sdelisser

My mother inlaw has lung cancer.  It was diagnosed a little over a year ago.  It was inoperable.  Within the past two months it spread to the brain.  This was treated with an intense dosage of radiation/chemo, which removed almost all of it, leaving only a tiny bit.  Now her neck has swolen and doctors are pretty sure it is in her neck.  If so what is next?  I have read that radiation can not be used for the neck?  Is this true? Is there other options?

[Fernando Roque, MD]

Hi.  If your mother is not too physically debilitated, she may still be a candidate for chemotherapy.  There is also an option to give her some of the new targeted therapies for lung cancer, such as erlotinib or imatinib, which she may be able to tolerate better than chemotherapy.

If her neck is swollen, it is possible that she has lymph node metastases along her neck, or she may have a condition called superior vena cava syndrome. This happens when the lung mass impinges on the superior vena cava, a large vein draining the head and neck.  This results in swelling of the face and neck because blood cannot readily flow back to the heart because of the obstruction caused by the lung mass. Treatment for superior vena cava syndrome is radiation to the obstructing lung mass in order to shrink it.