Nsclc: From Thailand - What Next After Chemo?

Greetings from Thailand!

I write to seek advice. My dad has been diagnosed with Stage IV NSCLC (Adenocarcinoma) - metasis to lymph nodes, in October 2004.

He has completed 6 cycles of Carbo-Taxol Chemotherapy. Pet Scan in February 2005 revealed only slight reduction in the original 8X5X4cm tumor on the right side of the lung. Some activity in right hip was also noted (about 2X2cm).

He is currently taking Iressa (in his second month) which, according to a study showed that the chances of it having an effect is higher for Asian with Adenocarcinoma, but even higher for female non-smoker (my dad was a smoker). It is still too early to tell whether Iressa is working out for my dad.

Questions:

1. How can we know for sure that the "activity" in the Pet Scan on ther right hip is cancer?

2. Should radiation be considered at this stage?

3. What about chemo-radiation at this stage?

4. Did anyone experience swollen ankle when taking Iressa? How can swollen ankles be reduced without medication?

5. If Iressa does not work, what is the alternative apart from going back to chemotherapy?

6. If my dad do go for chemotherapy, are we limited to second-line chemotherapy drugs such as taxoltere and the new alimta?

7. How effective is alimta?

Thanks in advance for taking the time to answer my questions.

Hope to hear from you.

Christine

I have been on Iressa since Clinical Studies and it works for me. Tarceva is a like chemo drug (growth preventative) that I may switch to soon. I am plagued with dry skin and chronic congestion. I have had chemo-the standard drugs, and radiation. I believe that a combination of chemo/radiation/and follow on growth preventative works, at least for me. 3 years now and no new. Avastin is another drug to consider-it is a blood supply preventer that is just now being used in lung cancer therapy. It was/is used in colo-rectal cancers with good success. Hope this helps. I spent some time in Bangkok, after Vietnam and went to Phuket etc. I spent 1 1/2 yrs in Malaysia and got to Thailand then also. Nice country, nice people overall. Hope the above helps. sincerely, RBS

Richard

Thanks for your reply. It certainly helps.

Tarceva is not available in Bangkok yet but will be soon.

My dad has been feeling weak lately. He just can't seem to be able to get to sleep.

Anyways, I hope you don't mind if I ask you a few more questions.

My dad's lung cancer has spread to the pelvis area and we are planning to do radiation.

Have you had chemotherapy and radiation at the same time? How were the side-effects?

Have you tried Alimta as a second-line chemotherapy before?

Thanks again and hope to hear from you soon. Phuket has been quiet lately after the tsunami but I think business is picking up again...

Best wishes

Christine

Yes, I had radiation and chemo together for a 3-4 month period. I would go to radiation at 8:00am, then be at chemo by 10:00am, finish chemo at 3:00pm and then be at work at 4:00pm and pull a 12 hr shift-grit. I never missed a day of work. Mind set...Towards the end of radiation my chest was really burned. Ensure that the skin gets plenty of ointment/salve to make the burning less severe. My oncologist asked if I wanted to switch to Tarceva, at this time I told him no. Maybe in the future. I am reluctant to change from something that obviously works for me.