This is Dr. David
yes, I would be happy to review the CT scan and biopsy information.
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does he have a smoking history?
there needs to be more testing of the biopsy to know if it is a squamous cell or adenocarcinoma type of non small cell cancer.
in these situations, where there are multiple masses in the lung, we consider it most likely stage IV lung cancer.
the brain needs a scan to check for metastasis to the brain.
that was good work typing.
he should have the option to receive chemotherapy to fight his lung cancer if he wishes to fight the cancer.
some rare adenocarcinoma type non small cell lung cancers can have special EGFR or ALK1 mutations causing the cancer, especially if he was not a smoker.
is he willing to receive chemotherapy?
that sounds like a cop out sort of statement.
which is like, I don't want to cross the street because I could get hit by a car.
chemotherapy is used to fight lung cancers like this.
in the UK NHS system
doctors are always looking for ways to cut cost and not have to pay for expensive treatments.
chemotherapy has been shown to extend survival by a few months in patients who have metastatic lung cancer.
but chemotherapy can also have side effects and toxicity.
so it is up to him if he wishes to pursue with chemotherapy or not.
biological therapy can only be started after more testing is done on the biopsy specimen to see if there are those mutations I mentioned above.
some rare adenocarcinoma type non small cell lung cancers can have special EGFR or ALK1 mutations causing the cancer
so if he has the EGFR mutation, he would be a candidate for Tarceva or Irressa therapy.
if he has the ALK1 mutation in his lung cancer, then he should be getting Zykadia or ceritinib.
those are biological treatments which are used for certain patients who have certain genetic mutations in their lung cancer.
you should go with him to his oncologist appointment and ask for these genetic tests for his biopsy.
do you have other questions?
that is a personal question that only he, the patient can answer.
different people have different priorities in their lives.
some want to fight the cancer.
some want to go on holiday
so it is up to him and his doctors and family to try to help him make the best decision for him.
does this make sense?
best of luck to you and him.
let me know if you have other questions.
I can't see him or examine him.
no doctor can say how long a cancer patient will live for
it doesn't sound like he has had a brain CT scan
or an abdominal CT scan to check for brain and abdominal metastasis
he needs a bone scan as well to check for bone mets.
that is good.
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