Anyone know the optimal duration of chemotherapy for stage 4 NSCLC?

Question

My mother-in-law has stage 4 NSCLC (non small cell lung cancer) it has metastized to her brain and her bones. My question is how long should chemotherapy be given to her?

Answer 1

To be honest, chemotherapy does not cross the blood brain barrier in most cases and your mother is in the final stage of lung cancer. She probably is getting radiation to her head by now. It stops the growth of the tumor in her brain and makes it shrink, but only for a time.
Most likely, she is very sick because she contiues chemotherapy in an almost hopeless situation.
If she has cancer in her brain and her bones the doctor is buying her some time by giving her chemotherapy plus radiation and is not opting for a cure. This is called pallitive chemotherapy and radiation. Sometimes they do something called brachytherapy to radiate the lung.
Its really up to your mother when to stop. Of course, the Oncologist will tell her her cancer is "treatable", but keep in mind treatable is not curable. She may be willing to put herself thru total hell just to buy herself some time. It is up to her whether she wants to continue. If she decides she no longer wishes to go thru the treatment, hospice is an excellent option. Some Oncologist do not reccomend hospice because once she stops treatment, he is no longer making thousands of dollars off of her care.
Cancer which has spread to the bone becomes very painful and must be radiated for pain relief. Radiation to metastatic bone cancer is not a cure, but a pain relieving measure.
Prayers and peace to you and your special mother.
I am an Oncology RN for 11 years.

Answer 2

The answer to your question is "indefinitely".

Typically what happens is a patient will get 3-4 cycles of one regimen, and then restage (CT scan, MRI brain, PET scan, bone scan). If disease is stable, stay on same treatment. If disease has progressed but performance status is okay (still getting out of bed, able to do activities of daily living, enjoying life), then switch to another line of treatment. Second and third line treatments usually do not work as well. Eventually performance status will deteriorate to a point where the patient cannot tolerate chemotherapy and treatment will stop. Stage 4 is not curable.

Your mother-in-law, however, may elect to stop treatment at any time. Some people tolerate it better than others. Good luck to her.

Answer 3

A study was done by Mark Socinski at UNC Chapel Hill several years ago suggesting that in first-line NSCLC therapy, no benefit is gained beyond four (4) cycles of therapy. A cycle of chemotherapy typically last 3 or 4 weeks.

http://patients.uptodate.com/abstract.asp?TR=cancer/8947&viewAbs=9&title=9

In second-line therapy and beyond, the question has not been addressed, but patients are typically treated until the disease progresses or the patient is no longer able to tolerate it.

Answer 4

It would only be given as a palliative measure-she would be given it until oncologist feels it is no longer helping. It's supposed to help with pain,as is radiation, given in stage 4 NSCLC.
I've seen it prolonglife for up to six months

Answer 5

Stop the chemo please! Read my page and cancer testimonials

Answer 6

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