Would you consider treating a patient who has an unresectable slowly growing PET avid lung mass with concurrent chemo RT when multiple biopsy attempts have only resulted in pathology "suspicious" for adenocarcinoma of the lung?
Answer from: Medical Oncologist at Academic Institution
I would consider treating the patient if they have a highly suspicious biopsy with the proper clinical context and after speaking with the pathologist to understand why the report indicates only "suspicion" rather than "confirmation". The patient in question had "multiple biopsy attempts" and demons...
Comments
Medical Oncologist at Saint Vincent Cancer and Wellness Center Thank you, Dr. @Nasser H. Hanna. Could you elabora...
Radiation Oncologist at Cancer Care Centers of Brevard Sure, the question would be whether the medical on...
Medical Oncologist at Indiana University School of Medicine My criteria would be "clear and convincing" eviden...
Medical Oncologist at NYU Winthrop Hospital I will not treat without tissue diagnosis and mole...
Medical Oncologist at Meharry Medical College What are the size and location of the lesion in qu...
Answer from: Radiation Oncologist at Community Practice
No. We need to protect against all slippery slopes that may allure us to treat without a cancer diagnosis. The use of empiric SBRT without path confirmation for stage I lung cancer is a unique situation as it parallels empiric Surgery without path confirmation. Extrapolating such a paradigm to deliv...
Answer from: Medical Oncologist at Community Practice
I would not treat with chemotherapy or targeted therapy until a definitive diagnosis is made. Blastomycosis and other conditions have been mistaken for malignancy. If you treat based on suspicion of... sooner or later a rather serious error will be made.
Answer from: Medical Oncologist at Academic Institution
If the patient is not overly enthusiastic to receive therapy and asymptomatic, I don't think it would be wrong to observe very closely with follow-up imaging in 2-3 months to assess the rate of growth.
Answer from: Medical Oncologist at Community Practice
It sounds like this is stage I disease. Chemotherapy is never indicated for stage I disease. The therapeutic choices are surgery, SBRT, or observation. If fit, surgery is preferable. If life expectancy is less than 5 years, then observation is appropriate for a slowly growing lesion. For the rare pa...
Thank you, Dr. @Nasser H. Hanna. Could you elabora...
Sure, the question would be whether the medical on...
My criteria would be "clear and convincing" eviden...
I will not treat without tissue diagnosis and mole...
What are the size and location of the lesion in qu...