Chemo for Lung Cancer Archive Questions

Below are Dr. Edelman’s answers to Chemo for Lung Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 15 of 58.

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Q : 1 07/13/2009	My father was diagnosed with non-small cell lung cancer (NSCLC) in August 2007. He never smoked nor was he ever exposed to dangerous chemicals. He has stage 3 NSCLC with a growth of 4" on the left lung and 3.5" on the right. He endured chemo for 6 sessions and completed in April 2009. Now they want to put him on another session of Chemo. There has been no growth mentioned since the last diagnosis. Should we get a second opinion? Lung cancer in people who have never smoked can be a very different disease than lung cancer in smokers. In particular, this type of cancer is frequently associated with mutations of the EGFR and ALK genes. Certain drugs have significantly greater activity in this group of patients. Your description of his disease does not completely correspond with the stage and therapy you indicated. I would advise a second opinion. If you wish to be seen at the University of Maryland, please call 410-328-7904 and speak with Rosemary or Gary.
Q : 2 06/08/2009	Can chemotherapy help a person with stage 3 small cell lung cancer that has spread to the kidneys and the lymph nodes? Small cell lung cancer is an extremely aggressive disease. If it has spread to the kidney, then it is considered "extensive" or a stage IV disease. There can be considerable benefit from chemotherapy, in the form of marked symptom improvement and extension of life. As always, not every patient benefits and it is certainly possible that one can get all the side effects and none of the benefits. However, if an individual has not received any chemotherapy for small cell lung cancer, I would recommend treatment as the majority of patients do benefit from the therapy.
Q : 3 05/01/2009	My mom had colon cancer in February 2008 and at that time had a small spot on her left lung that was removed and ruled benign. She went through chemo and she was clear of cancer in October. Recently, she's had some shortness of breath and after having it checked learned that there is a mass on her right lung the size of a grapefruit. Realistically, could this be cancer? If so, can it be treated? Her blood tests are all completely normal to date. It is certainly very possible that the mass in the right lung is metastatic colon cancer. It also could be another, independent primary cancer. In either event, it does not appear to be related to lesion that was on the left lung. She will need a biopsy of the mass for further evaluation. If it is cancer, the therapy depends upon the type of cancer. Treatment will be very different depending upon whether it is metastatic colon cancer vs. another type of cancer (i.e. primary lung cancer). In the former case, therapy will depend upon whether there are other sites of disease. In the latter, therapy will depend upon the type of lung cancer, stage and other medical issues. Blood tests for the detection of cancer are generally not very useful for lung cancer and are of only marginal utility in colon cancer.
Q : 4 04/23/2009	My wife was diagnosed with stage 4 lung cancer that has metastasized to the liver and the bone. She is 49 and in good health. We are now four months into treatment and there has been shrinkage shown in the lung and even more in the liver. Her oncologist has said that most of her liver is fine. Does the amount of cancer in an organ make a difference in prognosis? Unfortunately, metastatic disease is always worse than localized disease. Patients who have many cancer sites and bulky disease generally have a worse outcome than those with a lesser tumor burden.
Q : 5 03/21/2009	Are cigarettes today more harmful than the cigarettes from the 40's and 50's? Are Newport cigarettes one of the worst cigarettes for you? I have been smoking for a year and don't smoke a lot. I never have more than one or two in a day. If I only smoke for a few more years, could I still get lung cancer, emphysema, or develop heart disease? All cigarettes are dangerous. There is no truly safe type of cigarette. The risk of diseases like heart disease, emphysema, blood vessel disease (which could lead to impotence) and cancer (head and neck, lung, esophageal, bladder etc.) increases the more and the longer one smokes. There is no "safe" duration of smoking. Furthermore, smoking is highly addictive and it gets harder to quit the older you get. The sooner one quits, the better.
Q : 6 02/23/2009	I had an abdominal Ct Scan, and a 4mm nodule showed up at the base of my left lung. Two months previously, I had several chest X-rays and they were clear. I am 77 years old. How often are these tiny nodules cancerous? What else could they be? Pulmonary nodules are very common. These are occasionally cancerous. The risk depends a great deal upon exposure to tobacco and other carcinogens. A dedicated CT scan of the chest is indicated. In the absence of other findings, a follow-up scan to assure stability in six months should be done.
Q : 7 01/26/2009	I am a 44-year-old healthy woman, no family history of cancer. From age 20-30, I smoked socially (at parties, in bars), but have never been a "smoker." No smoking at all in the past 12 years. Recently I went to ER due to some dizziness and light-headness; had a lung CT scan with contrast and chest X-ray. X-ray was totally clear; CT scan showed a "3mm upper right lobe nodule, clinically insignificant, likely a small granuloma." On the Internet, I have read everything from "this is nothing," to "50% chance of malignancy." What is your experience in such a case? The chance of malignancy is much less than 50%, but it is not zero. You should have a follow-up CT scan in 6 months to assess for stability, and then (if no changes) another scan about a year later. If there are no changes, then it is very unlikely to be malignant. The intervals cited above are somewhat arbitrary and others may recommend differently. There is no need for biopsy, and a PET scan is unlikely to be helpful at this time. If there is growth of the nodule, then PET (or PET/CT) and biopsy/resection should be considered. Dr. Richard Battafarano at the University of Maryland runs a lung nodule clinic to assess precisely this type of problem. His office can be reached at 1-800-888-8823.
Q : 8 11/24/2008	I just received my radiology report: "Bilateral apical scarring. 3 mm nodular density w/in the lateral aspect of the right upper lung. 5 mm nodular density at the fissure on rt lung, 5 mm nodular density in the rt lower lobe. Other scattered smaller nodular densities are seen bilaterally." My dad died of lung cancer (smoker), his mom died of lung cancer (non-smoker). I'm 53 and have investigated fires for years. My doctor considers me a low risk since I'm not a smoker, yet I'm very concerned. I have no energy and want to sleep all the time. Am I off base or is this nothing to be concerned about? The finding of small nodules in the lungs is not unusual. Many individuals in California have been exposed to coccidiomyosis and have this finding. It is reasonable for your scans to be repeated at least once (in 6 months to 1 year) to document stability.
Q : 9 10/25/2008	My grandfather died of lung caner at age 60; my uncle died of cancer in 2001; my mother died of lung cancer in 2006 at age 50; my other uncle also now has cancer. Are there any tests, (genetic testing, DNA testing, blood testing), or a schedule of x-rays I should have? There are no screening tests or genetic testing for lung cancer at this time. It is recognized that some families are more susceptible to lung cancer, and a variety of potential genetic abnormalities have been identified, but none that is ready for routine use. The major piece of advice that I can give you is to not smoke or quit if you are a smoker.
Q : 10 09/22/2008	I am a former heart patient experiencing upper chest pain with any exertion, accompanied by shortness of breath, panting, wheezing, and having to cough at times to clear my chest to breathe. I am 60, a non-smoker, non-drinker, normal weight. Several siblings have had skin, breast and lymph cancers and lung problems. I have had a history of tumors and cysts removed surgically and have had pneumonia 5-6 times in the last 25 years. I received a clean bill of health, except for an 8mm left lower lobe nodule with minimal pleural fluid/thickining on the left and some fluid, found on a CT scan. In a general sense, would you consider me at risk for lung cancer, and if so what tests would you consider? If you are a life time never-smoker, than your risk of lung cancer is fairly low. Even if you are an ex-smoker, an 8 mm nodule would be observed with serial CT scans, as your physician suggests. If it increases in size, then additional evaluation would be indicated. As for your other breathing problems, I would suggest that you obtain another opinion from a pulmonary physician.
Q : 11 06/17/2008	I have COPD & Emphysema. I had a CT scan and was found to have a small lesion with alot of scar tissue around it. I am scheduled to have a PET scan. Does this mean they think I have cancer? I've also had a painful case of pleuresy on my right side where the lesion is for about 3 weeks. My doctor is afraid to give me much pain medication, so she said she'd have to wait on that until she got my PET results. I'm 53. The presence of a nodule on CT scan in a patient with COPD is of concern. There are several possibilities, including cancer. A PET scan can help to evaluate this, though it cannot actually diagnose cancer or completely exclude cancer. Comparison with a prior CT (if available) is frequently very helpful. There is no reason not to administer pain medication in this setting.
Q : 12 05/15/2008	My father-in-law was recently diagnosed with Stage IV Lung Cancer. The type of cancer is adenocarcinoma. After getting a second opinion, we decided that the best option was to send him back to our native country. We are trying to get him treated there for radiation and chemotheraphy. However, the doctor there tells us that he cannot treat our father unless he knows what kind of tumor it is. My question is, isn't adenocarcinoma the type of tumor. If so, what else would he possibly need to start treatment? Adenocarcinoma is definitely a type of cancer. There can be adenocarcinomas of the lung, colon, breast and other organs. Sometimes it is unclear as to which organ is the site of origin. This can usually be determined by evaluation of the biopsy specimen and the radiographic studies.
Q : 13 05/14/2008	My father, age 82 and a life-long smoker, has emphysema and black lung, had pneumonia in September, 2007, and now has a "suspicious" 1-inch mass in his lung. He had a CT scan and PET scan. His lung doctor wants to do a biopsy to confirm whether or not it is cancer. What should we do? He uses oxygen and has diminished exercise tolerance and limited appetite. He is 6 ft. tall and weighs only 130 lbs. and is losing weight. What do we do next? His GP does not think he can tolerate anesthesia for a biopsy. This is a difficult situation, as there is both risk from the procedure and the risk that this is lung cancer. Biopsies usually do not require general anesthesia and can be done safely, even in a high risk patient. The type of biopsy depends upon the location of the mass. The indeterminate lung nodule clinic directed by Dr. Battafarano at the University of Maryland can evaluate the nodule and discuss the risks and benefits of biopsy.
Q : 14 05/01/2008	I have emphysema and RA. I also have ILD. I had a suspicious area on the left lobe 3 months ago and had another CT scan done which showed that area now having a 7mm ground glass nodule. I go again in another 3 months for another CT scan. I do smoke and am 51 yrs old. Everything I read on the internet points to cancer. What do you think the chances of this being cancer are? Impossible to say. It is certainly a possibility, but given your other medical problems, inflammation is also very possible. The first thing to do is to stop smoking. You should have regular follow-up, such as that provided by the Indeterminate Lung Nodule Clinic directed by Dr. Richard Battafarano at the University of Maryland.
Q : 15 04/29/2008	My brother just had his CT-scan after 6 dose of Anzatax/Carboplatin (21 days apart) chemotherapy. The image shown a larger active region than previous CT taken about 2 months ago. Looks like he might already be in phase IV and currently coughing blood. Is it still possible to do radio/chemotherapy at stage IV? And what is the best drug combo? How much should we worry about the blood coming out of each cough? The doctor here in VietNam thinks it's not worth trying radio/chemotherapy; there is so much hopelessness that I would want a 2nd opinion. In the setting of metastatic lung cancer (stage IV), increasing size of disease indicates that therapy is not working. If hemoptysis (coughing up blood) is a serious problem, than radiotherapy (by itself) should be considered. Occasionally, we will do combined chemotherapy and radiotherapy even in stage IV disease if there is a major problem with the "local control" of the cancer.

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