Decision whether to do chemo with Stage IIA resected NSCLC - 1264369

mermiad7, I'm very sorry your mom is in this position. You're asking all the right questions, unfortunately the only person to make the decision is your mom, with help from her family and doctors.

Depending on where the tumor was located a complete resection of a 7mm tumor is thought to not particularly need adjuvant treatment.

This post is written about early stage which is norm the term used for tumors less than 3 cm http://cancergrace.org/lung/2011/08/12/sacrilegious-thoughts-on-adjuvan…

I hope this is helpful. Please let us know if you have more questions,
Janine

I've started this new post because I misread 7mm for 7cm, big difference. So I did some quick editing of my first post but want to be clearer.
Dr. Wakelee wrote a post on the subject as has others. About midway through the second pp she says, "The studies have been clear that chemotherapy for patients with small tumors (< 3 centimeters) does not help reduce the risk of the cancer coming back." http://cancergrace.org/lung/2010/05/17/systemic-therapy-for-resected-ns…

If your mom or you would like to be clear with the oncologist (there are circumstances such as involved malignant lymph nodes or primary tumor in the pleural lining that make the outcome different) a copy of the posts may be helpful. Many do this, me included.

Too, there's a problem with timing of adjuvant tx which oncologists want to be 4-7 weeks post surgery. It sounds as though your mom may be past that point. So there would need to be a discussion about that.

I hope your mom can get back to living her life soon.
All best,
Janine

You've posted it as 7mm which would not require chemo. But as Janine explained, if it's in fact 7cm, then chemo is recommended with a tumor that large. Did she have any lymph node involvement?
Take care, Judy

Chemotherapy would typically be favored in someone with either a 7 cm cancer (or anything larger than about 4 cm), or a node-positive NSCLC of pretty much any size, but that's presuming that someone is fit enough to do it. The survival benefit of 10% is a reasonable estimate but probably even a bit on the high side unless there were multiple nodes involved. If just a single node, the benefit would probably be closer to 5%.

Also, it's worth highlighting that the trials with post-operative chemotherapy were done in an unusually young, unusually fit population compared with the more general lung cancer population. While your mother is right in the age range of an "average" patient with lung cancer, these trials were done in patients whose median age was 59-62. It may well be that if these trials were done in older and less fit patients (who better represent the real world clinical experience), the benefit could be lower than the risk from chemo.

It ends up as an individualized decision, but post-operative chemotherapy isn't for everyone.

Good luck.
-Dr. West

I raise my eyebrows when I see comments that she doesn't trust her doctors. If I did not trust my doctor I would find one I did trust. Note, I have never run into one I did not trust.