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How can my mother's stage 4 lung cancer be managed?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

My mother has lung cancer. It is in the fourth stage. Currently, the doctor has advised her to take stage 4 lung cancer targeted therapy. She is taking Gefitinib tablets every day. Is there anything serious?

Please help me.

Answered by Dr. Pawar Satyajit Jalinder

Hi,

Welcome to icliniq.com.

Please say something about the histopathology report, after which I can tell you about targeted therapy in stage 4 lung cancer in older adults. Please explain the condition briefly. Please state whether there was a mutation before starting Gefitinib. All these things are essential for deciding the response to Gefitinib. In general, on taking Gefitinib, the average survival is 13 to 14 months. But some patients have long-term survival for three to four years. Some patients do well for five to six years.

Usually, Gefitinib is well tolerated. The most common side effects are skin rash and acne. Rarely, it can cause hepatitis or pneumonitis, which is manageable with drug discontinuation for a few weeks. I recommend doing a PET (positron emission tomography) scan every three months. Have a look over the drug response. Please send your report so that I can guide you further.

I hope this information helps you.

Thank you.

Patient's Query

Thank you, doctor.

I have attached the reports.

Answered by Dr. Pawar Satyajit Jalinder

Hi,

Welcome back to icliniq.com.

Please give me a clear picture.

Thank you.

Patient's Query

Thank you, doctor.

I am attaching some pictures.

Answered by Dr. Pawar Satyajit Jalinder

Hi,

Welcome back to icliniq.com.

I have gone through the attachment (attachment removed to protect patient identity). I am puzzled regarding the thyroid mass and multiple lymph nodes. The PET (positron emission tomography) scan suggests lung cancer in the fourth stage, as there is a pleural-based nodule. She is a good candidate for having Gefitinib based on genome testing.

Please explain the condition of tuberculosis and the medication taken for tuberculosis.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.

Patient's Query

Thank you, doctor.

I will explain it briefly. Two years ago, she had a node below the throat. The doctor operated on it, and a small portion was sent for biopsy. The result came as tuberculosis. She has been taking treatment for one and a half years. After a few days, she had left lung chest pain. They took a biopsy of the lung with the guidance of CT immediately. The result was cancer in the lung. They also found a node in the thyroid.

A biopsy was taken. The thyroid report came back negative for malignancy. So the doctor concentrated on treating the lungs. Then we took EFGR.

Regarding the histopathology report, immunohistochemistry shows positivity for Vimentin. The tumor cells are strongly positive for TTF1, CK7 and negative for WT1, CK20, and thyroglobulin.

Answered by Dr. Pawar Satyajit Jalinder

Hi,

Welcome back to icliniq.com.

The histopathology report shows TTF-1 (thyroid transcription factor), CK7 (cytokeratin7) positive and thyroglobulin negative. It is lung cancer. Now, the dose of Gefitinib has to be increased as ATT can reduce the effectiveness of Gefitinib. It is important.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.

Answered byDr. Pawar Satyajit Jalinder

Medically reviewed byiCliniq medical review team

Published At March 19, 2018
Reviewed AtApril 2, 2026

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Stage 4 Lung Cancer Care Companion

How it works

Stage 4 lung cancer means the cancer has spread beyond the lungs. Care at this stage is about control, not cure. The five steps below explain how an oncology team usually thinks about managing it. Every decision below is made with your loved one's oncologist, based on their specific cancer and their overall health.

1🔬

Confirm
the Type

2🗺️

Map the
Spread

3🧭

Pick the
Approach

4📊

Watch the
Response

5🤝

Add
Support

Why your doctor talks about "managing" stage 4 lung cancer

At stage 4, the goal of care shifts from cure to control. Your loved one's care team will work to slow the cancer, ease symptoms, and protect their quality of life for as long as possible. The plan is built around their cancer's specific features and their overall health, and it is reviewed at every visit. Always confirm their plan with their oncologist.
Dr. Pawar Satyajit Jalinder
Dr. Pawar Satyajit Jalinder

Medical oncology

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