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Dad Diagnosed with NSCLC Stage 3B (Have questions)


futbol_11

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Hello everyone. First time on this site. A came across this site as I was trying to get as much info as possible on my dads condition, and found myself feeling better after reading so many positive stories.

My dad was recently diagnosed with Lung Cancer Stage 3B. Doctors told us it was not operable. He as a large mass in his chest, one on his back and one in his neck. A brain MRI was done yesterday, have not received the results yet.

I have a couple of questions. I know we are not doctors here, but any info would be greatly appreciated.

Can his condition ever be operable if the medication shrinks or eliminates some of his tumors?

He is going in for radiation 5 times a week and chemo once a week. They are not going to give him an aggressive dosage now. Has anyone one started off their medication with a less aggressive dosage and then moved up to an aggresive dosage?

Sorry about the 20 questions. Just have a million thoughts running through my mind.

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Welcome, so glad you found us and that you are researching. We who have been told that we have lung cancer are in such shock we need all the help we can get. Your Dad is blessed to have you.

You did not mention what type of lung cancer your Dad has. There are many types. I am going to assume that it is one of the Non-Small Cell ones because you said "Stage 3b" ( small cell lung canceris not decribed that way)

In response to your question if it shrinks after chemo and radiation could he have surgery - that could be a possibility. Some people , like myself, get great results , go on to surgery , and are "cured". I have met recently a man who had Stage 4 lung cancer , diagnosed 8 years ago, had chemo, radiation, surgery, more chemo, 2nd surgery, and today has been cancer free for several years. There is hope, even if the survival numbers aren't 100 percent, the people who survive , survive 100 percent!

Keep us posted.

Donna G

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My cancer wad determined inoperable because of the overall condition of my lungs due to other problems. I guess what I am saying is you need to find out the WHY of the diagnosis of inoperable. I did undergo radiation and chemotherapy and am currently tagged as "stable". Let us know what chemo cocktail your dad will be receiving. And come her for answers, support and folks that truly do understand what you are going through.

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Welcome to the site. I had IIIb/IV nsclc, inoperable. I was given chemo only. I have been cancer free since November 2005.

The condition can improve and they may say it can be operated on. When mine was reduced to where they thought they could do surgery or radiation, they did a PET scan and found there was nothing but scar tissue. They did not operate. I am not sure what is best but I have no after effects from surgery and I am thankful for that. It may be better not to operate if there is good response from the chemo.

You should try to post his time line in the profile. That way we would be able to give you some better information.

Stay positive, :)

Ernie

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Stage IIIB contains a few different categories.

There are the following based on TNM staging.

T is basically the size of the primary tumor and N is the ammount of lymph node involvement.

1) IIIB (T1-4 N3)

2) IIIB (T4 N2)

3) IIIB (T4 N0-1)

Case number 1 is considered not operable because of the distant lymph node involvement and there was a study - Southwest Oncology Group (SWOG) 8805 study.

Case number 2 is not likely be benefit from resection because of the nodal involvement. Sometimes surgery can be done based on individual cases.

Case number 3 is the most amendable to resection.

If the N2 nodes are clear after chemo-radiation then maybe resection can happen. You might also want to investigate photodynamic thereapy. The pioneers I *think* are at Thomas Jefferson hospital in Philly.

Take care

==================================================

T1 Tumor 3 cm or less in greatest dimension, surrounded by lung or visceral pleura, without bronchoscopic evidence of invasion more proximal than the lobar bronchus (i.e. not in main bronchus)

T2 Tumor with any of the following features of size or extent:

More than 3 cm in greatest dimension

Involves main bronchus, 2 cm or more distal to the carina Invades the visceral pleura

Associated with atelectasis or obstructive pneumonitis which extends to the hilar region but does not involve the entire lung

T3 Tumor of any size that directly invades any of the following: chest wall (including superior sulcus tumors), diaphragm, mediastinal pleura, parietal pericardium; or tumor in the main bronchus less than 2 cm distal to the carina but without involvement of the carina; or associated atelectasis or obstructive pneumonitis of the entire lung

T4 Tumor of any size that invades any of the following: mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina; or tumor with a malignant pleural effusion

Lymph node involvement

N0 No regional lymph node metastasis

N1 Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes, including direct extension

N2 Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s)

N3 Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene or supraclavicular lymph node(s)

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Doctors hand out estimates of life when they don't really know. They have no idea how one may react to chemo or radiation. They told me 18 months. This is my 18th month and I am cancer free. I would get a second opinion for sure. I would try to get to one of the top centers like Sloan Kettering or M. D. Anderson in Houston.

Stay positive, :)

Ernie

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Hi and welcome to the site.

Many chemo's make radiation more intense, so that may be why the dosage is low for starting. When I had radiation, my radiation oncologist wanted no chemo for a week befor or during the treatment.

As far as staging, I thought metastisis outside the immediate area, categorizes the cancer as stage IV. I also thought that stage IV is generally considered inoperable because of the spread. I have had bone, clavicle and brain mets.

By the way, the operation is a tough operation. Based on what I have read, it is very unlikely that I would agree to an operation given my condition.

If I were staged differently, then I might want the operation.

Anyway, as we go through this, we learn so much. The board can really be helpful in hearing others experiences and in just knowing what questions to ask.

Good luck.

Mary

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Hi. I see you have gotten a lot of good info here already. I just would like to welcome you.

I think your dad should go to a major comprehensive cancer cener for a second opinion at least, to verify the treatment, especially if his current doctor volunteered the opinion that he has 6 months to live.

However, chemo with concurrent radiation is a good course of treatment for late stage cancer.

don M

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Hi, and welcome. I agree with Don. Go to a major cancer center asap. A second opinion, and sometimes a third, is very important. Please read my husbands profile. Thank heavens we got to Orlando. The local onc was totally ineffective. Good luck to you and your Dad

Wendy

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marym,

you are right stage IV means distant metastasis. Since futbol is stage III, the area in the neck is probably a lymph node and the area on the back probably means the tumor has become large enough to invade structure outside the lung, but it is not in another organ

That is my guess at least

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