finishing Altima. What's next???

[LisaAF]

My father was diagnosed with stage 3 Mesothelioma. He will be finishing up is chemo (Altima) next month. Although a scan hasn't been done yet it is obvious to the Dr. and my father that the tumor has shrunk. We have no idea what comes next.

Do they usually start chemo again after a certain amount of time? Any information on what happens next would be appreciated.

[RandyW]

what happens next depends on what the next scan shows basically. You will have to wait and see what scans show from alimta treatment to determine the next step. Right now we play the wait and see game ands of course pray for great scan results. And of course I will say a prayer for great results, also.

[LisaAF]

Randy, thanks for the information but even more for the prayer.

I know this cancer is incurable, but is surgery ever performed in an atempt to remove the tumor? The Drs. are unfortunately way to busy with so many cancer patients to give us any info new treatments.

[Don M]

I think Dr West has addressed Meso, it's treatment and possible surgical treatments.

http://www.onctalk.com/bbPress/

Don M

[LisaAF]

Thankyou Don. We're new to this and having a hard time finding answers.

[fillise]

Lisa,

this is a great place to find answers. It sounds like your Dad is making progress and that always sounds good!

Susan

[sbf815]

scans are done and usually as long as it is working they will keep him on the alimta because it isn't that bad. If it is not working they will go on to a different chemo. Hopefully the chemo has worked well enough that he can have surgery. This is very important: You have to find a doctor that specializes in mesothelioma. Regular oncologists don't deal with meso all of the time because it is rare. We deal with our oncologist here but all orders come from Dana Farber in Boston. There have been so many times that regular oncologists have given late stages and then when seen by a meso specialist it isn't that bad and surgery can be done. Of course surgery is not a definite cure. It can help or it can make it worse so there are many hard decisions to make. We see one of the head surgeons at Brigham and Women's who works with Dr. David Sugarbaker who is the best in world. He has designed special tools to do the exptrapleuralectomy that is done to remove the lung, lining, lining of heart and some of diagphram. Then a new heart lining and diagphram are made with gortex. I actually watched the surgery live on the Brigham and womans web page. It was amazing. Good luck. I am praying for you.

[DrWest]

Although I don't see as many mesothelioma patients as they do in Boston or Chicago or a few other places, I see a fair number of these still unusual patients (far smaller numbers out there compared to lung cancer, and many too sick to be candidates for aggressive therapy). There is still some question about how much surgery really adds, because the patients who can have surgery are a selected subset of people who tend to be healthier and have less extensive disease than the "average" meso patient (as if there is one), so they would likely do better than the general meso population anyway. Still, many leading centers do pursue surgery, often combined with chemo and sometimes radiation, for the more fit meso patients with less extensive disease.

In the majority of patients, who aren't going to surgery, we can potentially give chemo for a prolonged period, but if patients have responded well to 4 or 6 cycles of chemo, I often stop chemo and follow them off of treatment. Some have been able to go a year or more before showing enough progression to warrant restarting chemo. Chemo does take a cumulative toll on the body, so I favor spreading out the chemo over time rather than just hammering a patient with chemo constantly, especially if their mesothelioma has responded and there is no urgent need for more chemo right away.

In patients who show progression on first-line chemo, which often consists of a platinum with alimta, or sometimes alimta alone, there are other chemo agents that can be tried, such as gemcitabine and/or navelbine, but unfortunately the vast majority of cancers tend to become less responsive as people move from one line of treatment to the next.

-Dr. West

[LisaAF]

Thankyou all so much for your responses. We've felt so isolated with this.

As I said my father was diagnosed with stage three, but he isn't showing the symptoms that should accompany that. Is oxygen levels are high, he doesn't have a cough, just this terrible pain that comes from the tumor growing between his ribs. Luckily this has improved greatly with the chemo. They are giving him two different chemos but I can't remember the second.

[utahLisa]

You both have made my day! I haven't checked this site for a while since I didn't hear any replies from any mesothelioma patients. I know that this is so rare and just knowing that there are others out there going through the same thing helps more than words can say. I will keep you both and your families in my prayers. I, too, have been wondering what is next after Alimta/Cisplatin. My mom has gone through her first two rounds and is doing amazingly well. She's fatigued but has done great. She is determined to make it through the next six treatments and hopes she will be cancer free. My mom didn't want to know the prognosis of this disease. She deals better with just doing what she's told and holding onto hope. She thinks this will be curable and we've decided that it's best for her to handle it this way because she's fighting so hard. I beleive she is probably in stage III since they found some cancer in a few small lymph nodes. Her cancer is surrounding her entire chest cavity and a bit into the lung. She is not a candidate for surgery, or so they say, and radiation is not an option. We are fearful but holding onto hope and know that God's will is perfect. Any information is sooo appreciated. Thank you with all my heart...it helps immensely to know that someone else is carrying this same burden.

Please e-mail my any time...utahungers@yahoo.com...I will check out the site you mentioned, Stephanie, and e-mail you directly...thank you for that so very much!!!!

Take care, Lisa

[utahLisa]

me again...so sorry, I thought I was posting a new message and had responded to you, Lisa, and Stephanie in the last post. I am so new to this forum...please forgive my oopsies!!!