• Does non-small cell BAC lung cancer met. to the bones first, or does it generally go to the liver or brain first?

    Asked by Journey on Saturday, May 11, 2013

    Does non-small cell BAC lung cancer met. to the bones first, or does it generally go to the liver or brain first?

    I still do not know if I have stage 2A or stage 4. The PET/CT showed "possible" met. in the bones, but also a lot of degeneration of my bones & discs, probably from arthritis. My bone biopsy came out OK. Pathology report showed all lymph nodes clear.

    3 Answers from the Community

    • carm's Avatar

      Hello I am an oncology nurse and actually BAC rarely metastasizes outside the lung. This type of cancer usually stays confined to the lung and generally has a very good prognosis. It is distinct in that its cells are easily determined and very non aggressive. BAC is often monitored after treatment because it has a tendency to either resolve itself or regress on its own. Good luck to you, Carm RN.

      over 3 years ago
    • CAS1's Avatar

      Carm is right.. If your going to get LC this is the one to get.

      BAC can be related to smoking. If you are a smoker now is the time to quit because any LC can morp into other mutations and other types of LC..

      over 3 years ago
    • CraiginPA's Avatar

      As you've already read, BAC usually doesn't spread outside the lungs, but it can consolidate and start to act more like a regular adenocarcinoma. BAC is a subtype of adenocacinoma, and the experts have stopped calling it BAC. Instead, they call it one of 5 different subtypes of adenocarcinoma ranging from idle "adenocarcinoma in situ" through "adenocarcinoma with BAC features" to the more difficult "mucinous adenocarcinoma." My mucinous BAC would probably be called "mucinous adenocarcinoma." My has some IHC-test attributes of regular adenocarcinoma but has been behaving like mucinous BAC, so it could change at any time.

      I know a person who was diagnosed with BAC but had already had spread to lymph nodes. I am wondering if that might have been a clue that it might act more like a regular adenocarcinoma.

      I you have real BAC I can understand having skepticisim about suspected bone "mets" being cancer as opposed to something else. You may need to see further growth (and/or bone pain) or get a biopsy to determine for sure. Is a biopsy scheduled so you can try appropriate treatment ASAP? Or are they going to just assume it's cancer an try to eliminate those mets with targeted radiation?

      As far as where adenocarcinoma would spread first, there are people who could quote odds (e.g, maybe liver), but it could be anywhere (e.g., half of patients who are on Xalkori for ALK-driven adenocarcinoma get brain mets as their first progression on the drug because the drug doesn't get into the brain so it can't protect there).

      FYI, when cancer has jumped a distance away from the original site, e.g., to the bone, it would usually be called stage IV. And stage IV adenocarcioma should automatically be tested to try to determine it's driving mutation because if it is driven by a useful one it might be inhibited for a number of months with a targeted therapy. KRAS (only slightly useful), EGFR, ALK, ROS1, RET, BRAF v600e variant, and HER2 all have promising drugs either available by Rx or via a clinical trial. There's usually only one (they are 97% exclusive of each other, at least initially), so testing stops on the first match. KRAS is very common if their is a smoking history. The most useful ones are mostly found in never-smokers (up to 90% of those cases are in never-smokers), but if a smoker doesn't have KRAS it is worth a shot testing for the more useful ones anyway in case a person is lucky.

      Best hopes,

      Craig in PA

      over 3 years ago

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