative in malignancy (01/23/07)

Non-small cell poorly differentiated malignant epithelial tumor, transthoracic fine needle aspiration biopsy. Cytological findings are inline with poorly differentiated adeno Ca. (01/30/07)

TREATMENT: Chemoteraphy Cisplastion 35mg/m2/day and Gemstabin 1000mg/m2/day, 21 day cycles with chemo on day 1 and 8.

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welcome to the boards here. Lots of great info available. What I would do for this info is check in our ask the expert Forum. You may want to cut and paste this report ther for a real accurate answer.

Dr. West is mour resident expert and a fully licensed Oncologist specializing i Lung Cancer at the Swedish Institute in Seattle Washington. He is also very prompt in his presponse and you can find a a Link in the Ask the expert forum. I would not hazard a guess on this question, But he is very good in this dept.

Sending prayers for better days ahead

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Hi Neighbor! :D

Very sorry about your Dad. Sounds like they have a good plan with aggressive treatment in place. I'm sorry he lives away from you, but seems like you have good contact. The others are right, please check with the good Doc West on his site for staging info.

My husband also was diagnosed with poorly differentiated adeno confined to his chest area. Is your Dad having difficulty breathing? Sounds like he might if some of the bronchial tubes are being collapsed by the tumor. The same thing happened with my husband. He has been on oxygen 24/7 since diagnosis and that has helped keep his strength up. I hope they have done blood oxygen level tests on your Dad.

If I can be of any help and you need to talk, let me know via email or pm.

Welthy (Debi)

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Welcome, I started with chemo and radiation before I had surgery , This month it has been 9 years since they removed my right upper lung. I Hope your Dad does as well. Keep us posted.

Donna G

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Thank you all for your help. I just got an e-mail from his doctor that says he is staged as Stage 3A. He had his second dose of Chemo yesterday and seems to be doing fine. I will contact Dr. West immediately and see what he thinks. I wish all the best for you all.


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I did exchange some messages with "gsoy" on Onctalk. It's hard to glean all of the details from the report. Although there's good detail, "a picture is worth a thousand words", and often there's no substitute for seeing the scans and seeing and working with the patient. It's an inherent limitation in what I'm doing. Although I can know the rules and the evidence and the general principles, in real life we bend those rules with patients all the time, and that's not a bad thing. Many of the people who have done very well on this site haven't been treated in a completely textbook way, and quite a few are better for that. There's still a place for seeing and working with the patient and dealing with their individual situation.

What I said in response, for those interested, was that the amount of disease sounds fairly bulky -- we usually use about 3 cm as a breaking point, above which the majority of lung cancer experts are much less inclined to recommend surgery. That's not to deprive anyone of anything, but rather in recognition of the fact that chemo and radiation can do a comparable job for stage IIIA, and probably better for the bulky stuff. I do favor a cisplatin-based chemo approach for treatment in stage I - III, where our treatment goal is curative. Overall, the data are a bit stronger with cisplatin than with carboplatin, although carboplatin has considerably fewer side effect issues.

The exchange on OncTalk is here:

http://onctalk.com/forum/general_discus ... recent=580

and a discussion on the questions about how to treat stage IIIA is here:

http://onctalk.com/2006/11/09/can-we-de ... iia-nsclc/

Good luck.

-Dr. West

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