Issues with medication for lung adenocarcinoma?
Hello Doctor: I was recently diagnosed with stage 3B lung adenocarcinoma with an ALK gene mutation.
I am currently undergoing treatment with Alectinib.
Initially, while waiting for the health insurance approval for the medication, the hospital provided me with their stock of the public drug, and I took two pills in the morning and two in the evening.
After two weeks, my follow-up chest X-ray showed improvement, with a reduction in the shadow.
The health insurance approval for the medication has also been granted, but the doctor still prescribed me two Alectinib pills in the morning and two in the evening.
I have read that most people take four pills in the morning and four in the evening, but I am only taking half the dosage.
Could it be that the doctor forgot to adjust the medication dosage? Will this affect my condition? If the dosage is appropriate, why is my dosage different from others? I initially sought medical attention due to coughing and hemoptysis, and I have been taking Alectinib for about 20 days.
I still cough occasionally, but the coughing is not as severe as before starting the medication, and I have not experienced any hemoptysis.
Currently, I am coughing up phlegm that is sometimes white and foamy, and other times slightly yellow.
Is it normal to still have a cough and to produce slightly yellow phlegm? Thank you for your response.
Ke Le, 40~49 year old female. Ask Date: 2022/05/02
Dr. Wang Lanfeng reply Pulmonology
Hello: The initial recommended dosage of Anlisat is indeed 600 mg, taken in the morning and evening.
Perhaps your attending physician has other considerations.
It is advisable to discuss your treatment situation with your attending physician.
Thank you.
Reply Date: 2022/05/02
More Info
Managing ALK-Positive Lung Adenocarcinoma, particularly in the context of your treatment with Alectinib (安立適), involves understanding both the medication's dosage and the symptoms you may experience during treatment.
Understanding Alectinib Dosage
Alectinib is a targeted therapy specifically designed for patients with ALK-positive lung adenocarcinoma. The standard recommended dosage for Alectinib is typically 600 mg taken orally twice daily, which translates to four capsules of 150 mg each day. However, your current regimen of two capsules twice daily (300 mg total) may be a temporary measure, particularly if your healthcare provider is monitoring your response to the medication or if there are concerns about tolerability.
It’s essential to communicate with your oncologist regarding your dosage. If you feel that your prescribed dosage is lower than what is commonly recommended, it’s worth discussing this with your doctor. They may have specific reasons for this decision, such as your overall health, potential side effects, or how well you are tolerating the medication. Adjustments in dosage can be made based on individual patient needs, and your doctor will consider factors such as your response to treatment, side effects, and any other health conditions you may have.
Symptoms and Side Effects
Regarding your symptoms, it’s encouraging to hear that your chest X-ray showed improvement after starting Alectinib. This suggests that the medication is having a positive effect on your cancer. However, it’s not uncommon for patients to continue experiencing some symptoms, such as coughing or changes in sputum production, even while on effective treatment.
1. Coughing: It’s not unusual for patients with lung cancer to experience a cough, which can persist even after starting treatment. The cough may be due to residual irritation in the lungs from the cancer itself or from treatment-related effects. If your cough has improved since starting Alectinib, this is a positive sign. However, if it worsens or if you develop new symptoms, you should inform your healthcare provider.
2. Sputum Production: The presence of white or yellowish sputum can be normal, especially if you have a history of lung issues. White sputum often indicates mucus production without infection, while yellow sputum can suggest a mild infection or inflammation. If you notice any changes in the color or consistency of your sputum, or if you experience increased coughing, fever, or other concerning symptoms, it’s important to seek medical advice.
Conclusion
In summary, while your current dosage of Alectinib is lower than the standard, it may be appropriate for your situation. Always consult with your oncologist to ensure that your treatment plan is tailored to your specific needs. As for your symptoms, ongoing communication with your healthcare team is vital to manage any side effects and to monitor your response to treatment. Regular follow-ups and open discussions about your symptoms will help ensure that you receive the best possible care as you navigate your treatment journey.
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