[asian010]

to my knowledge, bronchioloalveolar carcinoma is a non invasive neoplasm. meaning it does not attack the cells surrounding the mass. this cancer is a "Carcinoma in situ" (CIS) meaning its just a lump of neoplasm. CIS in definition cannot kill. but bronchioloaveolar carcinoma is special, it slowly fills the lung thus restricting breathing and possible killing the patient. it is malignant, but NOT invasive.

note. neoplasm is now considered synonymous with tumor...

note. i am not a doctor, though im working on a biology major hoping to become a doctor or pharmacist.

[just4kickz]

Originally Posted by asian010

to my knowledge, bronchioloalveolar carcinoma is a non invasive neoplasm. meaning it does not attack the cells surrounding the mass. this cancer is a "Carcinoma in situ" (CIS) meaning its just a lump of neoplasm. CIS in definition cannot kill. but bronchioloaveolar carcinoma is special, it slowly fills the lung thus restricting breathing and possible killing the patient. it is malignant, but NOT invasive.

note. neoplasm is now considered synonymous with tumor...

note. i am not a doctor, though im working on a biology major hoping to become a doctor or pharmacist.

interesting.

[xT4iw4n3zx]

Originally Posted by asian010

to my knowledge, bronchioloalveolar carcinoma is a non invasive neoplasm. meaning it does not attack the cells surrounding the mass. this cancer is a "Carcinoma in situ" (CIS) meaning its just a lump of neoplasm. CIS in definition cannot kill. but bronchioloaveolar carcinoma is special, it slowly fills the lung thus restricting breathing and possible killing the patient. it is malignant, but NOT invasive.

note. neoplasm is now considered synonymous with tumor...

note. i am not a doctor, though im working on a biology major hoping to become a doctor or pharmacist.

Originally Posted by just4kickz

interesting.

This is extremely interesting, and has just put some joy into my day today.
Asian010 are you pretty certain of this knowledge? I have been reading up on BAC all day till now and some sources say it's invasive, other's say it's not. I don't really trust information from a website as much, because I'd prefer if I could get it from a textbook. So I've also been brushing up on my AP Bio Cancer notes (not much help, but it does explain the basics). Anyways this sounds good good!! It might mean that BAC can be curable? But then why did the oncologist say that patients with BAC along the lungs are usually less than a year? @___@"

Gah so much information/disinformation out there. If you don't listen to the news you're uninformed. If you do listen to the news you're misinformed....

[Kev]

Originally Posted by xT4iw4n3zx

This is extremely interesting, and has just put some joy into my day today.
Asian010 are you pretty certain of this knowledge? I have been reading up on BAC all day till now and some sources say it's invasive, other's say it's not. I don't really trust information from a website as much, because I'd prefer if I could get it from a textbook. So I've also been brushing up on my AP Bio Cancer notes (not much help, but it does explain the basics). Anyways this sounds good good!! It might mean that BAC can be curable? But then why did the oncologist say that patients with BAC along the lungs are usually less than a year? @___@"

Gah so much information/disinformation out there. If you don't listen to the news you're uninformed. If you do listen to the news you're misinformed....

Sorry to burst your bubble. His information is not entirely correct.

It is true that BAC is a well organized and highly differentiated tumor if you look at it underhistopathology and is, by WHO definition / classification, non-invasive, meaning that it does not cross the basement membrane and DIRECTLY invade nearby structure. However, it can still spread by aerogenous route (through the airways) and lymphatic invasion. Local growth is usually along intact alveolar septa (known as Lepidic growth) and in advance cases can result in bronchorrhea (increased watery secretion that can drown the lungs), or a V/Q shunt resulting in hypoxemia, which is life threatening.

As I said before, if they recommend the use of chemotherapy instead of radiotherapy and surgical resection, this can reflect advanced disease so the prognosis might not be good as implied by the oncologist.

[Ravioli]

Tell us about your mom's medical history. Does she eat a healthy diet with lots fruits and vegetables, exercised a lot, smoked or never smoked in her life? Has she been under a lot of stress in her life? Was she diagnosed at VGH?

[xT4iw4n3zx]

Originally Posted by Kev

Sorry to burst your bubble. His information is not entirely correct.

It is true that BAC is a well organized and highly differentiated tumor if you look at it underhistopathology and is, by WHO definition / classification, non-invasive, meaning that it does not cross the basement membrane and DIRECTLY invade nearby structure. However, it can still spread by aerogenous route (through the airways) and lymphatic invasion. Local growth is usually along intact alveolar septa (known as Lepidic growth) and in advance cases can result in bronchorrhea (increased watery secretion that can drown the lungs), or a V/Q shunt resulting in hypoxemia, which is life threatening.

As I said before, if they recommend the use of chemotherapy instead of radiotherapy and surgical resection, this can reflect advanced disease so the prognosis might not be good as implied by the oncologist.

Okay... So if it does spread that means it'll metastasize right? @@

As for bronchorrhea, she does has watery secretion from the lungs, but the Doctor's say that this is pneumonia. She's been on Avelox for a while now and it's working so I'm guessing it's not bronchorrhea? Meaning this isn't advanced BAC?? BTW, what exactly is hypoxemia?

Also... What do you mean by the last bit...?

Originally Posted by Ravioli

Tell us about your mom's medical history. Does she eat a healthy diet with lots fruits and vegetables, exercised a lot, smoked or never smoked in her life? Has she been under a lot of stress in her life? Was she diagnosed at VGH?

Medical History: Diet is Asian-based. Meaning she gets alot of vegetables, mainly seafood. She tends to have a preference for not having red-meats (she kind of detests red-meats). Mainly her intake of drinks are Tea (first) and the morning cup of coffee. She has been eating fruits only lately (seems to be all she can keep down) but on normal times she does eat fruits, I don't think up to what you're supposed to eat everyday though.

As far as excercise goes it's zero-none unless it's shopping in the mall >O>"

Never smoked in her life, and has been under a lot of stress. She was diagnosed at Burnaby Hospital.

[asian010]

great information, guess u guys can tell i dont have much knowledge yet but im working on it.. always good to help. btw kev, how far are you in your education in becoming a doctor. (very sorry off topic)

Originally Posted by Kev

Sorry to burst your bubble. His information is not entirely correct.

It is true that BAC is a well organized and highly differentiated tumor if you look at it underhistopathology and is, by WHO definition / classification, non-invasive, meaning that it does not cross the basement membrane and DIRECTLY invade nearby structure. However, it can still spread by aerogenous route (through the airways) and lymphatic invasion. Local growth is usually along intact alveolar septa (known as Lepidic growth) and in advance cases can result in bronchorrhea (increased watery secretion that can drown the lungs), or a V/Q shunt resulting in hypoxemia, which is life threatening.

As I said before, if they recommend the use of chemotherapy instead of radiotherapy and surgical resection, this can reflect advanced disease so the prognosis might not be good as implied by the oncologist.

[boymonkey]

One of my relatives has cancer in the intestines. She was in chemo for a few months (ended in March). She seems to be all good now.

[xT4iw4n3zx]

Originally Posted by boymonkey

One of my relatives has cancer in the intestines. She was in chemo for a few months (ended in March). She seems to be all good now.

Was the cancer extensive? Which hospital did she go to?

[AllydNYC]

Though I have no advice to give, I'm sincerely sorry to hear this. My heart sank reading this. Best wishes.

[firstkill]

** disclaimer this is based on US practice and US trained physicians

if surgery is not an option, i am assuming she has more distant disease.
At least in the US surgical resection is standard of care if localized. Otherwise its chemotherapy +/- radiation

Stereotype of oncologist usually do not tell it like it is. They are always hopeful of "more" chemo. I would ask her primary care physician (or google) for pure statistics if u wish to know. Usually measured in 6 month or 1 year or 5 year survival rates.

multi drug chemotherapy will likely be given, the combination will be up to your physicain as each one may chose a different combo. Each one has its own side effects, and complications. Each treatment with the same drug may not have the same side effects.

You absolutely cannot compare different types of cancers and outcomes. Each type of cancer is completely different.

The family and your mother should have a talk about what she would want if it came down to Life support. Machines to keep her breathing and machines to filter blood. This decision is too tough to make when you need to make it in an emergency. ****** this is the most important thing to do as this will be the only thing the family can control.


The antibiotic she is getting is treatment for community aquired pneumonia. You should ask your doctors if this is adequate, as it seems more like "post obstrutive pneumonia" which has different treatment

also, if this is at a Non Univeristy medical center where she had her biopsy, ask her docotors if they ruled out wegners which can look similar on radiograpys and pathology if they didnt get that great of a sample.

fk

[DimSumBoy]

sorry to hear about your situation. my father had pancreatic cancer when i was 14 and passed away when i was 16. its not a fun situation but you have to do what you have to do. good luck and best wishes to your family.

[letsg0]

I'm so sorry to hear this, OP. Cancer is always so unpredictable; every human body differs from each other so don't base your situation off others'. I knew a little boy who was diagnosed with a rare form of leukemia at the age of 2, but after continuous treatment and a bone marrow transplant, he passed away when he was 5. Then I also know another lady who was diagnosed with cancer at Stage 4 and was told she only had maximum 6 months to live..but she was pampered with Chinese herbs and different types of medicine and ended up extending her time to 5 years (but ultimately passed away as well). I hope tomorrow's appointment will provide you with comforting news. Good luck, you're in my prayers..

[ChaneRZ]

Originally Posted by DimSumBoy

sorry to hear about your situation. my father had pancreatic cancer when i was 14 and passed away when i was 16. its not a fun situation but you have to do what you have to do. good luck and best wishes to your family.

pancreatic cancer is the fastest killer of all cancer.

[boymonkey]

Originally Posted by xT4iw4n3zx

Was the cancer extensive? Which hospital did she go to?

She had a pretty big tumor, five centimeters in diameter. It didn't spread to other organs. She went to hospital in New Jersey. She is 56.

[boymonkey]

Originally Posted by ChaneRZ

pancreatic cancer is the fastest killer of all cancer.

Yeah, I know someone who has a relative going through that right now. He could go anytime in a month or two.

[DimSumBoy]

yeah kidna rough.

im 19 now and my mom is seeing another person? there is another issue, maybe for another thread lol

[E(@M#]

god bless...my prayers and best of wishes :/

[Kev]

Originally Posted by firstkill

** disclaimer this is based on US practice and US trained physicians

if surgery is not an option, i am assuming she has more distant disease.
At least in the US surgical resection is standard of care if localized. Otherwise its chemotherapy +/- radiation

Stereotype of oncologist usually do not tell it like it is. They are always hopeful of "more" chemo. I would ask her primary care physician (or google) for pure statistics if u wish to know. Usually measured in 6 month or 1 year or 5 year survival rates.

multi drug chemotherapy will likely be given, the combination will be up to your physicain as each one may chose a different combo. Each one has its own side effects, and complications. Each treatment with the same drug may not have the same side effects.

You absolutely cannot compare different types of cancers and outcomes. Each type of cancer is completely different.

The family and your mother should have a talk about what she would want if it came down to Life support. Machines to keep her breathing and machines to filter blood. This decision is too tough to make when you need to make it in an emergency. ****** this is the most important thing to do as this will be the only thing the family can control.


The antibiotic she is getting is treatment for community aquired pneumonia. You should ask your doctors if this is adequate, as it seems more like "post obstrutive pneumonia" which has different treatment

also, if this is at a Non Univeristy medical center where she had her biopsy, ask her docotors if they ruled out wegners which can look similar on radiograpys and pathology if they didnt get that great of a sample.

fk

FK gave some very good information here.

It's important to designate a healthcare proxy early on such that in the unfortunate case that your mother is unable to make medical decisions, there is some sort of documentation what her wishes when she is more lucid may be and who in the family will make the final decision on life support such as intubation, mechanical ventilation, tracheostomy, hemodialysis, CVVH, transfusion of blood products etc. People usually don't make the most rational decision under stress.

Given the clinical picture that OP was painting, it is unclear whether the site of pneumonia / consolidation coincide with where the lesions are located. Therefore, there remains question of whether the treatment with a 3rd generation FQ is adequate because we are not sure whether this is CAP or post-obstructive pneumonia (but shouldn't they have bronch'ed her if there is doubt of obstruction?).

Originally Posted by xT4iw4n3zx

Okay... So if it does spread that means it'll metastasize right? @@

As for bronchorrhea, she does has watery secretion from the lungs, but the Doctor's say that this is pneumonia. She's been on Avelox for a while now and it's working so I'm guessing it's not bronchorrhea? Meaning this isn't advanced BAC?? BTW, what exactly is hypoxemia?

Also... What do you mean by the last bit...?

There is a chance of metastasis, but there are different level of metastasis, such that treatment and prognosis are different. In fact, pathologic staging of tumor is based on three things, T (tumor size), N ([lymph] nodal metastasis), and M ([distal] metastasis). This can be translated into a clinical staginng (the Stage 1, 2, 3, and 4 that you said). So, you'll have to sit down and talk to the oncologist in detail as to what they have found in biopsy, +/- bronchoscopy, PET scan or PET/CT scan.

Bronchorrhea is just a condition of water secretion >100ml per day. If it doesn't seem to be affecting her, then don't worry about it. It doesn't necessarily reflect the extent of her tumor. Hypoxemia literally translates into low oxygen in blood, meaning that the patient has trouble maintaining the amount of oxygen in her blood so that her tissues are not getting enough of oxygen.

The last bit has been explained by FK above. The first line treatment for more localized (Stage 1/2) BAC, the treatment of choice is surgical resection. Otherwise, for more extensive disease (Stage 3/4), the treatment of choice is radiation +/- chemotherapy. The fact that they stated that your mother is not a surgical candidate and treatment of choice is chemo, this might imply that she has more advanced disease.

If you have not received a second opinion yet, try to get one from UBC Medical Center.

[Chewyjr15]

i lost my father at 13 to lung cancer he was a smoker, all i can say is cherish the time you have now and my thoughts and prayers are with you.

[darkphantom]

Hey OP, stay in there. My friend's mother had a very similar cancer, related to the lungs, and she is only 20-21 years old. She has 4 other sisters and they're all younger than her.

Her mother was diagnosed several months ago, taken to the hospital. Luckily, they got her admitted in time. They removed one of her lungs, and thank god, she is ok now. Slowly recovering, but recovering nonetheless.

Keep hope and stay strong, god is merciful. Just give her support because that is what she needs right now. If the patient does not have hope, than I don't know what you can do, so make sure you support your mother!

Good luck OP, god speed.

[xT4iw4n3zx]

Originally Posted by firstkill

You absolutely cannot compare different types of cancers and outcomes. Each type of cancer is completely different.

The family and your mother should have a talk about what she would want if it came down to Life support. Machines to keep her breathing and machines to filter blood. This decision is too tough to make when you need to make it in an emergency. ****** this is the most important thing to do as this will be the only thing the family can control.


The antibiotic she is getting is treatment for community aquired pneumonia. You should ask your doctors if this is adequate, as it seems more like "post obstrutive pneumonia" which has different treatment

also, if this is at a Non Univeristy medical center where she had her biopsy, ask her docotors if they ruled out wegners which can look similar on radiograpys and pathology if they didnt get that great of a sample.

fk

What do you mean by decisions on Life Support? I'm not too sure what the problem is with that.. @@ Could anyone tell me?

What is Post Obstructive Pneumonia? Will Avelox (Moxifloxacin) do anything? I've read up on the drug and it says it's "to treat severe and life threatening bacterial infections. The licensed uses for moxifloxacin are quite limited as moxifloxacin is to be considered a drug of last resort when all other antibiotics have failed." I got that from Wikipedia, yes I know, not the best source e_e.

Also the biopsy I think was done at VGH which is right next to a University. Why would it be mistaken if it was at a Non-University Hospital? Are University Hospitals better? Should we move her to one? What the heck is a wegner?