Stage 4 NSCLC Poorly differentiated adenocarcinoma

My 74 year old mom had a severe cough. She was a heavy smoker until 9 years ago when she quit..She went to primary Dr. on April 1st...x-ray shows 8cm mass in right upper lobe and 3cm mass in left upper lobe. Dr gave her antibiotics which cleared the cough...she went in for ct scan which confirmed the masses.. Had biopsy on april 8th and was diagnosed with stage 4 NSCLC poorly differentiated adenocarcinoma...She has since seen a good oncologist, from which i understand is known world wide for his expertise...she just went in April 22nd for a Brain MRI...a PET scan and a abdomen and pelvic ct scan.....we go back to oncologist April 27 for which we have no idea what to expect....the patholgist report says "very unusual" because some markers show sqaum cell while others show adenocarcinoma...so they are favoring adenocarcinoma<<<<seems very strange to me that pathologist says "Very unusual" in his report....anyway, has anyone had similar experiences? if so could you give us any advise or anything that could help us along on this whole thing...If only we could turn back the hands of time, Sincerley, Brian from Minnesota PS...poorly differentiated i think is bad....worse than others....is that correct??? im confused about that part...any help would be great thanks

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Hey Brian,

My mom has stage 3b non small and small mixed lung cancer. Her surgeon told her he had only seen one other case that was mixed. Moms was poorly differentiated, I think that talks about the agressiveness of the tumor and how invasive it is, from what I understand. How is her health otherwise? My mom is 74 also, and an ex smoker. Also try cancergrace.org you can ask onocologist questions on that site. I have asked some about mom that I was scared to ask in front of her. Wish you all the best.
Kelli

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Hi minnguy and Welcome! I'm sorry that your Mom has LC but I'm glad you found this site because you will get alot of information, support and encouragement here that will help you to help your Mom. I have Small Cell so I'm sorry, but I don't know alot about the type of LC your Mom has. I'm sure otheres will answer that know more about it soon.
Hopefully her Drs. will have more answers for you and a treatment plan together this week, as well.
For now, DO NOT read the statistics - there are many long-term survivors of this illness! God Bless You and Your Mom. ♥ Viktory

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Get her plan in place, but send her slides to another pathologist for a second opinion. You can ask her onc about doing this. They will treat her as if she has adeno and see how she does. Wishing you all the best. Take care, Judy

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Hi minnguy. I am so sorry you and your mom are going through this. My father in law was diagnosed with nsclc adenocarcinoma in Nov. Kelli is right, "poorly differentiated" specifically means how "different" the tumor cells are from the surrounding tissues. A well differentiated tumor with have a clear line... this is where the tumor ends, this is where the healthy cells begin. A poorly differentiated tumor is "invading" the tissue around it. They often have cells in varying stages of mutation is the same area, some healthy, some precancerous, some cancerous. It is hard to find the line where the cancer ends and the healthy tissue begins. These types of cancer tend to be more aggressive.

Personally, I've never heard of a mixed squamous cell and adenocarcinoma. I'm sure its possible, but I think pretty rare. One thing I've learned, for better or worse, is cancer has no rules. There are trends, and generalities and statistics. For every disease trend there are cancers that that defy it. And, thank God, for every mortality statistic, there are many people who defy them.

As Judy says, consider a second pathologist opinion (the reading of the biopsies they took). Also consider a second opinion with an oncologist as well. There are many grey areas in the treatment of cancer. Any oncologist worth seeing will welcome other opinions. In fact, many cancer centers have regular "tumor board" conferences. The entire group of oncologists, surgeons, radiologists and pathologists meet to discuss the care of each patient in treatment. This is an extension of the idea of 2 doctors opinions are better than one.

Best of luck to both of you. Check back here often. So many days when I was feeling hopeless, I found my strength in the people who share here.

Jen

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Hi,again minnguy.Well the best way I think of the poorly differentiated cells is they aren't quite sure what they want to be when they grow up.So they try things more.I have a warped sense of humor and love far side cartoons.This rollercoaster ride is easier if you preserve a sense of humor.I now have the same diagnosis as your mom.I was Stage 1A in spring of 09.Had removal of tumor with good margins but developed Atrialfibrillation 5 days later.3weeks later roughly I landed in hospital with 20lbs of fluid,pneumonia,COPD excerbation and atrial fib unstable.Because my pathology report had been adenocarcinoma,poorly differentiated,I was supposed to have 4 treatments of chemo to mop up.My onc talked with my various Drs.and they decided the steroids or chemo would probably kill me.So I didn't have the followup chemo.In Stage 1A they actually don't do chemo so hoped I was safe.Slowly mended and went back to work.Was Ned 6 month check up but on yearly CT I had one liver metastasis.Began Chemo and did pretty well with Shrinkage.Met finally hid but a lab test showed me as having Increasing slowly Cea"s.Took 8 treatments of 1st chemo,4 maintenance treatments and had initial met grow some and several baby mets new appear.So I am now taking A 2nd line of Chemo.My CEA dropped 500 pts the 1st treatment,then lab to low on 2nd so couldn't haveday 8 Gemzar dose.Cea went back up some so Held 2 weeks,lowered Gemzar last week with same Carboplatin.Lab was within acceptable range this time so had Gemzar at same dose today.So my point is,listen to recommendations,read and ask here and make your best choice.Get a 2nd opininion if in doubt.If doctor is rude or won't explain things,you can change.I just wasn't lucky unless you realize I really could have died,when had all the complications.i have survived over 2 years the 24th,retired and doing pretty good,Prayers,AndiB Sorryn post is long

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So sorry for your news. Lost my mom to lung cancer, and am an RN. Tumors progress and as they do they become less differentiated. The mixed cells may be an indication of her progression from one type to less differentiation.

The most important part of her prognosis will be the staging which depends on the findings of the PET scan. Cudos to your docs who are doing that before cutting because while you can cut cancer out of the lung, if it has spread there is not much point as the lung cancer does not until very large and obstructive generally cause death, it is where it moves to.

If it is other places especially multiple places (commonly brain bone, spinal cord) I would ask some very specific questions before treatment.
1. What percentage of patients with this tumor type and grade respond to treatment?
2. How much more time would it give her?
3. what are the side effects and complications?

For my Mom it was very advanced and poorly differentiated so it would not have responded well to chemo and she could have died from the complications. We chose radiation for the tumor in her back and in her brain for relief of seizures and back pain. She also had an agressive diet of fresh antioxidants and a wonderful attitude and lived 12 times longer than the projected. Noone has an expiration date.

Be with her at her doctors appointments as she may be too overwhelmed to remember all they tell her. The most important question that physicians I work with respond to: What would you do if this was your mother?

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