Rather bad news

[LMighty]

My mom's X-ray today shows that her pleurodesis for the left lung done 20 days ago was again unsuccessful as the fluid accumulated again. There is also newly appearing shadow in the lung area. Our onc said it is very likely tumour. When asked if it could be resected, he said no because the tumour is located in the pleural cavity instead of on the lung itself, as the accumulation of fluid is evidence. I sort of expected something to show on scans after 3-month break from chemo but still find it hard to swallow. It's worrying as it's the first time the cancer visibly progressed ever since stage IV diagnosis.

Going forward, my mom will be going through Irinotecan + Cetuximab. Xeloda/5FU is dropped as our onc thinks it's not working anymore.

I have a few questions I wish anyone here would share your views on:
1. Is pleural cavity metastasis inoperable? Should I seek second opinion in this regard?
2. For those with who have been on Irinotecan before, how did you adjust your diet? Did you lose energy or weight significantly?

Thank you very much.

[stu]

Hi ,

I can help with your questions but I am very sorry to hear about your mum . I hope bumping this back up will help get the answers you need.
Take care,
Stu

[CRguy]

1. Is pleural cavity metastasis inoperable? Should I seek second opinion in this regard?

Yes it can be operable, but the techniques vary according to patient status and presentation.

YES you should consider a second opinion.

Have they considered / discussed a temporary indwelling drain ? ( kind of like our power ports for infusing chemo, these systems allow for fluid to be removed without repeated pleurocentesis (thoracentesis, thoracocentesis) procedures
I have placed these and used them successfully for years in cats and dogs.
The human medical folks have even better methods in the hands of a certified specialist.

here is a link to a site for mesothelioma ( which my father had ) and a whole list of things which are potentially possible with the right doctors, hence maybe the need for another opinion. Your Mom's presentation has many similarities to my Dads even though it is not mesothelioma.
https://www.asbestos.com/treatment/surgery/

Best wishes to you and your Mom

CRguy

[LMighty]

Thanks a lot to Stu for the bump and CRguy for the very useful information. It gives me a bit more hope!

At the moment the tumour is only a small cloudy area appearing on X-ray. It's exact location, margin and size is still unknown. I think my mom would need another PET scan to identify it more clearly. The last one was done in Jan so the next one should be around July, by then my mom would have been thru 5/6 cycles of Irinotecan + Cetuximab. I guess we will have to wait for that PET scan result and seek second opinion in case the tumour is not resolved by chemo.

We have yet to discuss a temporary indwelling drain. Our onc's approach is to attack the lung mets with the current chemo in order to stop the fluid from generating and let the body naturally drain the remaining fluid.