kathypat81
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Posts:2
I had a wedge resection in Sept 2013. 1.2 cm tumor taken out. No lymph nodes checked. I am a 4 year survivor stage IIIa breast cancer. I think they thought it was metastatic breast cancer. Non small cell lung cancer. Had a base scan in October that was clean. Seeing oncologist in January.. Does this sound right? 53 years old. No new scan scheduled........
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Reply # - December 26, 2013, 07:57 PM
Reply To: Stage I a
Its reasonable, though it's fair to question whether someone who has undergone a wedge resection for lung cancer without undergoing a full lobectomy and lymph node dissection should undergo a "completion lobectomy" or not. There's actually a large study being done that is randomizing patients with tumors less than 2 cm and no imaging evidence of lymph node involvement to a "sub-lobar resection" (wedge resection or segmentectomy) or full lobectomy. The traditional approach has been a full lobectomy and nodal dissection, but the trial is being conducted because an argument can be made that this is an overly conservative approach and that a wedge resection or segmentectomy may be sufficient.
This link describes the situation in more detail: http://cancergrace.org/lung/2010/12/14/revisiting-the-optimal-early-sta…
There is no standard role for post-operative chemotherapy for such a small tumor in the absence of documented lymph node involvement.
-Dr. West
Reply # - December 26, 2013, 09:12 PM
Reply To: Stage I a
According to PET scan my lymph nodes look fine. I have 2 nodules on the left lung that haven't changed in 2 years. The one that showed up and was removed showed up in 1 year. It was solid and poorly differentiated. I am just worried that not enough was done...so concerned that I might have micrometastasis in the nodes. I had 11 months of chemo for my breast cancer. I am afraid that the lung cancer will come back and that I am not long for this world. Should I have them check the tumor they removed for any markers? Is it more of a possibility for it to come back? Should I have more scans?
Reply # - December 27, 2013, 05:44 PM
Reply To: Stage I a
I'm sorry that we can't answer "should" questions...that constitutes giving medical advice to people who aren't our patients. We can provide general information, and then people need to discuss their individual cases with their own doctors or medical team.
As I mentioned above, the first question is whether a more extensive surgery should be done beyond the wedge resection. There is no established role for molecular markers for a resected early stage lung cancer, and this is something that I do not routinely or even ever do.
There is also no evidence to support giving chemo for a cancer that small without lymph node involvement.
After initial surgery, it is most common to do surveillance scans, typically a chest CT, on regular intervals. I typically repeat a chest CT about every 4 months in the first year (and only about every 6 months for a small, node-negative lung cancer), every 6 months for the next 3 years, and then annually for the next few years. There is no magical, evidence-based surveillance plan, but now that low-dose screening CT scans are becoming more routine for screening, I'm inclined to favor them after the first few years of surveillance as a good intersection of minimizing radiation over time while providing a good amount of detail.
Good luck.
-Dr. West