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Staging and Chemo Questions


Guest Sam Smith

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Guest Sam Smith

Please pardon me for finding this site and seeming to jump right in with my questions. I've actually been reading all of your posts for some time, and I take great comfort in your advice and insight and most of all the fighting spirit you all seem to have!

Now for my questions. My mother-in-law was diagnosed with stage II nsclc and had surgery followed by radiation in 2/03. Last month, a bone scan showed mets to the spine and a rib. She started chemo today, and she says she was told she is still stage II. Is that possible? I thought bone mets automatically meant stage IV.

I know that reactions to chemo vary from person to person, but is there a typical timeframe during which reactions occur? She feels fine after the first chemo treatment so I want to believe this means she won't have an adverse reaction.

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Hi Sam,

Welcome and I am very sorry to hear about your mother-in-law. My mom just finished her second round of chemo and seems to be suffering just a bit more with fatigue than her first time around. She has not experienced any other side effects, so we are keeping our fingers crossed that more do not appear in the future. I know everyone is different when it comes to their reactions to chemo, but I just thought I'd share my mom's relatively minor one.

I am a confused by your staging question and I too would like to hear what the others have to say. According to all the websites out there, if it has spread to the spine and other areas of the body outside the lung area, it is Stage IV.

Denise

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Hi Sam, I felt better than I had in months for the first week after my first chemo treatment but the side effects, mainly fatigue, started to set in the 2nd week. Extreme fatigue was my real problem........of course my hair started coming out so I went ahead and shaved it all off. Please let us know how your mother in law does.

David C

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Sam,

At the time of your Mother in Law's surgery she may have been put at Stage II. I will tell you that I was told by my first two Oncologists that if you are Stage I at diagnosis, but subsequently develop mets you are STILL considered Stage I, but with recurrent metastatic disease. For treatment purposes you would then be 're-staged', but technically you're still Stage I with Recurrent Metastatic Disease. The exception to this would be if the new tumor were actually a new primary, in which case you would still be Stage I. Clear as mud, huh?

Fay A.

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Guest Sam Smith

Fay A.,

Thanks for the info. It is confusing since the conversation in question occurred while the nurse was telling my mil about a new trial drug for anemia. The nurse then looked at her chart and said, "oh nevermind, you're stage II and this trial is just for stages III and IV." So, I understand she may be technically considered at her originally diagnosed stage, but it seems she should be re-staged in order to receive the most appropriate care. Frustrating!

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I have having problems understanding why your MIL has not been restaged. I am a patient at the University of Wisconsin Comprehensive Cancer Center and I had mets to my entire lymphatic system in April and restaged to Stage IV from Stage I. The way I understand it, you can be restaged from a low stage to a higher stage, but it is not reversible. In other words, I will now remain a Stage IV. I can not go back to a lower Stage. My oncologist is Dr. Joan Schiller, who is one of the nation's leading lung oncologists. I would certainly question the oncologist as to his reasoning for not restaging. http://www.cancer.gov , the website for the National Cancer Institute gives a detailed description of staging of lung cancer and that is supposedly the standard for staging in the US.

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There are good drugs out there already for treating chemo induced anemia. I receive injections for both red and white blood cells. I'm currently receiving Taxotere and Carboplatin.

As far as the Nurse's comments I would bring this up with your Mother in Law's Oncologist and have him or her indicate in your Mother in Law's chart her present stage. It may just be that the Doc's most recent notes on restaging for treatment purposes hasn't caught up with the chart yet. Any time there is a question ask, and keep asking until the answers are clear.

Best Wishes,

Fay A.

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