aggressive vs. non-aggressive

Some background info...My father was diagnosed with NSCLC Stage 3b in August (cancer cells in the lower lung and pleural effusion). He had six rounds of cisplatin and was given a 3 month break from treatment in December when a PET scan showed no active cancer cells. He started getting sick in early February (what we thought was a flu...fever, chills, cough, fatigued, etc.) After a CAT scan showed fluid in the lungs, the doc ordered another PET scan, which showed cancer cells in the upper lobe of the lung, more fluid and mets to the bone and lymph nodes. He had one round of treatment (cisplatin and alimta) but then was hospitalized due to the fevers, which were spiking high (up to 102.9). He was given several tests to rule out an infection and the docs determined that the fevers are being caused by the cancer and therefore he will begin treatment this week. They also put a pig-tail in his lungs to drain the fluid and attempted to do the antibiotic/talc procedure (sorry, not sure of the medical word for it). We are waiting to find out if that worked or not.

My question is...the doc said that it appears his cancer is "aggressive" and that he will have continuous chemo from now on (no more 3 month breaks). What does "aggressive" mean? If the mets to the bone were not there in December and showed up in March, how "aggressive" is that? How quickly does non-aggressive cancer spread? I'm trying to remind myself that the only thing that matters is how my dad is feeling, not what the tests show but the word aggressive scares me. Will the chemo be able to be as aggressive? (they will continue with cisplatin and alimta) He responded really well to the cisplatin the first time but I'm not even sure if that matters.

Thanks so much for your help.

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I just read your post about your dad. I'm sorry to hear that. I believe what the doctor means when he says aggressive is that since there are mets to the bone the cancer is spreading and your dad is probably now a stage 4. When you say chemo from now on, it sounds to me like they may be afraid to break from it for fear it may spread further without the chemo. The non-aggressive usually means that the cancer is stable or moving slowly. I am by no means a medical professional but being a stage 4 lung cancer patient I have learned a lot since it started. I do not mean to scare you. Not at all. But I also believe that if you are armed with the facts you can make better decisions (or your dad can). I was diagnosed with tumors in both lungs, stage 4 from the beginning and this Saturday it will be 18 months and I'm still going strong and work every day. The point is no matter what the docs say, there is always HOPE. Do not give up for any reason. God works in mysterious ways. If someone had told me 18 months ago that I would still be here now after seeing all the tests results, I probably would not have believed them. In fact I didn't. But I have come this far on a drug called Tarceva, a once a day pill. And if the same chemo regiment your dad was on doesn't work this time, there are plenty of others out there that they can use. They change the drugs all the time to get the best results. So hang in there and fight. There is always hope. Don't be afraid to ask the docs questions when you have them. The docs are working for your dad and he has a right to know everything and ask all the questions he wants. One thing I have learned is if you don't ask point blank, they are surely not going to volunteer the info. I ask questions all the time. I wish you and your dad all the best. Your dad is lucky to have you helping him and I know he appreciates having such a caring daughter. Keep hanging on and please keep us posted. God Bless.

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I have a question. I was diagnosed stage 4 nsclc in Sept 2007. I was confused when they told me I was stage 4 because I had tumors in both lungs. I thought stage 4 was only when the lung cancer had spread to other organs.

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To Chessie-thank you so much for your reply. Hearing a story like yours is a constant reminder that I need to maintain hope. I know I shouldn't get too hung up on tests and's how my dad is feeling that should be my only concern. He starts treatment again today and I am hopeful that the chemo will be more aggressive than the cancer.
To Wilkjud-my understanding is that if the cancer spreads from its original site, it is considered stage 4. So your cancer most likely originated in one lung and spread to the other (even though it's still in the lungs, it still spread from one to the other) Hope that helps.

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Stage IV can mean any tumor that has spread to another section of the lungs, as well as elsewhere in the body.


Sometimes there can be mutegenic (changes form) reactions to chemotherapy that failed. Mutagenesis in a genetically unstable tumor could lead it to be more aggressive. More emphasis should have been on matching treatment to the patient.

Infections can develop from white blood cell deficiencies while in the process of receiving chemotherapy. A good, healthy immune system helps one to fight off infections, but while under chemo (even years later) your immune system has been compromised and one needs to try a stave off infections as much as it is possible.

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As others have said, There is always hope. Believe me I know.
If I anderstand correctly your fathers cancer has moved outside of his lungs? Hence stage 4. Forget it, It's only a number. Agressive. It is moving at a steady rate.
Reminder: We are talking lung cancer. I do not have to explain what that means.
1) Has he had multiple 2nd opinions?
2) Have you explored other possibilities (Oncologists) at other locations even states where they are working on new and advanced technology?
3) Are you /father up to date on all that is going on with lung cancer? (google alerts, med alerts etc)
4) Is he getting standard protocal for meds or are they aggressive and thinking outside of the box?
ONLY my opinion: You must take charge as my wife did with me. and my cancer You must learn the disease better than you know what you were educated in or your favorite sport. You must take control for your father as it is difficult for him at his level of the disease.
Example: I now have 5 Oncologists in assorted locations. It is an option open to everybody if they want to take the time to do it. I had more tumors all through my body, more than I have freckles and was given 60-90 days to live. I am now going on 5 yrs and tumor free. My meds. stopped working in Jan 2008. the tumors grew and we took agressive action (outside the box thinking). Again, I am tumor free.
There is no single answer BUT, you must take control of the disease. You must be the knowledgable person. because its personal. Its your fathers life.

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would love to hear your story and meds that you have taken including your out of the box actions.

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It is a long story and a hard fight.
Please understand I will never win BUT I can and will stay ahead of my lung cancer. I do not mind having lung cancer, I mind it when the tumors grow. We just need to keep disease under control.
I do not know if I can write clearly enough to tell the whole story. I will try as long as I know it will go directly to you and not open on the site. Please advise. This is a thumbnail only..
I will tell you I had a choice die or fight. I am well ahead I believe it is because we took control, we went where we had to and added as many 2nd opinions as needed and continue to add more. To go to one doctor and expect a miracle is a miracle in its self.
I firmly believe you must keep moving and staying strong. Look at the Lance Armstrong Story all about staying strong... If you get out of bed even if you fall down as I did or if you lay on the sidewalk throwing up with no energy to pull yourself up, you must tell yourself to keep moving. I did., Saying "I can not do it" is saying I give up.
When I was near to death I was taken to the "Y" and did water aerobics with the "Blue Haired Ladies" I did get stronger and started walking. I never miss. 24/7. I did get stronger while alive, it was a golden key for me.. to fight.. In addition we must understand our meds.and what is available to us and what is in the wings, how they work and even if they can work for us. I made a mistake at the start by taking Chemo, No, ther is nothing wrong with chemo I was told we will start you with this and see what happens. That was the problem. It did not work and I was all but dead, my life was almost taken away because I was placed on a standard proceedure and I accepted it as the magic drip..Never again will I go blind.
It is My job to stay alive and keep well. I believe we must help the doctors help us. The more we help them the more than can and wiill help us. We must go on fast track to learn our disease.
I sincerly hope I have not offended anybody with my direct approach to my disease but it is the only way I know how to win and I was asked.

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Hi Chessie-

your story gives me hope for my dad. he was diagnosed on nov 7, 2007 with single brain mets (1cm) and is feeling good and tolerating chemo quite well..... I have read too many stats and have been trying to prepare myself for the worst...thanks for posting it gives me hope!

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hey, Larjo,
I'd like to add one thought - while he's breathing, you have hope. YOU need to be aggressive - help your daddy by being a warrior and fighting for him. I really agree that your best fight will be with education - about the treatments, about the disease, and most of all, about the side effects. (I'm half convinced that side effects are peskier than the disease). If you have a choice between a piece of research about statistics or one about "what to do when" - go for the second one, as it will be the one that helps out the most in the long run. Researchers like to use words that don't mean much - what does aggressive mean anyhow... And don't waste a single opportunity to show the world, including the doctors, how much your daddy means to you.

And, Ed - go get 'em, tiger!!!

I'm sending bear hugs your way.

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