How common to have two unrelated cancers?

[nimo956]

My father has recently been diagnosed with a 3cm adenocarcinoma in his lung.  On its own, this would be right on the border between stage 1a and 1b I believe.  However, his PET scan showed a possible 13mm metastasis on his rib.  We had it biopsied and I received an email with the results before being able to speak to his oncologist.  We were supposed to meet this week, but he had to reschedule since not all of the stains were finished, and he wanted a radiation oncologist to join us as well.  

The results say that the metastasis is cancer, but the primary source is the prostate and not the lung.  Does this mean he has both lung and prostate cancer?  I'd really like to know if it's more treatable to have stage 1a lung cancer and stage 4 prostate cancer as opposed to just stage 4 lung cancer (supposedly prostate cancer is very treatable?).  I'm going a bit stir crazy since it's a long weekend, and we won't be able to speak to a doctor until Tuesday at the earliest.

Does anyone know what questions I should ask the oncologist?

[Tom Galli]

Nimo,

Welcome here.  Sorry I missed your post yesterday.

First some questions: (i) what was the basis of diagnosis of adenocarcinoma? (ii) did the PET occur before the diagnosis of adenocarcinoma or after? (iii) did the PET show adenocarcinoma in the lung, metastasis to the rib, and metastatic activity in the prostate? (iv) I assume the 13mm met is in the rib not on it, correct?

I've known of people who've been diagnosed with two different cancers.  Most common of these is lung cancer and a slow growing type of prostate cancer.  But assuming the adenocarcinoma diagnosis was validated by pathology examination, prostate cancer was validated by pathology examination, and the PET showed metastatic involvement in the lung, ribs and prostate, I'd assume your dad has stage 4 prostate cancer with a lung cancer tumor.  If this assumption is correct, the larger challenge will be treating the stage 4 prostate cancer.

If the lung tumor is confirmed as adenocarcinoma and all other tumors are confirmed as prostate, it may be possible to use stereotactic body radiation therapy (SBRT) to address the lung tumor, then treat stage 4 prostate cancer with chemotherapy.  Alternatively, perhaps the idea is to use external beam radiation therapy (EBRT) to address the lung and rib metastasis. Radiation can be used against both types of tumors and perhaps that is why the radio oncologist was essential to the consultation.  My understanding is that chemotherapy recipes for lung cancer and prostate cancers are different.  But, all of the aforementioned are my assumption and speculation.  I'm not a doctor and could be wrong.

The fundamental questions to ask the oncologist are: does he have two different forms (lung and prostate) of cancer? What stage is each form of cancer? What is the treatment plan?  Are there chemotherapies that are effective against adenocarcinoma and prostate cancer?

Let us know after the Tuesday consultation.

Stay the course.

Tom

 

[LaurenH]

Hi, Nimo,

Just wanted to check in and see how you and your dad are doing. Please post an update when you can.

We are here for you.

Lauren
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Digital Community Manager
LUNGevity Foundation