What to Do When One Cancer Tumour Grows but the Rest Are Stable (Stage 4 Cancer Advice)
If just one or two areas of your stage 4 cancer are growing while the rest stays stable, you may be experiencing oligoprogressive disease. Stereotactic radiotherapy is a highly precise local therapy that can target these lesions while keeping you on your current systemic treatment. This personalised approach can be used in lung, breast, prostate and colorectal cancers to delay switching therapies.
Treatment for oligoprogressive disease
If you’re living with stage 4 cancer and your scan shows just one or two new spots are growing, even while the rest of your disease is stable, this video is for you.
Ask your doctor about metastasis directed therapy - an effective local therapy for metastatic disease that has started to grow. Rather than switching to the next line of therapy, or starting chemotherapy, ask your doctor about radiotherapy.
The best treatment for metastatic cancer is one that sequences all of your options in the best way for you. Combining metastasis directed therapy with active systemic therapy, particularly in the setting of oligometastatic disease, can yield excellent outcomes.
What is Oligoprogressive Disease?
When a person is on treatment for cancer and it's largely working, but one or two sites have escaped control, we call this situation oligoprogression. It doesn’t always mean your current treatment (systemic therapy) has stopped working.
Stereotactic Body Radiotherapy: A Precise Local Treatment
Stereotactic body radiotherapy is a useful local therapy that can be used to treat this type of disease progression. Oligometastatic disease is when there were only ever a small number of cancer spots in the body. It's subtly different to oligoprogressive disease which is when there are other sites of cancer as well, but they are being controlled with systemic treatment.
Stereotactic body radiotherapy treats the oligoprogressive lesions in a small number of treatments. It's incredibly precise meaning that side effects are usually minimal.
Case Example: Oligoprogressive NSCLC on Osimertinib
In the video, I talk about osimertinib, a treatment for metastatic NSCLC (non-small cell lung cancer). If the lung cancer is starting to escape control of the tyrosine kinase inhibitor therapy, consider stereotactic ablative radiotherapy to metastases in the body (e.g. lung metastases, nodal lesions) or stereotactic radiosurgery for brain metastases.
I see many patients who have been taking drugs like osimertinib for a long time with good results. Adding in SABR to treat any small spots that start to grow can be highly effective. In fact, it is often a way to stay on your current systemic therapy for longer without switching to the next drug.
Consultant Clinical Oncologist Dr James Wilson explains how stereotactic radiotherapy (SABR) can precisely treat the areas that have started to grow. This can help keep your cancer controlled while continuing the treatment that is working everywhere else.
This approach can be helpful in many types of advanced cancer, including:
- Stage 4 lung cancer
- Stage 4 breast cancer
- Stage 4 prostate cancer
- Stage 4 colorectal cancer
So, if you are a patient with oligoprogressive prostate cancer, oligoprogressive breast cancer, oligoprogressive NSCLC
If you’re on a targeted therapy like osimertinib and only one or two tumours are growing, stereotactic body radiation therapy may be the answer. Seeing an expert in radiation oncology may keep you on your systemic treatment, e.g. tki therapy for longer.
The same can be said if you're on treatment for metastatic breast cancer, metastatic colon cancer or metastatic prostate cancer. Always ask if you have the option of a local ablative therapy rather than changing a drug treatment that is mostly working for you.
If you’ve been told your treatment may need to change but you’re only seeing small areas of growth, ask your oncologist whether stereotactic radiotherapy for oligoprogression could be an option for you. This is true for breast cancer patients, lung cancer patients (including NSCLC patients on tyrosine kinase inhibitors), and patients with any type od cancer.
Rather than switching to the next protocol treatment or systemic therapy line. Ask for a personalised, sequenced, metatasis directed therapy.
Speak to a Radiation Oncology Expert
I see oligoprogressive patients via video consultation or in person in London. If you'd like to see me, get in touch here.
Alternatively, you can make an appointment directly by clicking here.