Lung mets, when to scan, change chemos?

I have bilateral lung mets, largest 1 cm, biopsied
late Nov. 2004 Several other smaller nodes, too.
I've been on Navelbine/Herceptin combo since Jan 7th
Three weeks on, one week off. Then another CT.
Last CT was done mid December when hospitalized with asthma,
first time in my life.

I still have strong asthmatic symptoms and productive cough
which are only relieved with steroid given with each infusion.
By the end of the week my asthma flares.

I'm concerned that my symptoms have not improved into the
second month of the Navelbine/Herceptin combo.
Should I request a two month CT?

Do most docs continue with 3 months on this protocol, then CT, regardless of symptoms unchanged at 2 months?

Important to note, I did have bilateral lung mets at time of dx 3/2002 which
completely disappeared with neoadjuvant Adriamycin/Taxotere
by next CT in July 2002. I had no cough until starting AT, and never
asthma. Strangely I had innumerable small mets then, but no symptoms
until chemo. The productive cough became less and less over time
during treatment.
My onco was considering Taxotere again. It was difficult for me with
neutropenia and anemia. I have no problem yet with Navelbine/Herceptin
counts have been excellent. Having been through this before,
my gut says it isn't working.

Advice anyone?
Thanks,
Susan M

Susan,
I would request the 2 monthCT. Don't feek guilty about asking for something everyone gets paid to do and could save your life! Go with your gut!!
Good luck,
Al

I also have lung mets and was diagnosed stage 4 with lung and bone mets in Oct, 2002. I also have innumerable bilateral tumors in both lungs. Most of little tumors have remained stable following almost 21/2 years of different chemos and combinations. However, I have a big mass 4.3cm mass in my right middle lobe. I never had symptoms before, but now I feel my lung sore and I have a cough and sometimes shortness of breath. My onc. wants to try a new chemo that just got approved, called Abraxane with Herceptin. I am also going for a consult with the radiation oncologist to see what they say about radiation on my lung. Will keep you postd and you do the same. My e-mail address is htrahan@aol.com if I can be of furthr help to you. My God bless you. I will keep you in my prayers.

Please post further info, Hope, on how this all works out. I am in a very similar situation with mets to both lungs. I was on Herceptin and Navelbine for 6 months and the large mass disappeared. I have only small nodes left and am now on just Herceptin. The new chemo sounds interesting. Good luck and blessings! Tricia

[Patty H]

Susan, I have lung mets and I have a scan every 2 months to see if the chemo I am on is working. I have changed chemo several times, when they quit working or don't work at all. I am on navelbine and herceptin right now, but unless something changes on my next scan, I will probably have to change again. Sometimes I seem to have a dry cough on navelbine. My Dr. doesn't think it has anything to do with the lung met. I did look up side effects of navelbine and sometimes a cough is one of them. Patty H

Susan

If you feel like you are not improving or are getting worse on Navelbine, you shouldn't feel like you have to wait the 3 months. There is no downside to having another scan.

I have lung mets and made the mistake last year of waiting too long to repeat my scanning on navelbine. By the time, I switched chemo I was really in bad shape. I could tell because I was needing more and more oxygen. When I switched chemo, I could start to tell the difference within a couple of weeks.

You don't want to wait until you have no reserves left.

As for the wheezing, and the wet cough, it could mean that the cancer is obstructing the airways. I found that using a breathing machine every 8 hours with a drug called xopenox really helped. And I used an inhaler called advair twice a day and that helped too. I had to see a pulmonary doctor to prescribe them. My lung mets are sometimes hard to follow on scans so he checks breathing tests in addition to the scans every few months.

Good luck!

Navalbine left me with an annoying, dry cough that got pretty bad at one point. I had never had asthma but my son did and I recognized that the sound of my cough sounded like his asthma cough.

Anyhow, for me, it did eventually subside. At the time my onc had me doing Navalbine and Herceptin every week. She felt like that was too tough on me and reduced it to Navalbine and Herceptin for 3 weeks then one week Herceptin only; that seemed to help my side effect symptoms.

Good luck to you.

Peggy in Florida

Thanks everyone for the speedy advice. I'm printing, and filing.
Saw the onco today. I'm getting the Chest/ Ab scan in two weeks,
on my break week. Will keep you posted. Thanks for the support
of my gut instinct. I'm not always good at taking my own advice.

Peace and Prayers,

Susan M