A 67-year-old man with stage 3 non-small cell lung cancer has had two sessions of chemotherapy (gemcitabine and carboplatin) three weeks apart. He is feeling well, his appetite is improved, and he has gained some weight. He has not had any of the usual side effects. Is this an indication that the chemo isn’t working?
—Duc Nguyen, MD, Gainesville, Fla.

The beneficial effect of the chemotherapy is likely the result of palliation of symptoms from the lung cancer. There is considerable heterogeneity in patient tolerance and side effects from the same chemotherapy regimen. After two cycles of this treatment, response can be confirmed with a chest x-ray or CT scan.
—Michael J. Flamm, MD, assistant professor of clinical medicine, College of Physicians & Surgeons, Columbia University Medical Center, New York City (124-15)