Treatment Options for Advanced Lung Adenocarcinom
My father is 57 years old and was recently diagnosed with an adenocarcinoma in both lungs (not operable) and cerebral brain metastasis. The oncologists consider the condition not surgically treatable, while the neurosurgeon considers the condition treatable with traditional surgery or radiosurgery. The doctors decided that my father should receive 3 cycles of chemotherapy with carboplatin (he just finished his first cycle) and then brain radiotherapy. However they told me that the possibilities of surviving are very low. In fact, they told me that the treatments are useful more to reduce the symptoms of the illness that to oppose it. I have fear that something more or something different could be done and that precious time has been lost. I would very much appreciate if you could give me any information.
Barbara Campling, MD, Medical Oncologist, responds:
Unfortunately, when lung cancer has spread to the opposite lung or outside of the chest, it is generally not considered curable with any form of therapy. However, it is still treatable. The goals of treatment are to alleviate symptoms caused by the cancer, to delay or prevent serious complications, and to prolong survival. In this case, the cancer has spread to the opposite lung and to the brain. His doctors have started him on chemotherapy with carboplatin. This is a useful drug in the treatment of adenocarcinoma of the lung, and it is quite well tolerated. Usually carboplatin is given along with one other chemotherapeutic agent, such as taxol or taxotere, vinorelbine, or etoposide. Chemotherapy for adenocarcinoma of the lung can sometimes shrink the tumor down and improve symptoms. However, it cannot cure the cancer.
The spread of cancer to the brain is another difficult problem. Does he have one or more than one metastatic deposit within the brain? Sometimes, if there is only one metastasis, it can be surgically removed. Patients then often receive radiotherapy to the brain after surgery. If there are multiple metastases, radiation alone is usually the better treatment. Chemotherapy is not of much value in treating brain metastases because it does not penetrate very well into the brain. Without treatment, the brain metastases are likely to grow and may cause disabling neurological symptoms.