Just beginning the journey.....

stevecmo · New User Joined: 26 Sep 2009 Posts: 5 Location: Missouri

I just found out today the my brother-in-law has been diagnosed with lung cancer. That's about the extent of my knowledge at this point.

I've made a similar journey myself after being diagnosed with Prostate Cancer seven years ago. I know that education is key at this point - determining what the best treatment is. I know the drill for PCa but don't have much/any knowledge about lung cancer. I'm looking for some direction as to what I need to know to determine how to best fight this.

In my brief research tonight I think I've got some of the basics as far as what the different types of lung cancer are. In PCa the keys are the PSA, the Gleason score, and the stage. I assem there is something similar with lung cancer? Obviously staging, although I don't have that info at this time. I'm not even sure how the diagnosis was made - biopsy or ??

I'm just looking for the basic direction to head at this point. What do I need to know???

Thanks in advance.
_________________
Steve

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2853

I'm sorry that lung cancer has touched your family's life. It is a whole different ball game from prostate cancer.

Type, staging, sub-type, cell differentiation, and tumor location and burden are all the different things you need to know. How much weight was lost before diagnosis also seems to have a bearing on survival.

They had to do a biopsy to determine it was lung cancer. Couldn't do it without one.

Feel free to ask any questions and we'll help you the best we can.

God bless,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

stevecmo · New User Joined: 26 Sep 2009 Posts: 5 Location: Missouri

PBJ - Thanks for the quick reply.

Yes, I understand that lung cancer is a whole different ball game than what I went thru with PCa. It took me a month of almost continuous research to dig out all the information I needed to make an educated decision as to what treatment was best form MY cancer. I'm just trying to gather the initial info to start digging.

You've given my some good data to start gathering. By "type" I assume you mean small cell or non-small cell? By "sub-type" I assume you are talking about squamous cell, large cell, etc.?

Regarding the biopsy, I thought I had read where they could detect (at least the likelyhood of) LCa in several ways - some type of mucus culture, or bronchial tube means, or a needle biopsy. I understand that the biopsy is the only definitive means of diagnosis. I'm not sure what he has done to this point.

My SIL just informed us of the news yesterday and I know it was hard for her to get thru it, so I didn't want to hit her with a lot of technical questions.

I've been reading quite a bit hear on this site. Are there any others that are worthwhile that you can steer me to?

Thanks again so much for all of your help. I'm hear to learn.

Steve
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Steve

Rmy953 · Regular Joined: 08 Sep 2009 Posts: 14

Steve,
My father passed away from lung cancer 23 years ago. In August we found out our mother has lung cancer. So much has changed in those 23 years; technology, treatment, resources. Luckily my mother is Stage 1, squamous cell. She is not a candidate for surgery which I was told would be the ideal treatment along with chemo/radiation due to chronic emphysema. We have just started chemo/radiation. I am learning as well. My mother's tests included a chest xray; CT scan; MRI's, Pet scan, and needle biopsy. The scans showed no spreading of the cancer. The needle biopsy confirmed what the doctor's felt was cancer. She was scheduled to see 2 oncologists; radiation, chemo. She also saw a surgeon who put a port-a-cath in for her to receive chemo. Hoping the best for your family.

stevecmo · New User Joined: 26 Sep 2009 Posts: 5 Location: Missouri

Rmy953 -

So sorry to hear about your mother.

Thanks for responding to my post. It's had over 200 "reads", but no one seems to want to offer much in the way of information or suggesstions (one response other than yours).

My BIL saw a surgeon yesterday and they scheduled surgery for next week. They are moving too fast in my opinion, but I couldn't gather enough information to slow them down. My wife asked my SIL (her sister) what the stage was and SIL said the surgeon said he "couldn't tell until they got in there"! Oh my! Personally I would run from that doc. We urged them to do their research before making any decisions, but they wouldn't / couldn't do it. Hopefully he will get lucky.

Thanks again.
_________________
Steve

JaLee · Regular Joined: 20 Aug 2009 Posts: 26

Hi Steve... my mom was dx mid Aug 2009... my understanding is that you must move quick with lung cancer.

For the most part, it's often (but not always) metastasized upon dx. This happens because the initial symptoms are so vague. You asked for some input.. I'm not sugarcoating... I'm finding it very scary.. it's certainly a [u]very[/u] serious cancer. So this is just my understanding of LC Steve.

Small cell is the worst, most aggressive (compared to non-small cell). It tends to respond well, at first, to chemo but also tends to come back with a vengence and the meds become less effective with time. When it spreads, it often does so to the other lung, the brain, liver, bones, lymph glands and/or adrenal glands. I believe the small cell is notorious for spreading to the brain. Again, simply my understanding.

Chemo will kill cancer throughout body, radiation can help if/when the cancer if localized (not mets). So, some receive both, some just the chemo. Some tumors are operable, some are not. Some are shrunk first, the operated on, it all depends on the patient condition and dx.

stevecmo · New User Joined: 26 Sep 2009 Posts: 5 Location: Missouri

JaLee,

Thanks so much for responding. I appreciate the non-sugar coated response. Smile

I does sound like a mean beast.

I wish your mom, and you, all the best.

Steve
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Steve

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2853

Steve,

They wouldn't be doing surgery if they didn't think there was a chance they could remove the tumor and any nodes that were impacted. Lung cancer is a rather speedy process, if you're lucky and get the right doctors. There is no time to lose, as most of them move all too fast. If it was SCLC, they wouldn't be operating at all.

Unfortunately, they can't really tell with all the nodes unless they remove them and test. The key here is that they are willing to operate. If he was a clear cut IIIb or IV, that likely wouldn't be happening as it's already too far spread systemically to do any good. (My husband did have a wedge section biopsy though, even though they knew he was a stage IV before going in. Still Monday morning quarterback that decision.)

Let's hope for the best case scenario here. Do let us know what the results are.

Another good site is cancerGRACE.org and it is run by oncologists and other docs with a specialty in lung cancer.

I'm sorry about you not receiving enough answers. Sometimes it's hard to lay it all out there as one never knows how much info is too much info. Also, a lot of people are still in the thick of the battle, so it's a sensitive area. I did tell you that lung cancer is a totally different beast than prostate cancer. It isn't the number one cancer killer in the U.S. for nothing. Crying or Very sad

God bless,
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

stevecmo · New User Joined: 26 Sep 2009 Posts: 5 Location: Missouri

pbj11,

Thanks for your response. I understand that the cancers are different (lung and prostate) but the process to treatment are very similar.

When I was diagnosed with PCa I researched almost non-stop, while undergoing all of the tests, scans and finally biopsy, to learn as much as I could about the disease. By the time the pathology report came back from the local lab I knew enough to send the slides to a known expert in reading and grading PCa tissue as this grading is critical in the treatment decision.

In my BIL's case, when asked about the stage the surgeons reply is - "oh we won't know until we get in there". I know enough to know that's a bunch of hooey! I also know that there are too many doc's that want to rush to treatment of their specialty.

It's just frustrating.

Thanks for helping. Smile

_________________
Steve

pbj11 · Site Admin Joined: 12 May 2007 Posts: 2853

Steve,

I hope they take the sample and test it for the EGFR mutation. That will let him know if the drug Tarceva will be part of an effective treatment plan in the future. They need fresh tumor tissue for this test, so you might want to pass that info on to whoever will be there to talk to the surgeon or oncologist, so they request this test.

Unless the nodes lit up like a Christmas tree on the PET scan, it's true that they can't tell until they get in and examine/test them. You don't have enough info on location, spread, etc. for us to help as much as we could and it is difficult shooting in the dark for either you or us.

You are still viewing this through the lens of a survivor, when the cold reality is that the majority of lung cancer patients don't see the 5 year mark, regardless of staging. Unless the biopsy comes back as some type of mixed cancer, the treatment protocols are fairly similar.

Keep us posted.
PBJ
_________________
Husband diagnosed with NSCLC Stage IV. (Non-Small Cell Lung Cancer) Fought & lived 2 1/2 years with multiple lines of treatment.

Post describing our battle: http://cancerforums.net/viewtopic.php?t=7026&postdays=0&postorder=asc&start=0

simplyklb

[quote="stevecmo"]PBJ - Thanks for the quick reply.

Yes, I understand that lung cancer is a whole different ball game than what I went thru with PCa. It took me a month of almost continuous research to dig out all the information I needed to make an educated decision as to what treatment was best form MY cancer. I'm just trying to gather the initial info to start digging.

You've given my some good data to start gathering. By "type" I assume you mean small cell or non-small cell? By "sub-type" I assume you are talking about squamous cell, large cell, etc.?

Regarding the biopsy, I thought I had read where they could detect (at least the likelyhood of) LCa in several ways - some type of mucus culture, or bronchial tube means, or a needle biopsy. I understand that the biopsy is the only definitive means of diagnosis. I'm not sure what he has done to this point.

My SIL just informed us of the news yesterday and I know it was hard for her to get thru it, so I didn't want to hit her with a lot of technical questions.

I've been reading quite a bit hear on this site. Are there any others that are worthwhile that you can steer me to?

Thanks again so much for all of your help. I'm hear to learn.

Steve[/quote]

I am well-versed in lung cancer unfortunately. My parents were both diagnosed with lung cancer last year. My dad had small cell lung cancer extensive and my mom non-small cell lung cancer stage III adenocarcinoma. My dad passed away on Oct. 15th last year (less than 5 1/2 months after his diagnosis) and my mom is still fighting.

Your brother-in-law needs a biopsy to confirm the type of lung cancer he has. Once the determination is made, the oncologist will lay ouyt the best treatment plan. The best piece of advice I can give you for your brother-in-law and sister-in-law... Definitely have an open dialog with the onc. He or she will literally be the heart of the medical team while going thru treatment.

Kristi
_________________
Dad - Andy, 70, diagnosed with SCLC in May 2008
2/20/38 - 10/15/08 Fly high, Dad!
Mom - Jackie, 68, diagnosed with NSCLC in May 2008
3/22/41 - 12/30/09 Fly high, Mom!

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