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Komal

Treatment with IGRT and concurrent chemotherapy

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My Dad is in 2nd week of his radiation therapy with IGRT and chemo. The doctors tell us that it will be 3 months before they can do a CT scan to find out the effect on the tumors.

Is that the normal process? Are there any indications during the treatment that would indicate that the tumors in his lymph nodes is getting smaller?

We are facing lot of anxiety as we have heard some bad stories about incorrect/inefficient radiation treatment and want to safeguard against them.

 

Thanks much

Komal

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Hi, Komal,

Yes, from what I understand that's pretty much the normal interval for scans.  You probably won't be able to tell anything in the meantime, unless the tumors were in a place where they were having an effect on some other structures--pressing on a nerve, for instance.  

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Komal,

The first in treatment scan is normally half way through first line therapy. 

What is his treatment cycle? Is he having daily radiation with weekly chemo? How many treatment cycles are planned?

Stay the course. 

Tom

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Thanks for the replies. He has a 7 week cycle, running Monday to Friday radiation with Chemo on Friday. He will be going in 3rd week now. His tumors are around the eseophagus and could barely eat. Is it fair to expect as the treatment progresses he should be able to take more food by mouth? He has an NG tube installed for feeding. Otherwise should we request for a scan midway?

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Komal,

Sounds like your dad has esophageal cancer. While there is some treatment that is common with lung cancer, esophageal cancer has different methods and drugs.

If he has a NG tube already installed, your question is will further radiation and chemo treatment allow him to take food by mouth.  That is tough to answer.  The radiation will likely shrink his tumors but the esophagus may become inflamed from the radiation and that could inhibit eating.  So, I don't know.  I hope he is allowed to resume normal eating.

A scan midway through first line lung cancer treatment is pretty common.  I wouldn't know if it is common or not for esophageal cancer but his doctor would know.  Best ask the doctor about a mid-treatment scan.

Stay the course.

Tom 

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Hi Tom, his diagnosis  is 'Poorly differentiated adenocarcinoma of pulmonary origin'. It is stage IIIB so has metastized to lymph nodes, I guess that is why it appears to be esophageal cancer. So this doctors recommended IGRT + Chemo. I checked with the doctors and they have ruled out a mid-treatment scan, maybe different protocols as he is being treated in New Delhi, India.

I guess we will have to wait for a few weeks before we find out the effect of treatment on the tumors.

Thanks again.

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Hi, Komal,

We just wanted to check in and see how you're doing. Please post an update when you can.

We are here for you!

Lauren
--
Digital Community Manager
LUNGevity Foundation

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Hi Lauen,

Thanks so much for checking. As an update my father is in his last week of Radiation/Chemo cycle and is really feeling it hit him now with fatigue, nausea etc. His next scan is due after 3 months and then we will find out how the tumors have responded. In the meantime he is advised just rest and recovery and considering on his ability to eat / drink might remove the feeding tube.His biomarker testing came negative for EGFR and the rest of the results are pending.At this time we are planning what should out next steps be? Should we consult and see if surgery is now an option for him, maybe something like cyberknife to remove any leftover tumor?

The doc wanted to start Durvalumab at some point and unfortunately that medicine was taken off from sale in India. So we are looking at all alternatives and any suggestions are welcome. The lymph nodes that are the biggest are in the subcarinal region..is there any surgery that can remove those lymph nodes?

Regrads,

Komal

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Komal,

Surgery after IGRT radiation? Not likely unless the affected lymph nodes were not the target of radiation.  If they were, suture healing would be compromised by irradiated tissue. 

I am not familiar with treatment protocols in India so I can't suggest further treatment.  But in the US, one might seek a clinical trial depending on the results of the balance of the biomarker test.

Stay the course.

Tom

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