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Cancer

Adenocarcinoma in Lung of Heart Patient

02/05/2010

Question:

My father recently had a biopsy of a mass in the upper portion of his lung (big enough it is causing it to collapse partially). They have said it is adenocarcinoma and they are sending him for a PET scan to see if it has spread.

I am trying to be realistic. He has been a heart patient for 16 years (2 bypass surgeries, pacemaker/defib, an ejection fraction of 27%, congestive heart failure, and recently a leaky valve). The local cancer center said they will know more after the PET scan, however they discussed already surgery, chemo, and radiation. With his health, can his heart withstand chemo and radiation?

Also, typically is prognosis good in this kind of a situation? I know no one will be able to predict or give absolutes - I`m just trying to get a realistic perspective on the situation.

Answer:

These decisions are difficult ones in the best of circumstances. Although you "want to know", I would advise being a support to your father through this journey as he learns about his lung cancer and the treatment options that may exist for him.

Your questions are good ones, i.e. do the risks outweigh the benefits, and what are the benefits. The answers depend on specifics of the disease and your father's health, as well as his values about risks and benefits that cannot be answered without a thorough knowledge of your father and his case.

Prognosis is best discussed after all the testing has been done, and the discussion is best had with the specialist that may be treating your father. I advise you to get at least two opinions and try to get to a large university hospital or an NCI designated cancer center for an opinion, if possible.

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Response by:

Paula  Silverman, MD Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University