Am I too late for surgery?

Sun, 01/02/2022 - 16:32

AfterCT, tissue biopsy and pet scan, I was diagnosed as stage 1 b lung non small adenocacinoma, exon19 deletion EGFR mutation and TP53 mutation. When the surgeon opened up, she found a few drops on my same side lung plural, so she closed up and did not perused the surgery we planned and told me it is stage 4 and I can not have surgery any more. I was really disappointed! but my most recent blood liquid biopsy shows that There is no detected blood cancer cell or any mutations in my blood. Yes, my stage is advanced but it is still localized since there is no lymph nodes or other organs invasion, I am still young, only 43, I am totally healthy, no other diseases except this lung cancer, am I too late for a surgery to remove the cancer to give me a better chance to cure?

JanineT Forum …

Hi Michel, Welcome to Grace though I'm very sorry you are here.

Blood/liquid biopsies can detect cancer cells but usually only if there are a lot of cancer cells circulating. So if a liquid biopsy detects cancer you can be sure there is cancer. But if it does not detect cancer it doesn't mean that cancer isn't there (that's maybe a confusing statement). It may mean that the sample just didn't catch any. Today, a negative result is pretty typical of nsclc that is localized or that is a small amount. So it makes sense that there were no cancer cells detected in your blood biopsy.

Unfortunately when nsclc is detected in the pleural fluid treatment is no longer considered curative. From UpToDate.com , "The presence of an MPE typically signifies advanced stage cancer...Thus, in general, the focus of MPE management is palliative and without survival benefit. Treatment should focus on patient-centered goals of therapy, which include sustained symptom relief, improvement in quality of life, acceptability of an intervention, affordability, and preference for less invasive procedures [3,4]." https://www.uptodate.com/contents/management-of-malignant-pleural-effus…

As a young healthy individual, if you're being seen at a private practice you might want to get a 2nd opinion at an academic center. Today video and phone consults are quite doable. Don't get me wrong, there are wonderful, brilliant oncologists in private practice but at large academic centers where nsclc is studied, you will find those who do nothing else but treat and study nsclc and discuss with teams of doctors. Even if cure isn't on the table, palliative care/treatments may be suggested specifically fitted to your needs.

Please let us know if you have questions about treatments or care. And please let us know outcomes if you have a 2nd opinion.
Janine