Anyone with SCLC had surgery in their lungs?

[Remembering Dave]

Hi all, this is Karen, posting for David:

This is probably an unnecessary question to ask because hopefully he doesn't have any more cancer in his lungs. If you will recall, he had a clean CT scan after his 6 wks of radiation and 4 rounds of chemo. He went on and had the last 2 rounds of chemo. Then had another CT Scan which showed a mass in his left lung where the original tumor had been. But the radiologist, oncologist and pulmonary doc all thought it was pneumonia and he had pneumonia symptoms so they treated him with two weeks of antibiotics and he did start feeling better. Today he's having a chest x ray to see if it looks better (scheduled by the pulmonary doc) and the oncologist scheduled a CT Scan for mid-September. We really grilled the oncologist last week on what to do if the CT scan shows a mass. He had us talk to the radiologist and everyone agreed at that point he'd have a PET Scan if a mass still showed. But the oncologist said "what do you want me to do if there is another tumor, cut it out?" at which point I said, sure, why not. He said, which we know, that SCLC is rarely treated with surgery. Now, this oncologist is very good - I won't go into all the credentials we got on him, but he knows his stuff.

He seriously doubts there's more cancer because of "all that chemo and radiation" but Dave and I want to have Plan B in place in case it is. So was wondering if anyone has had surgery, or if anyone has had an immediate recurrence in the same place like that and what they did at that point.

Thanks for any input!

p.s. By the way, we went camping this past weekend in the mountains with our "new" travel trailer and Dave did just great! Just driving up there and setting up wore him out, but he wisely spent the rest of the time relaxing as much as he could. The trip was good for him overall and our first outing since he was diagnosed in March, and really since our "small" outing to China to get Faith last Fall!

Karen C. - wife to David C.

[lynn]

Karen,

When my Dad had his last go- round with sclc we inquired as to surgery because his mass was located peripherally (not in the middle). We were told that in rare cases surgery can be done with sclc but several criteria must be met ;

1. peripheral lesion

2. no mets

3. no lymph adenopathy

Unfortunately, I think it's rare for sclc to cooperate with these criteria( we almost made it as we had the first two).

Another important question to ask is whether or not surgery would improve outcome...I believe in the past the answer to this last question has been no...but I may wrong...

I'm praying that you don't even need a plan B

Best,

Lynn

[bengel]

Hi Karen,

I don't quite understand the phrasing of your question. Are you asking if anyone has had surgery after chemo and radiation? The answer to the second question is yes. My oncologist had no dought about having my middle right lobe taken out after chemo and radiation. The chemo and radiation had shrunk the tumor from 2 cm to 1 cm. He was very happy with those results but had explained me at the start that the plan was to have surgery. Another reason was to visually see if any of the lumph nodes had cancer. They didn't. He had me go throught 15 days of brain radiation after surgery because the brain acts like a sponge for cancer cells. My last check up in July was clean.

I hope this experience helps you. My prayers are with you.

Bengel

[Remembering Dave]

Hey you guys, especially Bengel, I think my question was a little confusing, I was rambling, but I think you understood it, too. But yes, I meant surgery AFTER chemo and radiation.

Lynn - I think Dave meets the requirements you mentioned. Katie - yep, he has limited stage disease (barely, though).

I'd love to see if anyone else has input on this subject. But am hoping and PRAYING that we won't need it.

Thanks!

Karen C.

[Cindy RN]

I have never heard of surgery on sclc but I guess we all learn something new. I was told that surgery could be done BUT it would be like chasing a ping pong ball. You get rid of one spot and it pops up somewhere else. I had several areas of mets when mine was found so the Dr said it really was not an option for me.

Bengel, CONGRATS on making 2 yrs! It feels good to keep beating the odds! God is good!

[bengel]

Hi Karen and others,

In reading the other posts I realize I made my case sound cut and dried. It wasn't. Some of the comments from others are true and the decision to have surgery as I remember ( my wife has all of the copius notes) was because I was Stage IA. I had a very unusual presentation of the cancer and my onc, not only got a second opinion but sent me to UC San Francisco Medical Center for evaluation. I was placed in a study group for non-smokers with SCLC. The only rationale for my cancer was farm pesticides and petroleom based products since I grew up in the Bakersfield California area. Since I agreed to take everything they could throw at me, because I don't like the alternative, I had surgery and then brain radiation to clean up anything left.

I hope this helps. I know the decisions everyone has to make are tough ones.

Remember, our hope is in the Lord.

Bud

p.s. Today is the first day in 38 years that I don't have to show up for staff development meetings before school starts.

[Jenny G.]

I think is is very unusual to have surgery for SCLC, I was told it wasn't an option, but like you kept it in the back of my mind that if it shrunk after treatment, then why not. Bengel you were very lucky to find it so early and have this option as I do think surgery offers the best chance. It doesn't make sense to me that David would have a recurrance that large in so short a time. I really feel like it must be something else. My first CT after treatment showed scar tissue and a PET needed to be done to see if there was any activity. You're right to prepare for the worst, but in this case I think you have more reason to hope for the best. I'm glad you are getting out together and enjoying life.

Jenny

[Guest Jonathan]

I have heard of what is called a wedge resection, in SCLc, that is after a patient is in remission, they go in and remove the section or wedge that the tumor was in, trying to prevent it from returning. many oncologists do twice daily radiation now instead, but this is an option after remssion to be considered by the surgeons.

Jonathan

[john]

more info. It is basically what lynn said. The three criteria must be met.

Surgery is sometimes used for isolated relapse.

http://www.lungcanceronline.org/treatme ... rgery.html

[Remembering Dave]

Thanks for all the input. We'll see what happens. Jenny - been meaning to tell you, it sounds like you and Dave are on the same schedule, insofar as when your cancer was diagnosed and your treatment schedule, even your "remission" schedule, although his recent "mass" in his left lung has set him back a bit from you, the suspected pneumonia. He had a CT Scan of his brain last week and we go Friday to meet with the radiologist and if that is clean then his PCI will likely start the following week. we do know that he'll have three weeks, daily, but don't know the dosage.

He also had a chest x ray last week and the pulmonary doc called and said the "mass" looked like it had shrunk and still think it is/was pneumonia, is repeating the x ray on 9/11 (I don't like the date) but I reminded Dave that the oncologist scheduled a chest CT Scan for the following day so hopefully the 9/11 x ray will be cancelled.

If the CT scan shows something that continues to look bad the radiologist said he'll talk the oncologist into the PET Scan and then that's when the surgery option will be discussed, but HOPEFULLY that conversation won't need to happen!

I guess I'm thinking too far in advance but darn it all, I believe it is my job to stay on top of things and see to it that this is treated as aggressively as possible - we have a child to raise - TOGETHER!

Best to all and Jenny, good luck with the PCI!

Karen C.

[Donna G]

Karen-

Hopefully David will continue to improve and you won't have to worry about surgery. I asked Steve's pulmonologist if surgery was an option with SCLC and he said NEVER.. then added NOT ON PURPOSE. He explained that sometimes a small nodule or lesion is spotted on a CT and since it was localized, it would be removed, then the biopsy verified that it was SCLC. He went on to say that if it was known BEFORE the surgery that it was SCLC, surgery would not have been an option. From everything I've read over the past 5 months, chemo is the most effective on SCLC. KEEP PRAYING FOR MIRACLES!!

[Guest JasonChang]

Hi, I'm new here on the forum, but have been reading for a while. I thought I might chime in on this thread because my Dad, who was diagnosed with small cell lung cancer in 02/03, had surgery. It wasn't the main course of treatment, but when first diagnosed, the doctors said the tumor was 9cm's. With aggressive chemo therapy and radiation, we were able to get rid of just about the whole tumor. All that was left was a 1cm nodual, which they considered residue. With the success of the treatment so far, my Dad's doctors had a conference to discuss surgery for the residue. 2 weeks later my dad had the surgery to remove the residue. My dad has just taken his 3 month's check up ct scans, and I will let you guys know the results. It's quite scary having the ct scans here with us, waiting on my dads appointment next wednesday. I really wish I could read ct scans. Anyway, I better get going. This forum is really great, and Everyone is in my prayers.

God Bless.

[Jenny G.]

I too kept surgery in the back of my mind even though I was told it was not an option. I figured that if the chemo and radiation shrunk it enough then it could be a possibility. I'm not leaning in that direction anymore, but still do try to think ahead to plan B. What I'm really interested in at this point is a vaccine. Looking for a trial or someone who will just give me one. I think very good results and wider use are just a couple of years away. I told my doctor to be sure nothing happened to my bioposy sample (they may not keep them indefinitely) he didnt' think it would be usable, but just in case. I have a lot more research to do in this area. So glad to hear they went ahead with the PCI for David. I think that means good news.

Jason, thank you for sharing this information. Please do keep us updated on the progress.

Jenny

[Guest]

Last night, I saw a clinical trial for a vaccine on the NCI website.

[Jenny G.]

Thanks, I checked it out, but not right for me. I'm still looking, seems to be more available for NSCLC than SCLC. I just want my local doctor to get me a vaccine,, but don't know if that's possible. I'll work on him some more. He thinks I'm a real pain, but he's a good sport about it.

[/code]