Hello from IL

[JimsMNL]

My mother n law recent diag stage 4 nsclc. Was having a hard time breathing. Recently, had tumor (on trach right before the split) hit with radiation for 10 days in hospital stay. Let out of hospital and was home for 3 days then breathing problem returned. Now back in hospital with a trachy.  Was a 3cm tumor, now they say its a 5cm.  Do the tumors grow that fast or is this just a reaction to the radiation?  Eveyones kinda freakin out.  Thank you.      Great site by the way.

[Tom Galli]

Jim,

Welcome here.

A couple of questions first. I'm unsure what you mean by trach and trachy. Are you referring to the location of the tumor, i.e. in or on the trachea?  Are you referring to a tracheotomy? This is an incision made at the base of the throat to assist with breathing.  Did she have a bronchoscopy (an instrument moved robotically down trachea and if needed further into lung to see and sample for tissue biopsy) biopsy for diagnostic purposes.

Did she have precision radiation? Was the radiation identified as SBRT, IGRT, IMRT. Here is information about radiation. It appears so because fractional general radiation is normally administered over 30 sessions. The reason I'm asking is precision radiation can sometimes cause swelling or inflammation around the tumor site and this sometimes can be reported as tumor growth. Yes, a tumor can grow by 2cm in a short period but not generally in 13 days.

When you say your mother-in-law is back in hospital with a trachy, do you mean she is breathing through a tube at the base of her neck inserted during a tracheotomy? 

Stay the course.

Tom

[JimsMNL]

Thanks for the reply.       Tracheotomy? Yes.  She had a biopsy. No full results yet. Confirmed NSCLC Adenocarcinoma.  Pinpoint radiation. She had to do breathing lessons. Not sure of type of radiation.  The tumor is around her windpipe just before it splits to each lung.  

[LexieCat]

Hi, Jim, just wanted to welcome you here. I have zero experience with (and not much more knowledge about) radiation as a treatment, so I'll leave that to Tom and others who know what they're talking about.

This is a great place for information and support. Good luck wishes to your MIL.

 

[LouT]

Jim,

Welcome to our forums.  I'm sorry to hear about your MIL's situation, but glad you found us.  Our method of support here is to share our own knowledge based on our personal experiences and to support those who suffer from or are caregivers to those who suffer from Lung Cancer.  Like Lexie, my experience does not include radiation treatment so I'll leave that to others who have gone through it.  

I just wanted to welcome you and let you know that we're here for you.

Lou

[Tom Galli]

Jim,

Okay, I understand. A tumor in or around the trachea is a difficult presentation. Now I understand her 5-day radiation course. It was likely precision (pin point) radiation. Also clear why she requires a tracheotomy.

The trachea is sensitive tissue and a radiation inflamed tumor might cause pressure around her trachea that leads to difficulty breathing. Because of its sensitivity, she'll likely not have further radiation. But, she might benefit from chemotherapy. Has she had a consultation with a medical oncologist?

Chemotherapy for NSCLC adenocarcinoma comes in 3 flavors: conventional chemotherapy (a doublet like Taxol and Carboplatin), Targeted Treatment (specialized treatment that attracts tumors that display certain tumor markers) and immunotherapy. She may start on conventional chemotherapy to gain immediate relief and knock the tumor back, then move to Targeted Treatment and or immunotherapy depending on the laboratory analysis of her biopsy. Or, she may be prescribed a combination of conventional and or Targeted Treatment or immunotherapy. Chemotherapy is prescribed by a medical oncologist, thus my question on her consultation.

More questions, ask away. We'll help you out.

Stay the course.

Tom

 

 

[JimsMNL]

Thanks for all the welcomes.  

Tom, she is getting steroids and breathing treatments at this moment and breathing much better.  They are gonna do more tests today to see what they can do. Apprently the tracheotomy was a no go because of the placement of the tumor.  She was getting set up with chemo, and then her breathing changed so here we are trying to get this straightened out. Im thinking a stent and radiation and chemo combo straight away, but im not a doc. She is in Iowa at the cancer hospital at this time. 

[JimsMNL]

Bio marker test is still on going. I hope there is a chance at a targeted therapy.

[JimsMNL]

I seen on other posts of what you all call a "triplet".  That was the plan until the breathing got worse.

[LUNGevityKristin]

Welcome and I'm sorry to hear about your mother-in-law's diagnosis.  Could the triplet still be a treatment once they get her breathing better under control?  

[JimsMNL]

Yes on the triplet.

  They are now in a wait and see.  The steroids are reducing the swelling enough for good breathing.  They are going to hold the weekend and see what the tumor does size wise.  They kinda got her, and everyone really, freaked out with, if the breathing worsens then its a breathing machine for a few days to try and put in a stent.  Holy smokes.  I say stent now wile the stentings good, but i dont wanna add to the confusion/anxiety of the situation.  Aaaahhhhh.............

[Tom Galli]

Jim,

I had three trachea stents put in and removed over the course of a year. Mine was lower in the trachea. While they worked, the irritation caused a lot of coughing and phlegm. 

Stay the course.

Tom

[JimsMNL]

Her tumor is right were the tube splits to each lung.  Not a good spot i guess.  I dont know whether to push for the stent now or not.  Confusing stuff.

[LexieCat]

In my own experience, unless I have some reason to ask to do something other than what the oncologist recommends, it's best to go with it. Nothing wrong with asking why it can't be done sooner, of course, but if you're given an explanation and don't have grounds for pushing it, I'd assume the oncologist knows what s/he is talking about. 

[JimsMNL]

I agree, and feel, as well as the Doc's do, that she will be ok without the stent right now.  Just want the best outcome for everyone involved and you start to second guess.

Esp. when all this info is coming in hot and heavy.  A lot to dissect, and not much time to do it.  So it feels anyhow.  

[LexieCat]

Oh, I know! But second-guessing can make you nuts. Lung cancer is very iffy from the get-go. There is a lot more they can do today than used to be possible, and sometimes that can make the second-guessing even worse. The more options you have, the more you think, "Would this be (or have been) better than what was done (or what I decided on before)?"

I've learned to make a decision and go forward with it until/unless it no longer makes sense. And if the outcome isn't what I'd hoped for, oh well. None of us (including the docs) has a crystal ball. Every patient and every cancer is different and there's no way to know what will be the very best decision in every situation.

Hang in there.

[JimsMNL]

Thanks. 

I will start a new thread and let you all know how it goes.

Thank you everyone for the welcomes and answers.