Has anyone gotten a second opinion after being told “no more treatment” for stage IV NSCLC?
Hi everyone,
I’m posting for my father and would really appreciate honest feedback from people who have been through something similar.
He is 76. He has stage IV non-small cell lung cancer, diagnosed in early 2025. He initially had carboplatin/paclitaxel + radiotherapy, then durvalumab, and later progressed with liver and bone metastases. He then started carboplatin + pemetrexed + pembrolizumab, but after 2 cycles he had very severe toxicity: pancytopenia/aplasia, sepsis, ICU stay, transfusions, and treatment was stopped.
He has stage IV NSCLC, likely adenocarcinoma / initially reported as NSCLC-NOS, PD-L1 1%, no targetable mutation found
The difficult part is that no scan was done after those 2 cycles, so we don’t actually know whether the chemo helped the cancer or not. His oncologist has now decided no more chemotherapy and he is currently on home palliative care, mainly symptom control.
What makes this hard to process is that clinically he seems better right now:
- eating fairly well
- sleeping well
- walking on his own
- only mild cough
- stable for about a month
His latest blood test also looked much better hematologically:
- WBC back to normal range
- neutrophils back up
- platelets back up
- hemoglobin still low but much better than before
So my questions are:
Has anyone seen treatment restarted after a major crash like this, once blood counts and general condition improved?
Would you push for a CT/PET re-evaluation, since there was never any imaging after the 2 chemo cycles?
If an oncologist says “no more treatment,” did anyone here still get a second opinion that changed the plan?
For people with experience in palliative care: does “palliative only” always mean the cancer treatment chapter is truly closed, or can it sometimes be reconsidered later?
I know nobody can give medical advice for my father specifically. I’m just trying to understand whether this sounds truly final, or whether there may still be a window to re-evaluate if he stays stable.
Thank you.