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Wife with Stage 4 Lung Cancer


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Good morning.  I am here to try and get some clarity on my wife's expectations.  The medical community is not really forcoming with what to expect at my wife's cancer progresses.  It has spread to the bones and brain.  We had a Gamma Knife proceedure last week for the brain cancer.  She is 65 and been a smoker all her life. Guess I just want some idea on what is coming next.

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Hi Ran,

I wish I could tell you what to expect when it comes to lung cancer.  I can promise lots of ups and downs, highs and lows, good days and not-so-good days.  My mom (63 years old) is currently battling a NSCLC recurrence and is currently on Keytruda (immunotherapy).  So far, the cancer has not spread outside the surrounding are of the lung (I am knocking on wood right now), so I do not have any personal experience when it comes to bone or brain mets.  She went from being in and out of the hospital for nearly 3 months to feeling great for the past 3 months.  Now she's feeling shortness of breath and are currently investigating what's going on.  I think one thing I can guarantee you is regular moments of uncertainty for you and your wife.  As soon as my mom and I feel good about what is happening, she gets knocked down with some other challenge.  Her current shortness of breath is just another challenge for us to deal with.

From my experiences with other loved ones having lung cancer and eventually passing away from it, everyone's journey seems to be different.  Eventually all of the folks I know received palliative care assistance for pain management and then hospice care.  Is your wife to the point where she needs either of these services?   

It is my understanding that Gamma Knife can be very helpful for brain mets.  Is she receiving anything for her bone mets? Any other treatments she is doing?

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Welcome here.

Like Steff, it is hard to predict what comes next.  

If the GamaKnife zaps her brain tumors, perhaps your radio oncologist might dial up precision radiation for bone mets.  Alternatively conventional radiation for bone mets is often successful.  I'm assuming you are seeking curative treatment from your mention of GamaKnife. Here is information on radiation you may find helpful.  Select the right arrow titled: What are the different types of external beam radiation therapies (EBRTS).  Standard EBRT would be the conventional type while all others are precision types.

Has she had a biopsy? If not a biopsy would be a next step.  Has lung cancer been diagnosed? You mentioned bone and brain mets, but normally there is a primary tumor somewhere that causes the distant metastasis.  From the two different locations you mention, and assuming there is a primary mass, your mom would stage at 4.  So, she'd could have first-line therapy that may consist of a pairing of chemotherapy and radiation, perhaps tailored to address the primary tumor and bone mets. First-line treatment is a national standard of care; it is the combination therapy that is most effective for most people.

If your wife has a primary tumor, and if it is the lungs, I can provide more information.  Please let me know.

Stay the course.


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Hi Ran and welcome here,

You have heard from two of the best, Steff from the caregiver's point of view and Tom from the survivor's point of view. I don't have much to add to what they said.  This forum is a good place to find information, support and hope. Stay with us and let us know how we can support you.

Bridget O

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