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Anees

Stage 4 Lung Cancer with Brain Metastases

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Hello Everyone,

My father in law is 74. Although he was very skinny but he was very healthy up on till October 2018. Four months ago he had a pneumonia and the doctors found out that he has non-small lung cancer / non malignant. There were no metasteses at that time and other organs, bones brain etc were clean. There were spots on right lower and middle lobes and also few spots on left lung. While he was recovering from the pneumonia he had a second pneumonia attack which made him too weak to even stand on his feet.

Since he wasn't in the country it took him couple of months to improve a little bit so he could travel back to Canada. However last month he traveled back and he was not only little confused (forgetting words) but also very week. When we took him to emerge, doctors found out that the cancer has been spread and he has few brain mets. MRI has been done today and they found out that there is a bigger met right at the end of the spinal cord behind the head. They are going to do Surgery to remove the bigger met and then they will start with full brain Radiotherapy. 

As far as my fathers condition is concerned, he was confused but soon after taking the steroids his confusion was gone. He eats well, sleep well , could walk by the help of walker and use toilet. Only yesterday all of a sudden his Pulse and Blood pressure jumped up and had severe seizure like shaking but the ICU team was able to control it. Today hes going for head surgery to get that big met out.

We are really confused as to what is going to happen. Anyone who went through same conditions please share your story ?

We are not sure what to expect ? Would radiotherapy work ? Is it still curable? Will they be able to remove the cancer cels from the lungs without surgery ?

 

 

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Anees,

Your father-in-law has lot going on. While I've not had a brain met, I've had metastatic non-small cell lung cancer and three thoracic surgeries.  I'll answer your questions to the extent of my experience.

I think it is reasonable to assume the surgeons will remove as much of the spinal met as possible surgically.  And yes radiotherapy after surgery will work and his scheduled whole brain radiation will focus tumors that are two small to see or remove.  

Is his cancer still curable? We don't use the word cure in the lung cancer community because lung cancer frequently recurs after successful treatment. We hope for a condition called no evidence of disease or NED, and in your father-in-law's case, is NED possible.  However he's just been through back-to-back pneumonia battles that may have caused or exposed complicating health problems. 

To remove tumors from his lungs he may have combination of conventional radiation and chemotherapy.  His spinal met will be biopsied and when his type of lung cancer is known from the biopsy (large cell, squamous cell or adenocarcinoma) he may be given targeted therapy or immunotherapy, either as a substitute for chemotherapy or in combination with chemotherapy. These treatments are new to lung cancer and are in fact capable of addressing lung tumors effectively.

What can you expect?  I think it is reasonable to presume a successful surgery that hopefully removes all the tumor.  After 3 to 4 weeks of healing, he'll likely have a scan to check for additional brain mets before starting whole brain radiation therapy (WBRT).  WBRT is fractional radiation so he'll have daily sessions each about 10 minutes in length.  The number of fractions will be determined by a radiation oncologist and what is seen on the post op scan. He'll likely have WBRT before starting treatment for his lung tumors.  But these could be concurrent depending on your father-in-laws state of health and Canada's standards of treatment care.

Welcome here.  We hope your father-in-laws surgery is successful.  Please don't hesitate to ask follow up questions.

Stay the course.

Tom

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