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Game plan for mom!!!


shineladysue

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We finally have a game plan for mom. She had wedge section surgery on May 2nd in which two very small tumors were removed. One adenocarcinoma and one bronchioloalveolar carcinoma. The lymph nodes were clean. She has had two follow up appts. with the surgeon and chest xrays which looked good. She has also met with her pulmonologist. Yesterday was the BIG appointment with her oncologist. What a kind, sweet and compassionate man he is .. He seems to be very knowledgeable and was well informed of all information on her case when we arrived.

For now, the plan is as follows. He wants her to have a PET scan to establish a base from here and he is prescribing Tarceva for her with a follow up scan planned for 6 months from now. He will be keeping tabs on her in the meantime, along with her surgeon and pulmonologist. Hopefully, all of that is going to come together with a negative PET and no complications with the Tarceva. That's what we are praying for , anyhow. Hope we can count on all of you for a few good vibes and prayers as well. Will let you know how things go. Mama has such a strong will to live. She is doing very well at the moment. She has regained most of her presurgery strength and is willing to try what she can .

Take care all and know my prayers go out to each and every one of you. When I come to this board, I find I just pause a minute to pray for everyone. God Bless.

Love,

Sue

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I'm not sure how often Tarvceva is given as adjunct chemo , but the oncologist is taking many things into consideration. One of her tumors was that of the non smokers variety , she is 78, has emphysema, is a diabetic and has A-fib.

Dr. West, if you happen to see this, I would appreciate your input or perhaps I will ask the question on your site.

Sue

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Lots of prayers from me for your mom and that Tarceva is gentle and a complete success for her.

hugs and more hugs for you and your mom. Sounds like things are starting off very well!

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The value of tarceva after surgery is really an open question. If there is any type of patient in whom it would make sense, it's a never-smoker or otherwise someone known to have a tumor with the EGFR mutation, and also has other medical problems or some reason not to do chemo. Perhaps even more appealing an idea for a patient in late 70s or later. The hope would be that you could get the same kind of benefit that you get from chemo in many patients, but with tarceva being likely to be particularly effective in never-smokers or those with an EGFR mutation. But at this point, the only real evidence we have for post-op treatment is with chemo. There's a trial being done, called RADIANT, in which half of the patients get chemo and half get placebo after surgery (and chemo if patients are going to do it), and this is just for patients with EGFR protein or EGFR gene amplification (as measured by a test called fluorescence in situ hybridization, or FISH). I wrote a post about the trial at my website, here:

http://onctalk.com/2006/11/12/radiant-trial-adjuvant-egfr-inhibition/

But it'll be years before we KNOW if tarceva is helpful or not.

In the meantime, it's a complex issue that I think is appropriate to discuss carefully with a knowledgeable oncologist, which it sounds like he is.

-Dr. West

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Dr. West,

Thank you very much for your reply. My mom quit smoking 22 years ago and one of the tumors was the type of a non smoker. She is 78 years old, has severe emphysema, was on oxygen prior to the cancer diagnosis and still is, was on venilator 2 days after wedge-section and is not a candidate to have a lobe of her lung removed. So, her fragile condition does enter into the decision. Just praying for the best. Overall, she is pretty strong now and getting around pretty swiftly , but she does use a walker.

She just had a PET scan the end of last week which we haven't gotten the results of yet.

Again, thank you for your opinion.

Sue

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Geez, Sue, somehow I totally missed this one :oops: . Glad things are moving in the right direction. And you know you AND your mother are in our thoughts and prayers here. Hope things continue to improve. And BTW....how have YOU been doing?

Love,

Kasey

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