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I was on this forum for a time in 2007 when my little sister was sick for only 15 weeks before she died. My brother died in October 2018.of lung cancer and now my dearest friend of 48 years has stage IV metastatic lung cancer (he was IIIB 15 years ago, had a wedge resection 3 years ago). He is 76 years old. 

He may not be a candidate for treatment.  His PDL1 score was 22% and they told us he may be eligible for a combination of immunotherapy and chemotherapy.  He also has kidney disease, IBS, heart failure, and is already on O2. 

Our dilemma is likely like everyone's. Do we try treatment or just enjoy life to the fullest without him enduring side effects of treatment. No one has a crystal ball and they told us treatment will prolong his life and not be curative.  

Thoughts? Also, should we get a PET or pass because of false positives? Thank you. 

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I truly understand the dilemma. My grandmother was diagnosed with SCLC when she was 82 and she took all of the steps she could. Her cancer was aggressive but that treatment allowed her 13 months after diagnosis.  When I was diagnosed, I told Super Doc that we'd do whatever it takes to keep me going. I was scared of chemo side effects but they were very well managed.

Depending on the chemo and immunotherapy cocktail, his side effects may not be too bad. He will just have to decide what's most important. What does his medical team say about the PET?

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Oncologist said there are many false positives but will do what we want. Because of his heart failure they told us that stroke or heart attack are possible side effects.  We are having trouble discerning what to do. 

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Indeed this is a difficult decision. Lung cancer plus other significant health problems do complicate a treatment decision. I can't tell you how to help make this decision.  I can only tell you about my decision.

In my third year of treatment and after my third recurrence, I was running out of treatment options.  Only old style chemotherapy (Taxol and Carboplatin) was available and while it was having an effect on tumors, it was not eliminating them.  We were then at the junction of your decision dilemma and investigated hospice. I was 57 years old and not pleased by the prospect of an early demise, but my research (more truthfully, my wife's research) discovered life with end-stage cancer and chemotherapy was a very hard row to hoe.  We chose the hospice path because there was no treatment available to eliminate my disease. Fortunately a new FDA approved precision radiation treatment commonly used for brain tumors was approved for lung cancer, and my doctor suggested that method.  Absent that new method, I wouldn't be writing this.

Our decision was made and overturned for the same reason: eliminating my cancer.  I didn't want the nightmare of recurrence, and I didn't want to live out my life having infusions every three weeks. But, this new treatment method could and did eliminate my cancer.  Eliminating cancer is what we focused on.  We'd already had a long course of life extension through treatment. I didn't have any complicating health problems; lung cancer was hard enough!

Welcome here.  There is a lot of wisdom in these forums.

Stay the course.



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