2013 follow up guidelines for lung cancer - 1260078

ds
Posts:11

Dr. West,

I have read your articles from 2007 regarding follow up guidelines for lung cancer. Would you please let me know what your current follow up guidelines are for Stage 1 BAC. Have there been any new national guidelines published since 2007?

About 1 year ago you had written that you were contemplating doing online consults and was wondering if this service is currently being offered.

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Reply # - October 24, 2013, 02:23 PM

catdander
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Hi ds, I hope you're feeling well. Good to read of your NED. I just want to let you know we're here and we'll make sure Dr. West sees your thread today.

Best of luck on continued NED,
Janine

Reply # - October 24, 2013, 09:06 PM

Dr West
Posts: 4735

The guidelines offer a lot of latitude. For stage I BAC, I generally do a scan every 6 months out to 3 or 4 years post-surgery, then switch to an annual scan. stage for stage, BAC tends to have a better prognosis than other NSCLC subtypes, so while I often scan every 4 months for most other patients with resected NSCLC, I favor a 6 month schedule for resected early stage BAC and other cancers that have characteristics that lead me to expect them to be indolent.

I had developed a full company to do online consults, but my employer took the position that it would compete with my clinical practice with them. Unfortunately, I needed to leave it behind in order to keep my day job.

-Dr. West

Reply # - October 25, 2013, 05:55 AM

ds
Posts: 11

Dr. West

Do you have an end point for annual CT's in indolent lung cancer's?

In your response you said " while I often scan every 6 months for most other patients with resected NSCLC, I favor a 6 month schedule for respected early stage BAC and other cancers that have characteristics that lead me to expect them to be indolent. "

Is there a typo? Do you mean every 6 months for indolent lung cancers and every 6 months for most other patients with resected NSCLC?

Sorry to hear about your online consult service not going forward. I think it would have been very successful and very beneficial to those of us who are not in your area but want your great advise.

Deborah

Reply # - October 25, 2013, 06:24 AM

JimC
Posts: 2753

Deborah,

Based on what he's written previously, he probably meant 4 months for most NSCLC:

"...my approach is to generally do a CT every 4 months in the first year, then every 6 months until 4 years out, and then annually. As Dr. Pinder noted, the value of these scans is partly to monitor for recurrence and partly to screen for a possible new cancer, since someone who has developed a prior lung cancer is at higher risk for a new one than someone who has never developed a lung cancer before.

"My approach is still potentially modified by the circumstances of an individual patient. For instance, for the few patients I follow after surgery for a resected stage IA NSCLC, I generally do scans every 6 months instead of every 4 months in the first year, because the risk of recurrence is so much lower." - http://cancergrace.org/forums/index.php?topic=1721.msg10153#msg10153

You can also read Dr. Gadgeel's post on follow-up here: http://cancergrace.org/lung/2008/08/10/fu-after-resection/

JimC
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