Challenging Cases in Lung Cancer Podcast Series: Adjuvant Chemo for a Small NSCLC Tumor with a Satellite Lesion

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This is the first of a series of podcasts we've done, developed in partnership with LUNGevity Foundation, in which I present the same challenging cases in lung cancer management to a series of experts to learn the range of views offered by them, then the multiple thoughtful comments by all of them discussing the same single featured case for each podcast. The first discussants in each podcast will be Drs. Bob Doebele from University of Colorado and Jyoti Patel from Northwestern University, who are then followed by other terrific colleagues of mine:

Is lymph node involvement by direct extension more favorable than "separate" nodal involvement?

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The staging of lung cancer makes the distinction of whether there are any lymph nodes involved with cancer, and if so, whether they are within the lung that houses the primary cancer or outside of it; if the latter, a distinction is made among mid-chest nodes on the same side as the main tumor (N2), mid-chest nodes on the opposite side from the main tumor (N3), or above the collarbone (N3).

Case Discussion on Adjuvant Therapy for Stage IB NSCLC with Dr. Nasser Hanna

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It's been a few months since I sat down with my friend, Dr. Nasser Hanna, a great lung cancer expert from Indiana University, and also a friend in the field. Those of you who have been following GRACE content for a while may have come across his name: he's led a few of the more important trials that are part of our current core knowledge in lung cancer now, such as the

Adjuvant Therapy in the Elderly and/or Frail: Podcast of Discussion with Drs. Hesketh and Kelly

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Several weeks ago I had the opportunity to discuss several difficult cases with experts Drs. Paul Hesketh from the Lahey Clinic outside of Boston and Karen Kelly from Kansas University Medical Center in Kansas City, KS. These scenarios raise questions about how best to manage lung cancer issues in elderly and/or frail patients, starting with a 78 year-old woman who presented to me for discussion of the pros and cons of post-operative therapy, which also touch on other factors of administering chemotherapy to more marginal patients in general, regardless of the setting.

Stereotactic Lung Radiotherapy (SBRT) vs. Wedge Resection for Stage I NSCLC

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The subject of stereotactic lung radiotherapy (SBRT) for cure of stage I disease has been extensively covered on GRACE with good cause: we may be witnessing a major change in how we treat early stage cancer. Multiple strategies for improved surveillance are being developed, and hopefully one or more will be successful, resulting in more frequent detection of early stage disease. If so, we will have what my mentor calls a “delicious dilemma” – what is the best way to cure these early-stage patients?

Dr. Le, Radiation Oncologist from Stanford, on Radiation Options for Early Stage NSCLC

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Dr. Quynh Le, radiation oncologist and Professor at Stanford University, was kind enough to participate in our NSCLC Patient Education Forum. She spoke on the topic of emerging treatment options using radiation for early stage NSCLC. The new work she's describing on stereotactic body radiation therapy (SBRT) is looking promising enough that it's being considered increasingly as a very strong choice for people with localized lung cancer but who aren't good candidates for surgery or are disinclined to pursue it.