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NSCLC Adenocarcinoma


chrissy63078

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Can anyone else tell me if they have ever heard of this. My mom was just diagnosed this month with NSCLC. She is 47 yrs old. Smoker for 30 yrs. They found one 1.7cm mass on her left upper lobe, no regional involvement and 1 small mass under her armpit in her lymph node. My mom is very healthy, but because of the cancer metastazing to her armpit lymph node they are diagnosing her with Stage IV. I have read that stage IV is inoperable, but because they feel that the masses along would be considered early stages they are going to do VATS surgery on Oct. 5th followed by Chemo 4 weeks after. Has anyone else every heard of this. Please help!!!!!

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I too have stage 4 and am close to your Mom's age. Your Mom is in a earlier progression than I am. I have lymph node involvement in the chest and neck which makes it inoperable. Sounds like your Mom has a good chance to get rid of the masses before they start to spread to the other lymph nodes. If she is basically a healthy person then she shouldn't have any problem handling the surgery or the treatments after. Hang in there and if you don't feel comfortable with the doctor's choices then get a second opinion!

gin

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I think it probably is stage IIIB not Stage IV.

There are some instances when stage IV is operable but not many (isolated brain met, single adrenal met).

According to what you described it probably is not Stage IV.

It is very common to either do neoadjuvant chemo (chemo before surgery) or to do adjuvant chemo (chemo after surgery) for Stage IIIa or IIIb

Talk to the Doctors and also a 2nd opinion never hurts

Take care

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I thank you for your insight. My mom is going to UPMC Cancer Center in Pittsburgh. It is supposed to be one of the top cancer centers in the country. When we first meet the oncologist he was going to do Chemo first and then possible surgery. We then meet with the thorasic surgeon and he felt that we should to surgery first and then Taxotere, Cisplatic chemo about 4 weeks after surgery. I am very happy that they are doing the surgery. It took them about 2 months to diagnose my mom because at first they thought she had breast cancer because of the tumor under her armpit. But after all the tests they are certain she has lung cancer. I just haven't been able to find anyone with the same senario as my mom. I'm baffled.

You and your families are in my prayers.

Thanks,

Chrissy

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I really don't have much to add, the previous have done a wonderful job of it. All I can say is that each senario is different, but there are generally SOME similarities, unfortunately.

I'm SO glad to hear that they think that surgery will be an option for her!

Many prayers for you and your mom!

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The countdown begins. My mom will be having VATS Surgery next Thursday 10-5. They will be doing a Segmentectomy of the upper left lung lobe. This is the mass that is 1.7cm. They already removed the other tumor under her armpit (axillary Node) to do the biopsy that determined my mom had Lung Cancer. So hopefully this Segmentectomy will remove all of the cancer and the chemo will attack any cancer cells that could be swimming around. Please pray for my mom.

Thanks,

Chrissy

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UMPC is supposed to have a very good reputation.

From the article below it does say LC will rarely go to the lymph nodes in the arm pit.

It appears there are long term survivors when this happens so hopefully the surgery goes well.

I imagine the Drs may suggest other treatment after the surgery

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

Axillary lymph node metastases from bronchogenic carcinoma

Marc Riquet, MDa, Françoise Le Pimpec-Barthes, MDa, Claire Danel, MDb

a Service de Chirurgie Thoracique, Hôpital Laennec, Paris, France

b Laboratoire d’Anatomie Pathologique, Hôpital Laënnec, Paris, France

Accepted for publication April 7, 1998.

Address reprint requests to Dr Riquet, Service de Chirurgie Thoracique, Hôpital Laënnec, 42 rue de Sèvres, 75007 Paris, France

Background. Axillary lymph node metastases (ALNMs) from bronchogenic carcinoma are rare and their significance may be questioned. A surgical approach may allow a better understanding of the mechanism of their occurrence.

Methods. A retrospective study of 1,486 cases of surgically removed non–small cell lung carcinoma was performed. Twenty-two patients (1.5%) had extrathoracic nodal metastases. Nine of them were ALNMs (<1%). These cases form the basis of this study.

Results. In 1 patient ipsilateral ALNM was removed during a lung operation. It was a left non–small cell lung carcinoma invading the chest wall (T3 N2). In the other patients (n = 8) ALNMs were observed during postoperative follow-up; 4 underwent ALNM resection, 2 had radiotherapy, and 2 had symptomatic treatment only. For these 8 patients, in the TNM classification performed after an initial bronchogenic carcinoma operation, the lymph node status was, respectively, N0 in four cases, N1 in three cases, and N2 in one case. Survival ranged from 1 to 10 months, except for one patient who is still alive after more than 5 years. In this case, the ALNM was discovered 4 months after a right lower lobectomy for a T2 N0 adenocarcinoma.

Conclusions. Axillary lymph node metastases may be involved through direct chest wall invasion of bronchogenic carcinoma or retrograde spread from supraclavicular lymphnode block. However, another mechanism seems to be the systemic vascular route.

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