Week 166: progression in lymph nodes in right hilus

Written by Lars Haakon Soraas

Week 166 in the war on lung cancer has passed. Here are the highlights:

  • We got the results of the latest CT scan of the lungs. With one exception, it shows that things generally look stable. There is some growth in certain lesions, but both the lesions and the changes are small. The exception, however, is a conglomerate of lymph nodes in the right hilus. This has grown from 18 x 16 mm in August to 19 x 26 mm now.
  • The lymph node conglomerate was the area that was biopsied a week and a half ago. And this week we got the initial results from the biopsy: they have found cancer cells. The picture that emerges is thus this: the reason for the growth of this lymph node conglomerate is not benign, but cancer. Furthermore, this lymph node conglomerate seems like a plausible candidate for being the source of the increase in CEA (which, as mentioned in last week’s post, is rising uncomfortably).
  • The plan we have agreed with the hospital here in Oslo is to radiate the lymph node conglomerate ASAP. We will also radiate another lesion in the lung that has been growing slowly over the past 10 months or so. It currently measures 9×8 mm (up from 9×7 mm in August). Radiation will start on Thursday this coming week and be done in a bit less than 2 weeks.
  • Dyanne has had some fatigue and lack of appetite the last week. Perhaps side effects of recent treatments.

We have been exploring what to do with the tissue that was removed as part of the biopsy. The hospital here in Oslo will do some analysis, but this is rather limited in scope. In addition to what they will do here, we thus plan to send some of the tissue to be analysed in much more detail. The extra analysis will include whole exome and RNA sequencing that we can we use for making a new neoantigen vaccine.

I mentioned in last week’s post that there weren’t that much exciting news coming out of the big cancer conference ESMO. There was, however, another cancer conference that took place at the same time: ASTRO 2018. ASTRO is the annual gathering of radiation doctors. And at this conference there were some promising news. In short: two trials showed that aggressive use of local radiation can improve survival in certain groups of cancer patients. Attached are the two abstracts which contained these results.

Hope everyone has had a good weekend.

Local consolidative treatment improves survival in certain lung cancer patients

SABR-COMET trial shows local radiation can improve survival in some groups of cancer patients

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