bruce
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My mother was 54, and had a LLL by VATs 08/21/2014. And we were told it was 1A lung adenocarcinoma and no need to do adjuvant chemo. The tumor size is 2*1.5*1cm, edge and mediastinal lymph nodes are clean, the PET-CT scan before sugery shows no spread. But I am still not very confident it is a real 1A lung cancer since not all lymph nodes are checked, and the PET-CT is not always accurate enough.
The pathology says it is micropapillary pattern and I heard that it is a predictive of poor prognosis.
My mother is just 54 years old, I want her to have a long live. So I wonder that is the adjuvant chemotharepy needed or not at this momment, 5 months after sugery?
Forums
Reply # - January 16, 2015, 05:51 AM
Hi Bruce,
Hi Bruce,
Welcome to GRACE. I'm glad to hear that your mother's lung cancer was discovered at such an early stage, that she had a good result from surgery and that her PET-CT is clean. As Dr. West has said "stage IA cancers, despite still having some risk of recurrence and death, are considered to have too good a prognosis for to recommend adjuvant/post-operative chemotherapy in most cases." - http://cancergrace.org/lung/2007/02/24/individualizing-therapy-in-lung-… That post describes ongoing research into the question of whether some patients with early-stage lung cancer should receive adjuvant chemo.
On the other hand, it's good to remember that adjuvant chemo adds only a few percent to survival statistics, and as Dr. West has written "many of our trials have failed to show a benefit for patients with resected stage I NSCLC, at least for those with cancers smaller than about 4 cm." - http://cancergrace.org/lung/2008/07/11/ialt-long-term-risk-adj-ct/ As that post further points out, adjuvant chemo is not risk free.
JimC
Forum moderator
Reply # - January 16, 2015, 05:16 PM
As Jim noted, chemotherapy is
As Jim noted, chemotherapy is not generally recommended for patients with cancers under 4 cm and no nodal involvement. I understand that surgery wasn't extensive enough to be sure there are no nodes involved, but I suspect that the surgery was less extensive because the indicators all suggested this was low risk.
There is risk associated with chemotherapy, and I don't think that further treatment would be recommended by almost any expert taking into account the anticipated risk and benefit. We also generally feel that if chemotherapy is anticipated to be of value, it should ideally be administered within the first two months after surgery (typically starting 5-7 weeks after surgery). If it is more than 3-4 months, the value of adjuvant therapy even for patients with higher risk disease is unknown.
Good luck.
-Dr. West