COPD and lung cancer treatment...

• By Jolene
• Posted July 5, 2007 at 8:59 am
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Hi Elaine:
I am concerned when I see low lung volume and he is already on oxygen. My dad was also Dx with Emphysema when he was Dx with his lung cancer. The Pulmonologist/Oncologist (2) felt that Tarceva and Radiation were the best route due to it being inoperable. We sent him to St. Louis to a large lung treatment center where they do transplants, etc. The surgeon said only Tarceva and absolutely no radiation or IV Chemo. He returned home and decided to try the radiation going for a cure to the area. It was a fatal mistake. He sailed through the radiation, but, quickly went down hill and had absolutely no air. He went from no oxygen to 8 Liters at home just to maintain saturation levels in the upper 80's. He no longer was able to walk as it used up to much of his air. He ended up with multiple problems such as pneumonia, radiation pneumonitis, scarring, etc. He said, "I wish I would have never done this." I think it would be a good idea to get a 2nd opinon. While they told my dad the damage to healthy tissue would be minimal, he didn't have enough healthy tissue to spare. Thoughts are with you and your dad and prayers go out as he makes his decision. Jolene

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• By JackFaughn
• Posted July 5, 2007 at 9:55 am
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My husband has Copd and NSC lung cancer stage 3b. He only has 20% lung function. To get a second opinion on treatment we went to Mayo Clinic, and was told no surgery or radiation, but he have chemo (Carbplatin and Gemazar. He started in Jan. and now has finished these, and he did very well. Was never sick.

He has now started a maintance treatment of Docetaxal, and has had one treatment. So far so good. His last pet scan after his, after Carbplatin, and Gemazar, showed no spreading.Ofcourse the cancer is still in the lung, but we are thankful for each thing. He is on oxygen 24/7. But is enjoying his life. Can't do a lot of the the things we retired to do, but each day is a treasure for us. Jackie

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• By kops2da
• Posted July 5, 2007 at 10:01 am
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Guess I should have stated that I wanted only positive responses. You did not make me feel better but thanks for being straight forward. I know my husband will do all that is recommended. Elaine

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• By kops2da
• Posted July 5, 2007 at 10:04 am
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Thanks so much for an answer I can live with. I realize this is very serious but your positive reply is what I am looking for - too much negative with this disease. I hope my husband is as lucky as yours and can go on with life - no matter how short! Elaine

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• By Bette_Tx
• Posted July 5, 2007 at 10:07 am
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I have mild copd and also myasthenia gravis, an autoimmune disease that affects the diaphragm and can cause low lung capacity. Even though my cancer was in the early stages and operable, my doctor ordered complete respiratory function tests to see if I could have surgery. I did great on the tests and was able to have surgery and chemo later. Best wishes for your husband.


Bette

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• By Don_M
• Posted July 5, 2007 at 12:01 pm
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You could describe your husband's situation to the radiation oncologists who answer questions at the cyberknife support message board. Cyberknife is often used for cancer where surgery is not likely to have a good outcome. The side effects from ck are minimal.

http://www.cyberknifesupport.org/forum/

Don M

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• By robinwd
• Posted July 5, 2007 at 3:59 pm
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I was dx. w/ small cell and SEVERE COPD 27 months ago. 2nd pathologist said non-small cell....the experts at Siteman at Washington University/Barnes Jewish, St. Louis said no surgery, but never mentioned no radiation. I had chemo for NSC and SC and 30 doses of rad......my SAT' s are 93 on room air, so no O2 yet. My PETS are all clean. Yeah...I'm very short of breath on exertion, but I know my limits. The worst part is when I get a respiratory infection (knock on wood....last one was in Oct.) and then I use a nebulizer treatment. I do use Spiriva daily with good results and no side effects. The docs at Georgetown University in Wash., DC were much more optimistic about the possibility of surgery (cyberknife, VATs) if (when) the tumor reactivates....they did a much more extensive breathing test than Siteman did. Hope this helps. Good luck to you both.

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• By Jolene
• Posted July 6, 2007 at 2:21 am
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Sorry for being too blunt. I never intended to make my comments hurtful Elaine. I know someone emailed me similar information once when I posted. You have to remember that those who are battling cancer are individual just as their cancer is. Treatment affects each of them differently.
To be sincere and honest about what happened to my dad is all I intended. I would do anything to spare anyone what he went through; but, I am NOT a doctor and I am sure he is going to the best.
Sorry..Jolene :0)

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• By kops2da
• Posted July 6, 2007 at 10:16 am
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No problem! Just upset for sure! I ask for experience and you gave me your Dad's.

Doctor called my husband yesterday and they are scheduling a CT scan of the left lung again to see if the small lesion there has grown or ? This will tell them where to proceed. His pulmonary doctor got a second opinion from University Hospital (one of the best oncology centers in central NY). They would do the biopsy but my husband's pulmonary doctor does not like the risk. Anyway, NO cancer in lymph nodes from PET scan.
Pulmonary doctor is leaning towards surgery to remove cancer in right lung. He went through open surgery for aortic anuerysm in December with flying colors and lost no lung function. That COULD mean surgery would be ok and be the best way to go.
Sounds to me that your Dad is still alive and I am really sorry his quality of life is so bad. Right now we are just trying here to keep positive! Elaine

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• By Jolene
• Posted July 6, 2007 at 10:26 am
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If he had surgery for an aortic anuerysm and came through in flying colors that is POSITIVE! He is much healthier obviously than my dad. My dad was 81, looked 65, and in top shape...however, they told us that besides the cancer, he had multiple lung issues to contend with. The added years can make a difference just like so many other factors. The fact that the PET was clear for the lymph nodes is another POSITIVE! He has many, many things going in his favor...look to the positives as he has so much going for him. I wish him nothing but the very best and will pray for a great outcome to his new journey. He has you on his side and with faith...all things are possible. BELIEVE
Warm Hug From Iowa..Jolene

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• By raspberry
• Posted July 6, 2007 at 2:58 pm
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Hi,

We're pretty similar to other's comments above. My husband had extensive Stage IV NSCLC in both lungs and his lung capacity was at 50%, mostly due to the cancer. The COPD/emphysema, discovered at the same time, didn't seem to be too much of a player at the beginning, but has factored in down the line. He had spot radiation done at one point for a belligerent tumor in L-lung while all others were responding. Between the radiation and the chemo, his lungs are very touchy and it sparked a long period of pleural effusion from the irritation. No cancer cells in the fluid, but did have multiple taps. Pleural effusion causes extreme shortness of breath, so not a fun time.

He did have a VAT's wedge section initially for diagnostic purposes. He was also very faithful about using his plastic spirometer to increase his lung capacity. Sorry to say, he's gotten fatigued from a lot of chemo, and it isn't being used now so his lung function continues to decline. He is on 3.5 liters of oxygen all the time. Did some sort of home test at night early on without oxygen and as soon as he fell asleep, the alarm went off because his sat level dropped to 84%. Currently, with oxygen, at rest he is in the 96% area. Without oxygen and walking, he falls to 88 or below rapidly, but does come up quickly when oxygen is given following walking test.

We just asked the oncologist about the possibility of radiation for some of the other belligerent tumors and he definitely said we should stay away from any further radiation. This may be more because he is a Stage IV and the one tumor he did have radiated has now grown back. However, his lungs are very compromised from all the chemo, radiation, and COPD. He has extensive scarring and thickening throughout both lungs and suffers from shortness of breath upon any exertion. He also still has multiple masses and nodules remaining. Earlier stage patients may benefit from either radiation or more tissue sparing treatments like cyberknife or gammaknife. I've also read that some people have great success with pulmonary rehabilitation, but can't seem to get my husband on board with that idea. (Stubborn men!) COPD does add complications to the issue, but it depends on how far blown both the COPD and lung cancer is. Sounds like you have all the right team players in place for some good treatment decision making.

Best of luck with his staging and treatments - whatever they end up being.

And yes, our lifestyle is very limited, but we are still thankful that we have a lifestyle!
Razz

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• By annieug
• Posted July 6, 2007 at 8:36 pm
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Elaine,
I was lucky that I could have surgery even wtih COPD. No radiation though. I was extremely lucky that the lobectomy ended up acting like lung volume reduction surgery, giving the remaining lobes more room to expand. For two years following my surgery my FEV1 was actually improved over what it was prior to surgery. One of those little miracles no one expected but grateful for nonetheless.
I am now five years -- almost to the day -- post surgery and my lung function is back where it was before surgery or maybe a little less, as it declines for all of us as we age. I had no chemo and all doctors agreed I couldn't have radiation. But I was 1B and at the time none of that was recommended. Here's hoping for a couple of little miracles of your own.
Anne

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