Lung Cancer in lymph nodes.

[molinda]

My brother-in-law has today found out he has lung cancer which is also in lymph nodes. They have told him surgery is not an option & doubt if he will get Radiotherapy. Possibly Chemotherapy. He also has Caeliac. He is to have a P.E.T scan this Thursday. He also has Osteoporosis & is starting to get pain in his bones.
Could you advise me if there is anything else we could do to help slow down any more spread of the cancer please, or any info at all will be really appreciated.  Thanks in advance.
                                                                                        Regards Mo

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Alternative or complementary medicine systems are often tried by patients, especially those suffering from advanced cancer.
I am not a trained professional dispensing these therapies, so I would not be the right person to give you an informed opinion on this.
All the very best!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Mo,
I am sorry to hear of your brother-in-law' s health problems. One pre-requisite for starting chemotherapy in advanced lung cancer is that the patient must be in reasonable state of general health (called "good performance status" is oncology parlance).
If the oncologist feels that your brother-in-law cannot tolerate traditional intravenous cytotoxic chemotherapy, then other less aggressive approaches may be considered. These include the use of oral drugs (called EGFR inhibitors) or monoclonal antibodies. Enrolement into a clinical trial is also an option.
Please discuss in detail with your treating oncologist.
All the best, and be strong!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Mo,
Sorry for the late response.
I am sorry to hear of the progressive disease on PET scan. There is no accurate way of predicting how long an individual patient with advanced disease will survive. Statistics are based on the average survival of many similar patients. These too have a wide range, and the average survival figure may be irrelevant in predicting survival of an individual patient. There are just too many variables.
Has the decision been taken on the clinical trial enrolement?
All the Best!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Mo,
Chemotherapy is known to increase overall survival in advanced lung cancer as compared to best supportive care. Many options are available, and choice of drugs depends on patient parameters and physician preference. Usually two drugs (one of them a platinum) are selected in advanced lung cancer chemotherapy.
He may also benefit from the use of zoledronic acid and pain relief medications.
All the best, and God Bless!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Carboplatin-gemcitabine is a reasonable choice.
Studies have shown that chemotherapy has better results in advanced lung cancer as compared to best supportive care.
Hyperbaric oxygen has not been proven to have significant benefit.
In your sister's case, chronic steroid therapy is known to increase chances of infection. Please make sure that she remains under the continued care of a pulmonologist.
All the best, and God Bless!

[molinda]

Hi Dr,
           as far as i know they did acknowledge about Clinical Trials, but have started him on mild Chemo, he had the first one 2 weeks ago, i don't think he has any this Frid.
So far he hasn't had any side-effects but i suppose it's early days yet.
Carboplatin- Gemcitabine intravenous.. Will the chemo slow the cancer down in any way, i'm not really understanding why they are giving him chemo if it wont help get rid of it?

I have been reading reports about Hyperbacic Oxygen? Not sure if ive spelt that right, Where you go into an oxygen chamber for a while & breathe in pure oxygen, its said to help in some cancers plus M.S etc

My sister was rushed into hospital 3 weeks ago, Bronchiospasm, Asthma & a nasty Pneumonia, she was really very ill. She is home now but is very weak, not sure if its because of the high dosages of steroids, which she has to reduce slowly or the new tablet to help her breathing  Phyllocontin. So now i am worrying about them both!

Any advice or information will be very much appreciated Dr, thank you.

                                                                              Regards Mo

[molinda]

Hi again, sorry for delay in getting back to you, i wanted to wait until he got results of PET-Scan.  Not too good i'm afraid, it showed bits in his spine, breast-bone & also now in the middle of his lung. They have told him they can give him Chemo & possibly Radiotherapy to help the pain but it will not cure him. Obviously the outlook is not good.

Dr i know its impossible to define how long he has to go but is there a rough outline maybe, are we talking months, weeks? I need to figure out when to go to my sister to give support, she is 600 miles away. By the way, yes, they did ask about clinical trials, he has to go back next week for more tests so maybe they can discuss all these things then.  Once again, thank you for your help.
                                                                   Regards Mo

[molinda]

Hi Dr Saini,
                     thank you once again, i think that was the answer i was expecting.
I was wondering if the PhytoTherapy may be an option? Sorry, not sure if i have the right name or spelling. I'm trying to gather as much information as i can before his next appointment. I think it will help me to be aware of different possibilities.

                                                                       Regards Mo

[molinda]

Thank you Dr. I'm a bit worried if he is to have Chemo. He is very Anaemic, he also gets injections (B12 i think) He is also quite weak & tired. He has been ill for a couple of years, Caeliac, T.B ( clear now ) Osteoporosis etc.
I just worry Chemo  will be too much for him? My sister is not in good health either, i live about 600 miles away but feel i may need to go there to support them in any way i can, would you know if the side-effects of Chemo will be very hard for him?

Thank you so much for answering my questions, i am very grateful

                                                              Regards Mo