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Dad's results, terrified.


Aub33

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My dad's mass was found 13 days ago, and after a long torturous 12 days of waiting for more definitive answers we finally got our answers..

We knew he had a mass in his lung, we knew it was malignant because of the ebus procedure he had, and based off of that we left the hospital  after the initial finding with a staging of 2b because of the size and it was in his nearby lymph nodes, he also had a pleural effusion that they drained and sent off to find out if that was malignant. He headed down to the huntsman cancer institute early this morning and had a pet scan and then met with his oncologist. He was told he has stage 4 small cell carcinoma, it has spread to his bones, and his liver. They say that it is terminal, and hearing that word makes me feel sick to my stomach, and leaves me with a world of questions. Does that mean it doesnt matter what treatments he tries he will ultimately die because it is terminal? He has stayed surprisingly optimistic, and determined to fight with all he has. 

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Aub,

Your dad's diagnosis is very serious. Given it is small cell, the most aggressive form of lung cancer, and given it is an extended stage presentation, it will be difficult to arrest his disease. But difficult is not impossible, especially now when new immunotherapy and combination chemotherapy methods are being introduced.

Some possibilities you might discuss with his doctors are:  Is precision radiation available to treat mets in his bones and liver?  This could reduce the tumor burden and allow time for the chemotherapy to work on his lung mass and lymph nodes. A more aggressive precision radiation approach would be to treat all tumors with precision radiation than follow up with chemotherapy and perhaps immunotherapy in combination.  The discipline that handles radiation is a radiation oncologist and you might arrange a consultation with that discipline to explore these avenues. You can read into precision radiation here.

Stay the course.

Tom

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Hi Aub,

I'm sorry to hear about your dad's diagnosis and supposed prognosis.  I understand the torture of awaiting a loved one's diagnosis only then to hear a grim prognosis.  Although my mom's lung cancer is different - she has non-small cell, she has been one to benefit from new (at the time) treatment options like Tom mentioned.  

I am glad your dad is currently optimistic as his state of mind will help him along his treatment journey.  As Tom said, there are aggressive treatments that can provide relief and help his body keep the cancer at bay.  Not only are there relatively new treatment options for small cell LC, but there are brand new options in the form of clinical trials.  I am assuming since your dad will be attending Huntsman, his docs will have information about possible trials as an option.

Please reach out to us with questions or just to vent.  As I said before, we understand what you and your family is going through and are here for you.

Take Care,

Steff

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His doctor didn't really want to discuss other options at this point.. he said he wanted to start chemo right away. He is going down for a brain MRI this evening and we are told that of the cancer has spread to his brain then immuno therapy is not an option. If it hasn't spread to his brain he will be doing chemo 3 days in a row day 1 would be the immunotherapy Atezolizumab day 2 would be Carboplatin and day 3 would be Etoposide and then every 3 weeks it would be repeated, and this all will start next week. The doctor told my dad he is very confident he will shrink his tumors but it will come back and when it does, it will not respond to medicine and it will kill him. My mom asked about other treatment options such as radiation but he said he doesn't believe they work significantly enough to make a difference. 

 

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Is the doctor you are speaking of an oncologist?  As Tom recommended, I also recommend seeing a radiologist oncologist...my mom's radiologist was very insightful when we went to see him with her recurrence.  Although it was recommended that she not receive radiation again, he was able to explain things much better than her oncologist and helped us to make an educated decision about her treatment.  A radiologist may have a much different opinion about radiation that your dad's doc.  Beginning treatment in the near future is important since small cell LC can be so aggressive, so following the current treatment plan while awaiting an appointment with the radiologist is okay.  He can also pursue a second opinion while undergoing treatment as well.  

I know things seem very grim right now and being told that if/when the cancer comes back, it will not respond to treatment only makes things worse.  While that may be true of current treatments, that may not be true for all of the new treatments that are being tested.  When my mom was diagnosed with her recurrence, it pushed me to realize that even if we can't currently "cure" lung cancer, it can be treated like a chronic illness.  The key is to have lots of different treatments to throw at the cancer to keep it controlled.  And that is what is happening today.  So, if your dad's doc says there will be no treatment options in the future for a recurrence, that doesn't mean there won't be something tomorrow, next week, or next year.   My mom's treatment options tripled in just 1 year between her initial treatment and the treatment for her recurrence.  Treatment advances are moving quickly in the lung cancer world.  

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