Need an idea of my grandmother's chances?

[justplainjen]

I'm caring for my 75 year old grandmother who was just diagnosed with NSCLC and I have questions that I couldn't ask her dr (he's very busy and I couldn't catch him before he disappeared). She has lost a lot of weight (I don't know if she has any weight left to lose, it's gotten that bad), has absolutely no appetite, and she naps during the day now- she never used to do that. She's exhausted all the time and very frail. The oncologist was very careful NOT to tell us what stage the cancer was in, and was so Mr. Rogers upbeat about her chance at a cure, but since I am the one who will be taking care of her during treatment, I need someone to tell me honestly what to expect. I won't share this info with her unless she asks me because I know how important it is for her to have a positive attitude. PET scan found primary mediastinum tumors, spread to lymph node in aortic pulmonary window, all the axillary lymph nodes on the same side (left) and very large supraclavicular node tumor on the left side. This last tumor was the size of a small grape three weeks ago and is now the size of a golf ball- you can see it from across the room. From what I've read, I think that all means that the cancer is stage III, if not stage IV. PET report says there are "numerous foci" in the liver with "SUV of 3.6 and higher", but dr said that is nothing to worry about?!  She also has severe emphysema. The doctor didn't give her any choice- just said he was going to put her on chemo and radiation (said surgery is out of the question, his exact words were that it would be mutilation at this point.  He also said that since it has left the lungs, there's a good chance that it has already spread to other places but they can't see them yet). Between all this bad news and his cheerful statement that he thinks he can cure it, I don't know what to think. Seemed like some very mixed messages. Can you give me any idea as to what her chances are? How long she might have? Months or years? Please help?  

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
From your description, it appears that unfortunately your grandmother has very advanced (Stage 4) lung cancer.
It is unlikely that any intervention (surgery, chemo, radiation) will fully cure her. However, it is equally likely that modern oncology care can benefit her - relieve her symptoms, improve her qulaity of life, and perhaps extend the lifespan.
She needs a full evaluation, and treatment with appropriate chemotherapy (depending on her general condition), and supportive therapy in form of palliative radiation, zoledronic acid (if bone is involved), nutritional support, pain relief etc.
Please have a detailed discussion with the treating oncologist.
All the best, be strong, and God Bless!

[justplainjen]

Thank you so much for your answer.  I truly appreciate your honesty.