Sarcomatoid lung cancer stage 2 - 1265430

luvmymom2
Posts:9

Mom went in June 9 and now diagnosed stage 2 lsarcomatoid. I asked for molecular testing and was told not metastatic? I read this is an aggressive rare cancer. Can they not do testing? They are recommending a lobe tommy. She has NO symptoms and just wants to move on without surgery...as she is not even the slightest sick. Shouldn't they do testing though? Am I not asking the right questions?

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Reply # - August 15, 2014, 08:41 AM

JimC
Posts: 2753

Hi luvmymom,

At Stage 2, the best treatment for any kind of lung cancer is surgery, as long as it is feasible. Early stage cancer tends to be symptom-free, so it is not a surprise that your Mom has none. Especially since this is a type of cancer that tends to be less responsive to treatment, her doctors are quite rightly recommending that she seize the opportunity to eradicate it before it metastasizes.

Molecular testing is only helpful in deciding which systemic therapy to choose in the metastatic setting. If the tumor is surgically removed, the tissue could be tested or saved for later testing should the cancer recur.

Many patients do not like to see survival statistics for their cancer, partly because it makes them worry, and partly because they are individuals, not statistics, and their outcome may vary widely from the medians. In this case, however, it may be good to show those stats to your Mom so that she can see how much better her prognosis is if she opts for surgery. Dr. Weiss includes a link to such statistics in his post "An Introduction to Lung Cancer" which you can find here: http://cancergrace.org/lung/2010/04/05/an-introduction-to-lung-cancer/

Wishing her the best,

JimC
Forum moderator

Reply # - August 15, 2014, 09:51 AM

Dr West
Posts: 4735

I really agree with everything Jim said. Just a few points to underscore:

While there are many controversial questions in management of cancer, the question of how best to manage an apparently early stage lung cancer (at least a non-small cell lung cancer) in a patient fit enough to tolerate surgery well is not one of them.

The leading treatment for this is surgery. The 5 next most appealing options are also surgery. There is no clear role for molecular testing in this setting.

If your mother were too sick for surgery or simply refuses it, then radiation of the lesion would be the next choice, but it is far, far less studied and established in this setting than surgery.

Good luck.

-Dr. West

Reply # - August 16, 2014, 06:15 PM

luvmymom2
Posts: 9

Thank you for your information. I just hope they can schedule soon since it's already been over 2 months. Apparently they want to take out lymph node under arm to make sure not cancer and if it is, no surgery apparently. They did a biopsy but didn't get tissue apparently. Seems like do surgery anyway. Thank you again for the info. Doesn't sound like knowing markers would help much. Surgery best option, though they don't talk about a cure, so mom thought if no cure, why bother, this way she could enjoy for a little while longer while she is doing good. Pray I can convince her to do surgery

Reply # - August 16, 2014, 06:46 PM

Dr West
Posts: 4735

If this is stage 2, I would think it should be able to treat with a goal of cure. It may be worth clarifying why the doctors haven't discussed whether treatment might realistically be with curative intent. It may be that they are just reluctant about overpromising.

Good luck.

-Dr. West

Reply # - August 17, 2014, 04:07 AM

luvmymom2
Posts: 9

Maybe because it was on one of the lymph nodes in the lung...I think that is what she said when they mentioned no cure. But still local to lung, nothing in brain and pet scan yet. Just tumor and one node in lung. They would still do chemo after surgery just in case. Hopefully by the time they can decide it will not be too late. I know this is more aggressive too. Has there been a finding on how quickly this spreads?

Reply # - August 17, 2014, 08:41 AM

JimC
Posts: 2753

If it's been staged as Stage 2, it is possible to have some node involvement and still be curable, if surgery can remove all of the cancer before it has spread anywhere else. At this point it's not a question of how aggressive this particular kind of lung cancer is - any cancer left untreated is likely to spread, usually sooner than later. As a result, if curative surgery is an option there is an urgency to moving ahead with it.

In any event, it is impossible to judge in advance how quickly a particular individual's cancer will progress. That can only be determined over time, since every patient is different, even those with the same type of cancer.

JimC
Forum moderator

Reply # - August 17, 2014, 10:20 AM

luvmymom2
Posts: 9

Thank you! You guys are awesome. It's so nice to have another resource to go to. I think it is so difficult because it's on your mind when you go to sleep and there when you wake. It is not only physically, but mentally consuming. You are a blessing.

Reply # - August 29, 2014, 09:25 PM

luvmymom2
Posts: 9

Do you think it may be possible to do a VATS instead of the more open type? The tumor is more in the middle with 1 lymph node in the lung all in the left upper lobe? I read this is an easier recovery time. I don't know why it's taking so long to get this all done. Frustrating...

Reply # - September 20, 2014, 12:32 AM

luvmymom2
Posts: 9

She ended up with thoraciotomy but is doing well

Reply # - September 20, 2014, 08:20 AM

Dr West
Posts: 4735

Very good. I hope her recovery continues to be smooth.

-Dr. West

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