Options after surgery - 1286893

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Options after surgery - 1286893

My mum has just had a VATS lobectomy of LRL, CT scan on May 3rd also showed a 1cm nodule on her adrenal gland, PET scan on 23rd May showed 5mm growth in lung tumour as well as lighting up lymph nodes in her chest and the 1cm nodule in adrenal gland. To date we have had no communication or final staging regarding these other areas, the lymph nodes were removed during surgery and we are awaiting results. Do you think these hot spots on PET scan are likely to be Cancer spread? If so, is this still curable? Can the adrenal gland be removed? Would this mean that mum is stage 4? Is chemo and radiotherapy likely? Thank you in advance

Hi sinead41,

Hi sinead41,

I'm so sorry your mom is going through this. When lung cancer is diagnosed PETs are normally given to look for cancer spread in the body . Sometimes the PET is given with a CT (the CT provides pictures while the PET chemicals light up in places where cells rapidly divide such as cancer and infection, these are measured in SUV). These techniques show possible spread though aren't definitive in itself It is worrisome to have a cm mass in the adrenal with suv uptake when cancer has also been found in the lungs and possible lymph nodes.

You would need to talk you your mom's med team to know why they've done surgery before a full workup. One possible reason I can think of is the lung mass was not easy to get a biopsy from so they took the lobe in the process of getting an initial diagnosis.

If cancer is found to have spread outside the original lung (including the lymph nodes to the left in the mediastinum) it would be considered stage IV. More about staging can be found here, http://cancergrace.org/lung/2015/08/12/gcvl_lu-d01_tnm_staging_early_sta...

It's unusual to proceed with treatment such as surgery without staging. The standard of care for stage IV is very different from that of stage I, II and usually III. Stage IV disease isn't considered operable because it isn't thought to be curable. Treatment options for stage IV are good, they allow the person with cancer to live as well as possible for as long as possible so treatments should be adjusted to fulfill that goal.

On the other hand there is growing research being done that allows for more extensive treatment for those who have what is known as oligometastasis. Usually treatment comes in the form of pretty much non invasive SBRT and not so much the much more invasive surgeries. You can read more about that here, http://cancergrace.org/lung/2016/02/02/gcvl_lu_sbrt_oligometastatic_lung...

All best,