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Wait for mutation testing or start chemo right away?


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Hi Everyone!

So glad I found this site- everyone seems so helpful!

My mom was just diagnosed with Stage IV NSC Adenocarcinoma. Never smoked.

They did most tests but it will take 2-3 weeks for the mutation testing to come back- if it tests positive Dr. will recommend Tarceva.

My question is this: Are there any pros or cons that you know of to starting chemo in the meantime? Of course my mom is hoping to do Tarceva instead but I would think it is beneficial to start chemo in case she tests negative.

Has anyone gone through this? Any answers would be deeply appreciated.

God Bless you all!

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Hi. So sorry about your Mom. I'm sure others will respond with much more helpful info than I -- there are so many people with so much to share on this site. I can only tell you that my mother started treatment without any kind of genomics testing (I was very anxious for her to get started right away) and she went through a whole course of treatment without any real success. Then, a new doctor sent her biopsy out for the genomics testing to determine the best course of action, and she is now undergoing a different combination of drugs. We'll see how that goes. So, I'm not sure how to answer your question. It probably can't hurt to start the chemo, but on the other hand, my Mom's doctor then needed her to wait a month to get the current treatment through her system before starting the new drugs, so it may be better to wait the two weeks. I assume that the test will not just tell her whether Tarceva is an option, but perhaps tell which other chemo drugs she'll be most likely to respond to. That was the case for my Mom. Best of luck with this difficult decision making. Wishing the very best for your mother.

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I think they are just testing for the EGFR mutation to determine if Tarceva would be a good first line therapy. Over on Cancergrace, the doctors just wrote up an answer to this question. Look at responses 9 and 10 from the doctors. Very helpful.

http://cancergrace.org/forums/index.php ... 4#msg54494

How is her current health status? Waiting two weeks if she has serious symptoms and is getting worse may not be advisable. If she has no symptoms and is feeling well, it might be worth waiting rather than get into the chemo cycle. Few go through it without some serious side effects.

Best to you and your Mom. I hope whatever treatment does the trick.

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Hi and welcome. Sorry you have to be here. I wish they had enough tissue to test me for the mutation. In the meantime, I've been on several other chemo and am finally on Tarceva. I would wait. Everytime you start a different treatment, each has it own set of side-effects and problems to deal with. It gets exhausting. If this test can offer her the treatment with the highest likelihood of success, it's a good thing. Most of us rush into treatment because we are scared to death and sometimes second-guess it. Keep in mind Adenocarcinoma is relatively speaking typically a slow growing cancer.

Good luck to your Mom.

Judy in KW

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Hi Ariel,

I'm with KW Judy. Any kind of chemo has potentially harsh side effects. If she starts now and the testing shows she needs a different kind of treatment, she may have to delay that treatment due to the side effects of the one she would take now.

Two weeks is a short amount of time. I'd wait. I agree that most of us are so anxious that we want to start something immediately. But I think they are wise in doing the testing and waiting for the next course of action.

Cancergrace.org is an excellent place to get more information!

Judy in MI

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