Hopefully a quick one... - 1245924

dkm5859
Posts:89

If a person does not have opposite side lymph node involvement from where a singular nodule is located at...she is to have aden...what is the likelihood that 'mets' have started elsewhere? I hate to ask but is there a percentage? I'm sorry this is just eating me alive with the waiting and not knowing. I've lost a good number of family members and friends to cancer over the years. I recently lost a brother to pancreatic cancer just about two years ago. My mother like many mothers is a rock but obviously this is beyond description at least for me. I know she is very worried, troubled and wondering what are the best actions to take and try to very informed. Thank you very much again for your time, help and concern.

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Reply # - July 26, 2012, 03:52 PM

catdander
Posts:

I'm not sure how Dr. West answered your question on an earlier thread but I think this answers your question? "Stage III nsclc is cured about 20-25% of the time."

http://cancergrace.org/topic/question-regarding-post-thoractomy-spelling

There are a few different subtypes of adenocarcinomas, but they are all treated essentially the same way, except perhaps for bronchioloalveolar carcinoma (BAC), which is a non-invasive form of adenocarcinoma that can follow a more indolent pace of progression. There isn’t really enough known about the subtypes to assign different causes to one vs. another, except that BAC is less well associated with tobacco exposure than other forms.
Stage III NSCLC is cured about 20-25% of the time. Stage IIIA NSCLC is more on the higher end there, and stage IIIB is more in the lower part of that range.
Adenocarcinoma tends to have a greater tendency to spread distantly than squamous NSCLC, but I can’t really answer your last question except to say that the hope is that treatment is associated with no progression of disease beyond where it starts, and only regression of the existing cancer.
Good luck.
-Dr. West

Reply # - July 26, 2012, 06:51 PM

dkm5859
Posts: 89

No, I do not think that is my question here in this thread. I apologize if I misled but what I am asking is if mediastinal nodes are known to be involved but no other node involvement is involved what is the likelihood at this point ...the historical percentage likelihood that mets were then found in other organs like the brain...
Not necessarily the cure, survival rate at five years or NED but just the percentage of overall Aden cases and or NSLC cases at the Stage III that developed mets elsewhere? ...maybe I'm still missing something but I think there is a differentiation here but maybe there are not any stats on this and or any known studies. Thank you again.

Reply # - July 27, 2012, 05:59 AM

dkm5859
Posts: 89

Thank you very much. As for clinical trials..where are they normally performed?
I assume at large academic institutions...we are within 150 miles of John Hopkins and Penn.
How are clinical trials handled...in the sense that do they want the patient and or caregiver to stay 'on campus' or directly in the area of the hospital for treatment, testing and observation?
How are clinical trials paid for? Or is it because you are part of the study group?
I assume John Hopkins and Penn would be highly recommended? Do you have any recommedations?
Thank you very much again...I'm sure I will have more questions.

Reply # - July 27, 2012, 06:42 AM

Dr West
Posts: 4735

Academic centers are the most likely to have a wide array of trials, but many larger community cancer centers will also have several, even if not as many as a bigger center. They don't generally expect a patient to stay immediately nearby (though it depends on the trial and the specifics of what is done), but rather would have patients come and go. In most cases, it's most feasible if the patient is within an hour or so from the center, since visits may be every week or two, but there are some trials with infrequent visits of monthly or less frequently where patients may come from out of state and just visit here and there, as needed, with more frequent oversight done via phone discussions or with the help of local doctors.

In most cases, costs are borne by the insurer, for all of the things that would be considered "standard of care" (which is a lot of the bread and butter of management), but things that are specifically required for the trial, such as extra scans and labs, are almost always covered by the sponsor company. As a general rule, is really not expected that the patient bear financial responsibility for foreseeable extra expenses. We don't want to over-incentivize people for participating in trials (such that it could be seen as a bribe to participate), but nobody wants to penalize people for participating in clinical trials that lead to new treatments and move the field forward.

-Dr. West

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