I have so many questions but I will keep it to a minimum. First I notice many posting advise that the person with lung cancer has received chemo. My mom was dx with lung cancer January 2007 and it was discovered that the cancer had metastasized to her spine and rib in July. She has been given radiation (approx 44 treatments). We have been told that there are no other treatment options but palliative home care. Should we be pursuing chemotherapy?
Second question, we have been asking for some guidance regarding prognosis. We are wanting to ensure that we are prepared for her care but we are always confronted with evasive responses from the medical team. I would think it is responsible to help families make appropriate decisions regarding future planning. Do you have any advice?
Thank you so much for considering my questions.
Lost in the abyss of cancer.
There are general philosophies that guide treatment decisions with the use of chemotherapy in lung cancer. Ultimately however, each patient is approached as an individual, but I agree with you that anyone interested should at least get a discussion on chemotherapy.
In general, for patients with metastatic disease, chemotherapy can be used with the intention of prolonging survival by patients who are able to care of themselves (but not housework) and who are up and about at least half the time they're awake. What is hard to say here is if your mom has some weakness due to nerve compression on the spine - it would be hard to apply this rule. Another parameter is how much weight loss has occurred over the past few months.
Chemotherapy may also be used with the intention of improving symptoms when other meds (like for example medications for pain) are not able to control them.
I am assuming that at the present time, any pain from the back was controlled by the radiation. So, in the absence of other symptoms - chemotherapy may not be needed.
If she is still up and about - you may seek an opinion of the benefit of chemotherapy if the target is improving survival. The gains however are pretty modest, about a 10% improvement in the chance of 1 year survival, which would mean about a 30-40% chance of surviving 1 year.
If she is pretty ill, then the focus of treatment should be to alleviate any other symptoms as they come.
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