Continue chemo?

[Stephanie2024]

I am 46 year old Chinese female diagnosed with Stage IV lung cancer.  I started chemotherapy and Tagrisso.  So far I have done two rounds of chemo.  My most recent brain MRI shows the brain mass shrinking from 6mm to 3mm.  My lab metrics are all trending down, some dropping below normal ranges.  I wonder if I should continue chemo therapy (2 more rounds remaining).

[edivebuddy]

Sorry you're dealing with this and so very young.  Too young to be giving up while therapy is working.  The addition of chemotherapy to tagrisso reduces the risk of recurrence by 38%.  For tagrisso that's huge.   You have a very good chance of managing this disease for a long time. especially if you can get it into full remission. Chemotherapy is doing that for you.

If you expect to have your blood numbers to be normal it's not realistic. The doctors are really good at figuring out your numbers and what they mean or if there's a problem. And if there is, stopping treatment is usually NOT the first or prudent choice. 

I did 7 rounds of chemo. My blood numbers were NEVER in the normal ranges. Twice we had to delay my infusions to take care of problems but we continued.  I achieved a full remission over 3 years ago. Stage IV. END Stage presentation with cutaneous metastasis.  Additional metastasis' to the brain neck and liver. Plus stage 3 poorly differentiated squamous cell carcinoma of the head and neck just because the lung cancer wasn't bad enough. 

 

 

 

 

 

 

[tgif i guess]

carboplatin, alimta and keytruda

about 8 months in, remission so carboplatin was discontinued - still on alimta and keytruda

while on carboplatin, i had a udenca shot the day after carboplatin

my bloodwork remained remarkably normal until the last few months - but now my red blood cells are low

i think udenca is a neulasta generic - but there are treatments to get your bloodwork back in line (i think udenca is for white blood cells)

if you are otherwise tolerating chemo, i'd stay the course

[Stephanie2024]

9 hours ago, edivebuddy said:

Sorry you're dealing with this and so very young.  Too young to be giving up while therapy is working.  The addition of chemotherapy to tagrisso reduces the risk of recurrence by 38%.  For tagrisso that's huge.   You have a very good chance of managing this disease for a long time. especially if you can get it into full remission. Chemotherapy is doing that for you.

If you expect to have your blood numbers to be normal it's not realistic. The doctors are really good at figuring out your numbers and what they mean or if there's a problem. And if there is, stopping treatment is usually NOT the first or prudent choice. 

I did 7 rounds of chemo. My blood numbers were NEVER in the normal ranges. Twice we had to delay my infusions to take care of problems but we continued.  I achieved a full remission over 3 years ago. Stage IV. END Stage presentation with cutaneous metastasis.  Additional metastasis' to the brain neck and liver. Plus stage 3 poorly differentiated squamous cell carcinoma of the head and neck just because the lung cancer wasn't bad enough. 

 

 

 

 

 

 

 

[Stephanie2024]

Thank you so much for your response and for giving me more hope!  

[Stephanie2024]

Thank you for the suggestion for drug to boost my blood cells!  I’ll discuss with my oncologist.

[BridgetO]

Hi Stephanie and welcome here. Edive buddy is right that expecting blood levels to stay the same isn't realistic.  Neutrophils- white blood cells that fight infections- especially take a beating, My lung cancer was stage 1a and I didn't need chemo., but 12 years ago I had a different cancer that was stage 3 and aggressive. Chemo caused my neutrophil count to dip and the second time it went to zero, an emergency situation. I was given antibiotics to stop possible bacterial infections . After  subsequent infusions I had neupogen, given by injection, and it kept my neutrophils from crashing again.  I also had an infusion of packed red blood cells when anemia reached a dangerous level. My treatment was 12 years ago and I have been NED (no evidence of disease) since.

My point is that if blood levels of anything reach a dangerous level, there's usually some action that can be taken to remedy the situation- medication, biologicals, supplements, postponing your infusion until the level rises, etc. It usually isn't a reason to discontinue a regimen that's working.

Advanced cancer of any kind is life-threatening and treatment often needs to be aggressive to control it. So hang in there, talk to your oncologist about the significance of each level that's low, and what if anything needs to be done about it. Hang in there and I wish you a long and meaningful life.

Bridget O

[Stephanie2024]

Thank you for your feedback last time!  I finished four rounds of chemo and it’s been three months since I started treatment for Stage IV lung cancer (chemo and Tagrisso).  I  just completed MRI and PET scans.  Brain MRI showed the met is gone.  Other MRIs show some abnormalities in my spinal cord and bones are showing improvement.  My PET scan showed decreased but still metabolic activity in lung and pelvis.  Is this expected?  I was disappointed that there is still active cancer in my body after chemo and hoping that I wouldn’t have to do radiation.