Anyone do chemo and radiation therapy together for lung cancer?

@bob, I was cancer-free after treatment. However, I was diagnosed with a 3.2 cm cyst in my brain about 18 months later. That's because chemo doesn't cross the blood-brain barrier. A neurosurgeon removed the cyst, and my radiologist gave me five rounds of radiation to finish the job. My oncologist started me on Tagrisso at the same time because I have the EGFR Exon 19 mutation. That was almost four years ago.

Since then, I had one recurrence early this year, when my 3-month brain MRI revealed increased activity between the area of resection (where they removed the cyst) and my skull. I had one more round of radiation and continue taking Tagrisso to this day.

I've gotten way carried away with my advocacy this year as I'm both a civilian reviewer for the government organization that wants to cure all diseases prevalent among military personnel (the CDMRP) and a Patient Research Advocate-in-training with the International Association for the Study of Lung Cancer (IASLC). So, I know that, at the moment, Tagrisso is only recommended as a first-line treatment for Stage 3 and above. Again, that's only for the EGFR mutation. Have you received the results of your husband's cyst biopsy yet? Nowadays, the type of NSCLC determines the treatment.

Thanks so much for your response and sharing your story. I see now that cancer is a long journey.

Husband too was cancer free after lobectomy - 0% ctDNA and doing immunology just for “insurance”. . So we were surprised with latest PetScan showing SUV 4.3 on lung. He does not have mutation. APRN said probably CT next, then probably more chemo and/or radiation. We meet with oncologist tomorrow to solidify next steps,

@abob, how did the appointment go? What are next steps?

@tomm1951, how are you doing with treatment?

Thx for asking . Oncologist ordered Guardant Reveal blood test instead of CT to show cancer cells in blood cDNA which had been 0%. Awaiting results - if > 0%, then probably see radiation oncologist.

Result: ctDNA NOT DETECTED, Tumor Fraction: 0%

So is this blood test meaningless/misleading?
Just wait to see if new PetCT “focus” on back of lung grows?

@abob, you and your husband have had quite the ride. He's fortunate to have you at his side. None of the tests or scans are perfect, but they often do fill in one part of the puzzle. They rarely complete the puzzle, which is frustrating.
I am not a clinician, but my understanding is that ctDNA tests (sometimes referred to as a liquid biopsy) are looking for circulating tumor DNA in the blood stream. I've had one of these tests at the time that I was diagnosed. My oncologist has noted that the tumor has to be shedding a certain number of cells, so fairly far along, in order for the DNA to appear in the blood stream. Being that they found 0%, doesn't mean with 100% certainty that the nodule isn't cancer, but it also tells us that it's not shedding cells like crazy, which is good.
Did the oncologist give you an idea of what they believe may be happening? I'm assuming that they can't/haven't biopsied it? How long will you wait for the next PET or CT scan?

Thx for your reply.
ctDNA NOT DETECTED.
Since no cancer cells are circulating in the blood, this is not “metastasis”. So it might be new mass. 

CT chest,abd,pelvis w/contrast ordered for next month.

@abob, to add to what Lisa said, "ctDNA not detected" does not mean you don't have any circulating cells. This means there aren't enough circulating cells to exceed the minimum detection level. I've received many reports of no circulating cells, but I keep getting tested because I've had lung cancer that has metastasized to my brain. ctDNA is just one piece of information your doctors combine with everything they know about their patients to get the whole picture. As I say in my presentations, after your first lung cancer diagnosis, it's "Welcome to the world of testing!"

This is also why Dr. Google and Dr. YouTube are often wrong or misleading. They know nothing about the patient's history, lifestyle, personal habits, etc., which are essential to informing a doctor's picture of what's happening.

Thx for your reply. I do often get too much from Dr. Google. But the implication of “ ctDNA NOT DETECTED, Tumor Fraction: 0%” came from oncologist. So this very expensive “piece of the puzzle” seems rather insignificant and unhelpful re the new “focus” identified by PetCT.

Perhaps next month’s CT chest,ABD,pelvis with oral & IV contrast will determine next steps. We do now see that NSCLC is never over.

@abob, and my bad for not sharing an authoritative site: lungevity.com. There are many lung cancer statistics and much good information there.

I just returned from the World Conference on Lung Cancer, where, among other things, I learned that much work remains to be done to obtain meaningful information from blood tests. Sort of the Holy Grail of blood tests that several companies and Universities are working on is the ability to detect early-stage cancer well enough to use a blood test for pre-screening. That will enable many more people to get easily screened. We're not there yet. ctDNA is one of the first steps in that direction.

I also have a very different view on the permanency of lung cancer. Unless my doctor tells me that I currently have active cancer in my body, I am cancer-free. I've been cancer-free most of my journey. And as someone who is cancer-free, I pay it no mind. Life is way too short to walk around feeling like you have a gun to your head or certain that you know the day your life will end. I refuse to live like that.

As I've said at the end of my Lung Cancer Awareness presentations while displaying a picture of Han Solo from Star Wars: "Throughout my journey, the odds were there, the statistics, the prognosis. But I chose to be like Han. Not to live by the odds, but by hope, determination, and a sense of optimism. I urge all of you, not just in health, but in every challenge you face -- don't let the odds define you. Live your own story."