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 62.

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Q : 1 01/02/2010	I am a former heavy smoker. I quit 6 months ago. I now have low grade pain in my right lung. An X-ray was found to be clear. Should I have CT scan done? I will have to pay for the CT scan myself. If your pain persists, than you should discuss further evaluation with your physician. A CT scan might be indicated; however, there are many causes of chest pain and they are not all appropriately evaluated with a CT scan.
Q : 2 01/01/2010	My mother was diagnosed with lung cancer in 2008, an incidental finding after a fall and fracture of ribs complicated by DVT and PE. It was staged as a IB NSCLC adenocarcinoma. She underwent a right upper lobectomy with clean margins. Her oncologist told her that chemo was not indicated at that time. She has subsequently had serial PET scans with the latest one showing a new 1.2 cm right adrenal lesion compatible with metastases. The oncologist now wants to wait 2 months and get another scan to see what it shows before starting and treatment. This is VERY concerning to me as I think that delaying treat is not a good idea. Can you tell me a little about her treatment options? I have seen some literature suggesting that an adrenalectomy with chemo may be beneficial in this case. I would be concerned about a new adrenal lesion in a patient with a history of lung cancer. Most patients with low stage lung cancer who relapse will do so within the first three years. Depending upon the size of her original cancer, your mother has a 30-50% chance of recurrence. If there is a new adrenal lesion, then it is most likely cancer and should be evaluated and treated. If it is a solitary lesion, than it can potentially be resected for cure. Chemotherapy may be beneficial in this situation as well. If her recurrence is more widespread, then chemotherapy is indicated. If you wish an evaluation at the University of Maryland, please call 410-328-7904 for an appointment.
Q : 3 10/15/2009	My mom (86) has been diagnosed with adenocarcinoma, and has two lesions on one lung and a third on the other. She has been in the hospital for 2 weeks for testing. There are no signs of cancer anywhere else and it has been recommended that she receive modified chemo with tarceva as maintenance treatment. A test called EGFR was suggested to help evaluate her response to different treatments. She quit smoking 20 years ago, has congestive heart failure, anemia, diabetes, and a thyroid condition. Any thoughts about this test? Testing for EGFR mutations is recommended if tarceva is under consideration for initial therapy and there is available tissue. This can be sent to several commercial labs (e.g. Genzyme, Response Genetics and others).
Q : 4 08/05/2009	Is there something that can be done to help raise platelets after chemo? No. There are no actions that you can take to increase platelets after chemotherapy. While some drugs have been developed for this purpose, they are not that effective and not widely utilized.
Q : 5 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 : 6 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 : 7 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 : 8 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 : 9 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 : 10 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 : 11 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 : 12 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 : 13 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 : 14 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 : 15 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.

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