Dr. Wakelee has written a very readable blog/post on the subject of curative resected nsclc treatments. On chemotherapy after surgery she writes,
"Chemotherapy after surgery seems to work best when started 4-8 weeks after surgery. Some patients will have recovered enough to receive treatment earlier than 4 weeks, but that is unusual. There is some data to support chemotherapy as far as 12 weeks after surgery, but if a patient has still not recovered enough for chemotherapy by 12 weeks after surgery, it is unclear that chemotherapy given later than this will be of any benefit."
It's most common to start adjuvant (post-operative) chemotherapy about 5-7 weeks after surgery has been completed. Most people need at least a month to recover well and heal adequately from lung surgery before starting a potentially challenging and immunosuppressive treatment.
Thank u so much for ur responses! Doctors want to start chemo next week! Before that i would like to consult with u what chemotherapeutic drugs are usually used on 2 stage after surgery.thnx
Please understand our doctors can not consult with people who are not their patients. Grace is here to help you develop an understanding of lung cancer treatment and symptom management.
Chemo after resection for stage 2 nsclc the standard practice. So it sounds like you're on the right track. Good Luck and let us know how things go.
I think you will begin to understand better if you reread the linked blog/post below. It explains T2aN1M0 type of situation clearly.
"Patients with stage II NSCLC (lung cancer that has only spread to lymph nodes in the lung) have about a 50-60% chance of being cured with surgery alone. The larger clinical trials that included stage II patients have mostly shown that chemotherapy can improve the cure rates by 5-10%. All of the most recent trials that have included stage II patients have had similar results, so most physicians are in agreement about recommending chemotherapy for patients with resected stage II lung cancer. Exceptions to this would be people who are felt to be at high risk from chemotherapy either because they haven’t recovered well from surgery, or have other health problems. " http://cancergrace.org/lung/2010/05/17/systemic-therapy-for-resected-ns…
I'm so sorry to read about your diagnosis, but hopefully surgery and chemotherapy will cure you. If you are asking about particular chemotherapy drugs that generally are used for your type of lung cancer - - i.e., adenocarcinoma-squamous - - in a post-surgery setting (i.e., what is referred to as "adjuvent chemotherapy"), it is usually a platinum-based chemo agent, like Cisplatin or carboplatin, plus a second agent, like gemzar or a taxane (like taxol or taxotere). I am not a doctor, but my understanding is that Alimta (also known as pemetrexed) generally is not given as the second agent to people whose cancer is squamous. Hopefully your doctor will go through all of this with you.
I also vaguely recall that there is a link where all of this is discussed. I will try to find it and will post it here for you.
OK. . .so in addition to the link that janine posted above, here is the link to the thread that I was remembering: http://cancergrace.org/forums/index.php?topic=6926.0 The person who first was asking questions in this link also was post-surgery Stage IIa - squamous. As you will read, he wanted to know about choices of chemotherapy post-surgery in a IIa - squamous setting. You can click into the link and read the entirety of the thread yourself, but this is what Dr. West said about post-surgery chemotherapy:
"...So my recommendations to people with regard to adjuvant chemotherapy are typically cisplatin/Gemzar (gemcitabine), cisplatin/Navelbine (vinorelbine), cisplatin/Taxotere (docetaxel), or cisplatin/Alimta (pemetrexed), with the last only being felt to be effective for people with a non-squamous NSCLC tumor. My personal recommendation is most commonly to favor cisplatin/Gemzar for patients with a squamous cancer, cisplatin/Alimta for an adenocarcinoma, and cisplatin/etoposide (yes, not on the list of greatest hits) for the patients with the unusual NSCLC subtype of large cell neuroendocrine carcinoma. I don't really use molecular markers to modify these recommendations, though I suppose if someone wanted to use them, I'd just use them to work within the range of the treatment options I listed above. That said, it's still fair to say that there's plenty of room for individual judgment."
Good luck and please keep us posted on how you are doing. . .
Thanks to the terrific input and links from Janine and Laya, I don't have anything to add. Dr. Wakelee's summary in the reference library (available through the link in Janine's response) and my own comments quoted from Laya really summarize our current thinking about post-operative chemotherapy for resected NSCLC.
Reply # - January 3, 2013, 09:18 AM
Reply To: Lung Cancer
Dr. Wakelee has written a very readable blog/post on the subject of curative resected nsclc treatments. On chemotherapy after surgery she writes,
"Chemotherapy after surgery seems to work best when started 4-8 weeks after surgery. Some patients will have recovered enough to receive treatment earlier than 4 weeks, but that is unusual. There is some data to support chemotherapy as far as 12 weeks after surgery, but if a patient has still not recovered enough for chemotherapy by 12 weeks after surgery, it is unclear that chemotherapy given later than this will be of any benefit."
For the entire blog here's the link.
http://cancergrace.org/lung/2010/05/17/systemic-therapy-for-resected-ns…
Let us know how else we can help and very good luck,
Janine
forum moderator
Reply # - January 3, 2013, 09:20 AM
Reply To: Lung Cancer
It's most common to start adjuvant (post-operative) chemotherapy about 5-7 weeks after surgery has been completed. Most people need at least a month to recover well and heal adequately from lung surgery before starting a potentially challenging and immunosuppressive treatment.
Good luck.
-Dr. West
Reply # - January 4, 2013, 07:12 AM
Reply To: Lung Cancer
Thank u so much for ur responses! Doctors want to start chemo next week! Before that i would like to consult with u what chemotherapeutic drugs are usually used on 2 stage after surgery.thnx
Reply # - January 4, 2013, 07:39 AM
Reply To: Lung Cancer
Please understand our doctors can not consult with people who are not their patients. Grace is here to help you develop an understanding of lung cancer treatment and symptom management.
Chemo after resection for stage 2 nsclc the standard practice. So it sounds like you're on the right track. Good Luck and let us know how things go.
I think you will begin to understand better if you reread the linked blog/post below. It explains T2aN1M0 type of situation clearly.
"Patients with stage II NSCLC (lung cancer that has only spread to lymph nodes in the lung) have about a 50-60% chance of being cured with surgery alone. The larger clinical trials that included stage II patients have mostly shown that chemotherapy can improve the cure rates by 5-10%. All of the most recent trials that have included stage II patients have had similar results, so most physicians are in agreement about recommending chemotherapy for patients with resected stage II lung cancer. Exceptions to this would be people who are felt to be at high risk from chemotherapy either because they haven’t recovered well from surgery, or have other health problems. " http://cancergrace.org/lung/2010/05/17/systemic-therapy-for-resected-ns…
All the Best,
Janine
forum moderator
Reply # - January 4, 2013, 10:23 AM
Reply To: Lung Cancer
hi fonrims. . .
I'm so sorry to read about your diagnosis, but hopefully surgery and chemotherapy will cure you. If you are asking about particular chemotherapy drugs that generally are used for your type of lung cancer - - i.e., adenocarcinoma-squamous - - in a post-surgery setting (i.e., what is referred to as "adjuvent chemotherapy"), it is usually a platinum-based chemo agent, like Cisplatin or carboplatin, plus a second agent, like gemzar or a taxane (like taxol or taxotere). I am not a doctor, but my understanding is that Alimta (also known as pemetrexed) generally is not given as the second agent to people whose cancer is squamous. Hopefully your doctor will go through all of this with you.
I also vaguely recall that there is a link where all of this is discussed. I will try to find it and will post it here for you.
GOOD LUCK!
Laya
Reply # - January 4, 2013, 10:38 AM
Reply To: Lung Cancer
OK. . .so in addition to the link that janine posted above, here is the link to the thread that I was remembering: http://cancergrace.org/forums/index.php?topic=6926.0 The person who first was asking questions in this link also was post-surgery Stage IIa - squamous. As you will read, he wanted to know about choices of chemotherapy post-surgery in a IIa - squamous setting. You can click into the link and read the entirety of the thread yourself, but this is what Dr. West said about post-surgery chemotherapy:
"...So my recommendations to people with regard to adjuvant chemotherapy are typically cisplatin/Gemzar (gemcitabine), cisplatin/Navelbine (vinorelbine), cisplatin/Taxotere (docetaxel), or cisplatin/Alimta (pemetrexed), with the last only being felt to be effective for people with a non-squamous NSCLC tumor. My personal recommendation is most commonly to favor cisplatin/Gemzar for patients with a squamous cancer, cisplatin/Alimta for an adenocarcinoma, and cisplatin/etoposide (yes, not on the list of greatest hits) for the patients with the unusual NSCLC subtype of large cell neuroendocrine carcinoma. I don't really use molecular markers to modify these recommendations, though I suppose if someone wanted to use them, I'd just use them to work within the range of the treatment options I listed above. That said, it's still fair to say that there's plenty of room for individual judgment."
Good luck and please keep us posted on how you are doing. . .
Laya
Reply # - January 4, 2013, 09:35 PM
Reply To: Lung Cancer
Thanks to the terrific input and links from Janine and Laya, I don't have anything to add. Dr. Wakelee's summary in the reference library (available through the link in Janine's response) and my own comments quoted from Laya really summarize our current thinking about post-operative chemotherapy for resected NSCLC.
-Dr. West