How many types of non-small cell cancer

@amdabrock1, welcome to the club no one wants to join! The good news is that lung cancer is more survivable than ever. I was first diagnosed in June 2018, and I have friends who are 7, 9, and 16-year survivors.

Radiation is a treatment. Has your doctor also suggested surgery as a possiblity? That would give your doctors more tissue for sequencing. Of course, surgery will only be considered if it's possible without a major negative effect on your health.

The bigger question is where is the primary? Nowadays, we know that there is not one type of lung cancer. It's actually an umbrella term for many different types of cancer. Has your oncologist started biomarker testing? Those results can take a while to come back.

The results of the biomarker testing can be used to determine which type of non-small cell cancer you have. You could have the EGFR mutation like I do, or one of the others such as KRAS, ROS1, ALK, BRAF, MET, . . . You get the idea, and more are being discovered seemingly every day! Each of these types, and their sub-types, are treated differently with different medications. Fortunately, many have targeted therapies which have fewer side effects than chemo or radiation. We still use chemo in lung cancer, either alone, or to augment a targeted therapy. Immunotherapy is more rare with lung cancer, but certain types (primarily found in smokers) respond better. It all depends on what type of cancer you have.

Stage 4 is a bit confusing as that means widespread. How do they know that if they've only found one tumor? Did the PET scan reveal cancer in other parts of your body, such as the lungs, as well?

The radiation will control the local behind-the-ear mass. After that, treatment will depend on what your doctors learn from genomic and PD-L1 testing. There's no sense in worrying about what hasn't happened yet, so try to remain calm. "Hope" is the byword of all of us cancer survivors!

Ty for the input. The pet scan found 7 or eight place around the body that
were cancerous. They are wide spread in hips,back shoulders neck lung and
abdomen. The genetic testing revealed non small cell. The lung cancer is
assumed due to long history of smoking. 84% chance as opposed to 1 or 2
percent for other. The plan seems to be 4 rounds of chemo followed by
immunotherapy. Extreme discomfort from several large masses are the
immediate concern for me. I can't walk, stand sit or sleep for more than a
few minutes. I'm seven weeks into this. It gets more uncomfortable every
day. I'm not scheduled for the first radiation treatment until the 13th.
Pretty miserable.

@amdabrock1, I'm sorry to hear these details. Those driver mutations I listed are found primarily in nonsmokers. Chemo and immunotherapy is the current recommendation for non-small cell in smokers.

Ask your oncologist about palliative care the next time you see him. Palliative care is designed to help patients deal with the side effects of their treatments, including pain. My doctor sent me to a pain management clinic which has been able to help with my chronic pain. I pray that you can find some relief.

I'm scheduled to start palliative care to coordinate with the radiation. I
just hope, in my current condition, I will be able to stay immobile during
the radiation. The last two CT scans have been torture and the discomfort
increases daily.