My father (age 56 yrs & weight 70 Kg) has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lobe and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma.
He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. It was categorised as Stage 3B as the pleural effusion was para-malignant and no metastases was noted in any other body part.
He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy to his primary tumour site in his left upper lobe using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report.
Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. His doctor has started my father on Erlotinib 150 mg OD since 26 Jun 17.
My father has developed Post Obstructive Pneumonia in his left lung and there is consolidation in his entire left lung. This is evident from a recent X-ray. He is having difficulty in breathing, takes short & fast breath, sweats a lot, feels cold, has irritation in his throat and gets tired very fast. He also has issue eating solid food and had greatly cut down his diet.
He was started on Oral antibiotic for a week, but did not respond to it. He is admitted in the hospital and is being injected with antibiotics through IVs and injections. His condition remains to be same with no much improvement. His SPO2 level is also low at 90-92%.
Can you suggest anything towards treatment of my father? What is the sequence of treatment that we should follow to ensure recovery of my father in case he does not respond to the antibiotic injections?