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Multifocal Adenocarcinoma of the lung, continual recurrences
We have multifocal adenocarcinoma of the lung. @linda10 and @sakota.- Please join me in this discussion.
For a short explanation of this tongue twister. Briefly, Multifocal Adenocarcinoma (MAC) of the lung is a clinical entity of multiple synchronous (less than 6 months) or metachronous (more than 6 months), often ground-glass opacities (GGO) on CT scan, typically indolent-behaving cancers. There is a scarce amt of clinical data to guide treatment decisions.
This came from http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.15_suppl.e20041.
This means that more than one potential cancerous lesion, mostly ground glass, shows up at a time. For instance I had 3 cancerous lesions 10 years ago in my left lung and in the same area. They were all different sizes. They grow at different rates.
Multifocal adenocarcinoma is a very complex cancer because the medical profession doesn't know if the ground glass lesions are the primary cancer or small metastases of another primary cancer. They don't even know where they start..
Multifocal Adenocarcinoma has sub types and it's management is based on whether it's indolent or very virulent.
These are very simplistic explanations. Even doctors are confused by it and it's only been within the last twenty years that they have separated it from a Bronchioloalveolar Carcinoma (BAC).
The constant recurrences are the buggers. Not only do we have to constantly face lots of CT scans but when lung cells change, which they often do, we are in terror of another virulent cancer. I presently have several ground glass lesions. And I have had many that have disappeared. It's enough to drive you nuts and PTSD is exacerbated by the frequency of these devils.
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No, the report just said that I was positive. But Omicron is considered by far the dominant variant. I read "The first signs tend to be congestion and other symptoms of an upper respiratory infection (sore throat, etc.)". You will recall how they said Delta was so much more contagious than earlier Covid and then that Omicron was far more contagious than Delta. I avoided all people and still caught it.
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1 ReactionI know. Omicron can be in the air! Rest, drink plenty of water, and if you aren't too ill, walk if the weather is good!
Omicron can last in places that Delta couldn't! WHen do you see your doctor next?
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1 ReactionI had a follow up appointment a month after surgery with the oncologist and no treatment was prescribed. Other than a brief conversation about the biomarker test which is when she mentioned she talked to the surgeon about it, the remaining talk was about which stage I was. Very brief appointment. I did not get a postoperative follow up with my surgeon as he also works from a different state and was there at the time. Follow up was with the PA surgical assistant which was a little disappointing since I did have some questions specifically for him. So for now I guess it’s the wait and see approach. I have a 6 month CT scan in March and a appointment with the surgeon to go over it. I am considering a different oncologist as I don’t feel like they are very informative. I guess I just wonder why if you have a biomarker mutation they don’t treat with medication to reduce or get rid of other lesions that could possibly become cancerous and need surgery or radiation. I might be over thinking this but will definitely ask my new oncologist. I think your right that they don’t want to over treat too.
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1 ReactionHmm, I guess that I didn't explain myself very well. The reason that they just won't treat other lesions is that they might be healthy, just a simple cell change that will disappear or cause no harm. Doctor's just don't do that because trials and research have found them either unnecessary or harmful to the patient. Hospitals set up certain acceptable protocols for what can and can not be operated on based on the latest research. Doctors have to follow that.
I think that the biomarker test was done in case you needed it in the future. After 24+ years with my multifocal lung cancer, I'm still going strong with SBRT. I've never had immunotherapy.
Is this clearer for you?
Yes and thank you so much. It makes sense to just watch and see whether the lesions disappear on their own or something more concerning happens.
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1 ReactionI am scheduled for third week of March for CT scan and Pulmonologist.
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1 ReactionMy Pulmonologist mentioned it to me as a future possibility. My tumor tissues were sent for complete analysis to identify any mutations that are known to be more sensitive to specific types of treatment (radiation, immunotherapy etc.)
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1 ReactionI believe they tested my genetics to see if I was a candidate for targeted chemo therapy and I wasn’t, but I do know someone that did very well with targeted chemo.
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1 Reaction@jamineibs - Good morning. With multifocal adenocarcinoma surgery or targeted radiation - SBRT is the protocol. Chemo is usually preserved as life-extending after all other options have been used. It's the nature of our beast. Perhaps there will come a time when there is a test that can tell which lesions are likely to become cancerous and which are not.
We have some crazy cancer, right?
@merpreb, My team ran the tests for targeted chemo at the onset of my diagnosis in the event things started growing quickly at any point, then we’d know if it were an option for me. I understand from what my team has explained, some forms of adenocarcinoma can be aggressive.
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