Post operation

[Carl Rich]

Hello my name is Carl, I'm 75 years old and had an operation on my right lung

to remove a cancer tumer and severl small cells

They removed the lower lobe and and a small portion on top 10/24/08

The operation went well and they got all of the cancer out.

The Oncolgest said chemothearpy at this time would be a

preventive measure with no guarantee.

I don't feel I really need to go through the discomfort and

think I sould decline treatment at this time.

Any advice?

Thank you Carl

[MsC1210]

Hello Carl and welcome to LCSC.

I am sorry about your need to be here but so glad you have joined us.

I am sure you will get a lot of replies to this! My feeling on preventive chemo after "successful" surgery is that it is a GOOD idea. It only takes ONE stray cancer cell to travel and take up "residence" somewhere else for the cancer to come back. In the big picture, my feeling is that it's better to do the chemo and add that bit of proactive insurance than not. And chemo does not ALWAYS mean discomfort. Many people have minimal reactions and side effects to it.

Of course this is only my opinion and you will get others adding their advice, as well.

Please keep us posted and know we are here for you!!

Warmly,

Christine

[Donna G]

Hi Carl, welcome. Sounds like you must have had good lung function and health for them to decide to do the surgery on 2 lobes.

As above I agree, Chemo is a good idea to be sure any loose cells don't decide to nest in a new lobe of lung and grow. There are lots of meds available to help you with any possible side affects, chemo does usually not take more than a couple of months .

So if your meant to live to 100, that is nothing in the scheme of things. Keep us posted.

Donna G

[Bruce u]

Hi Carl

I had my upper left lobe removed. Everything came back clear and I was staged at 1B. The Oncologist told me that they do not recommend adjuvant chemo for lower than stage 2. He said the chance of reoccurance for stage 1 was less. They did not feel that the benefit of the chemo would reduce the risk enough to recommend it. I asked for a second opinion. That Oncologist checked with 5 of his colleagues. Two recommended it and the other 3 said they would leave it up to the patient. I decided to go ahead with the chemo. They wrote on my file that studies did not support my decision. It was only 4 rounds and I wanted to do everything I could to prevent reoccurance. I had the combination of Cisplatin/Vinerolbine. I did have alot of side effects but others did not have any. Everyone is different but they do have good control over it now with different medications. I asked the same question on here that you are asking now. I received a unanimous response recommending the chemo. Good luck.

[SandraL]

Hi Carl. Welcome here. I agree with others. Knowing what I know today about lung cancer, if I were in your shoes, and if I was relatively healthy besides this, I would not think twice about proceeding with the chemo. In fact, I think you are lucky to be offered it. There are some places where it would not be offered. I would do everything in my power to prevent a reoccurrence. Like others say, side effects can be managed, and the amount of time involved is really nothing in the grander scheme of things and compared to the rest of your life. Good luck with your decision

Sandra

[jaminkw]

Oh dear Carl, I don't think you're getting many posts supporting passing up on the chemo. I have to agree. The chemo isn't all that bad for a relatively healthy person. I didn't have a cancer that called for surgery and the chemo knocked it out. If I had surgery, I would certainly rather be safe than sorry. The chemo drugs they have today are so good, the added insurance is worth it.

Good luck and let us know what you decide. You don't need to agree with us to be part of the family.

Judy in Key West

[Bud Baker]

Carl,

I had the upper lobe of my left lung removed and was faced with the same decision after a single lymph node being cancerous made my diagnosis Stage II. I did the chemo. Everything I studied told me that chemo helps lower the odds of recurrence.

I did have my troubles with side effects. If it gets too tough, you can always stop treatments sooner, but I would recommend at least starting it.

Best wishes for you, whatever you decide!

[recce101]

Hi, Carl, welcome to the group. I think it was wise of you to ask this question, though I imagine you may not have expected the answers to be so one-sided. Here are a few comments from a 73-year-old:

...they got all of the cancer out.

Yes, they got all of the visible cancer out, and the tissue around the edges tested free of cancer, but there is always the possibility that a few cancer cells had already entered the bloodstream as others have said. The purpose of chemo is to zap those cells, though there is not a 100% guarantee that they will all be eliminated.

The idea that some cancer cells may have already entered the bloodstream is supported by this:

They removed the lower lobe and and a small portion on top.

If cancer was found in two widely separated areas, one needs to ask how it got from one place to the other. Did they both develop independently (possible but not likely), or did one start first then spread through the bloodstream to the other lobe?

This tells me that having chemo would give you the best chance of avoiding or delaying recurrence, though, as we know, there are no guarantees. But (this is important too and maybe the overriding factor) — how good is your general health, and do you have any specific "must do" plans for the next year or so? Beyond that, do you place more importance on quality of life or on longevity? If you're feeling pretty good and have no other major health issues, there's a good chance you would tolerate chemo well with just temporary side effects that should be mostly resolved after a few months. On the other hand, if you also have COPD or heart issues or diabetes or some other significant medical problem, chemo might decrease your quality of life to an unacceptable degree. The bottom line is, there is no right answer for this, and regardless of what you decide, you should not later second-guess your decision or allow someone to tell you that you were wrong. If it's still a tossup for you, consider starting chemo to see how it goes, knowing you can always stop if the side effects become too unpleasant.

Best of luck with whatever you decide, and Aloha,

Ned

[Carl Rich]

Thank you all for the advice, seems likeI should rethink having chemo

But can you explain what it consists of and how long is required , if they cant find any

cancer at this time how do they know when to stop treatment?

Thanks again

Carl

[Bruce u]

Hi Carl

In my case, 4 rounds is what they had scheduled. I never asked why 4. I was on a 3 week cycle. So on day 1 I would have both Cisplatin and Vinerolbine. Then on Day 8 I would have just Vinerolbine. This counted as 1 round. Then on Day 21 I would have both again. Of course this could all change depending on blood counts, etc. I had 1 treatment delayed by a week because my blood count was low. Hope this helped.

[SandraL]

Hi again Carl. In most cases, chemo is for a set regimen. In some cases here, folks will stay on chemo for an indefinite amount of time if it is working. In your case, there may be some choices with drugs and timing. I have heard from my med onc, that the chemo either does or doesn't do it's job with a set regimen, 4 cycles in many cases. You probably have the benefit/luxury of choosing your timing as well, like perhaps delaying chemo until after xmas. Best wishes

Sandra

[recce101]

Also, the specific chemo drugs to be used would be determined by the specific type of lung cancer that was found.

Ned

[jaminkw]

Carl, now aren't you glad you came to came to talk with us. Lot to digest huh! Hang in there and ask all the questions you need to ask.

Judy in Key West

[Carl Rich]

"jaminkw"]Carl, now aren't you glad you came to came to talk with us. Lot to digest huh! Hang in there and ask all the questions you need to ask.

Judy in Key West

Yes Judy I think its wonderful of everyone to share, i couldn't believe all the information I received this first day and I do need to digest what you have presented

[Debi]

Hi Carl!

I appear to be in the minority, but I did not have adjuvent chemo after surgery. My Oncologist told me basically that I would be dead if I didnt have it because my cancer would come back, but the 2 doctors I trusted advised against it. Like you, I was in a quandry.

There was no research to suggest that adjuvent chemo would benefit me as I was Stage 1A and Stage 1A was not included in any of the test groups. After thinking long and hard, I decided not to have chemo for chemo's sake.

I am not sure what stage you are Carl, but if I can quote Dr. West-

There is very little evidence to suggest that stage IA patients are likely to benefit from post-operative chemotherapy, or radiation for that matter. Very few of the post-op treatment trials have included them, since the prognosis is good enough that we think it’s likely that the risks of treatment, even if small to modest, may be equal to or outweigh the little benefit that treatment could provide over the already good prognosis.

Again, I am not sure what stage you are - I believe Stage 1B has shown a 3-5% increase in survival with Adjuvent chemo so my thought pattern may have certainly been different if I was 1B or above.

I am not advising you to go either way but just want to advise you to have the facts to make an informed decision. Ultimately it is your call. I can tell you that I have never had any regrets at not having chemo and apparently, I made the right choice, for me. Only you can figure out the right choice for you.

[robobbi]

Hi Carl-

Just have to add my 2 cents here - I had my upper left lobe removed (it will be 4 years in January) and my oncologist recommended chemo. It was controlled with meds and I was able to work all through it, other than the day I received chemo. It's a good insurance policy in my estimation!

Bobbi

[chloesmom]

Hi Carl,

I had surgery for stage 1B lung cancer (upper left lobectomy) in 2003. At that time, studies were just published to show a possible 5% increased survival rate in those patients who got adjuvant chemo after surgery for early stage lung cancer (1B and II).

My surgeon (for whom I have all the respect in the world) only mildly endorsed chemo for me. My oncologist said that a 5% survival benefit was worth it.

Since this was my second bout with cancer (I had early stage breast cancer two years prior), I decided I needed to do whatever I could to try to prevent this from happening again, so I decided to do the chemo.

I had three rounds of Cisplatin/Gemzar. I'm glad I did this, but it did not come without a price. I have lost some hearing from the cisplatin and my veins are totally fried on my right hand.

I am, however, still here 5+ years later and grateful I did what I thought was the right thing for me at the time. I worked throughout the whole chemo process, and didn't really even miss much work, but I did not feel well for the entire time I was in treatment, which was just under 3 months. I will say though, that once my treatment was over,I started feeling better almost immediately.

The decision is ultimately yours to make, and while you should certainly take the advice of the medical professionals working for your best interests, you need to make your own choices.

Cindy

[jang]

Carl,

Looks like I am in the minority also. But I agree with Debi completely. I was staged 1A and was told there was absolutely no evidence that chemo would be beneficial. I opted to not have it. If I were staged at 1B, I would probably have made a different decision. Good Luck with whatever you decide to do!

[Snowflake]

Carl,

I was staged IIIa and was not offered the chemo. That was 5 1/2 years ago. Now, were I to go through it all again at this point in life, thinking has changed on the benefits of chemo after surgery and I would have gone for the chemo. After all, my crystal ball would be out at the shop and I'd have no idea what was going to happen...

BUT, if you want an argument in the against column, just look at my stats. No IV chemo, no cancer. I did participate in a drug trial for Iressa, though, and was pulled off it due to side effects. Remember, it is YOUR body and you get to stop the whole process if you decide it's too much for you to handle.

Good luck to you!

Becky